Portofino TowersOty of Miami Beach Office of the Oty Clerk
1700 Conveflfl~ Center Drive, Miami Beach, FL 33139
Email: cib/derk~)ci.miami-beach.fl.us
LOBBYZST REGISTRAT/ON FORM
(Ob/of Miami Beach, Ob/Code Chapter 2, Division 3, Section 2-181)
(State) · (Zip Code)
EMA[L:
LOBBYX. s'r RETAI'NED BY:
NAME OF PRZNC:iPAL/CL[ENT:
B0~~4ESS ADDRESS: (Number and Street) ~Oty) (State) (fip'Code)
05.--53
lEaF HUMBER: FtO~ ~U~BER: (Optional) EI~II.: (Optional)
t o , o .r t- ( o .
Fill out this section if principal is ~ Corporation, Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFZCER~ PARTNF..~ OR BENERC/ARY:
· I/El' ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~e"m be lobbies (~ in detail):/-- t~' ,, / . J ., ' / / d ~[
CITY AGENCZESIZNDI'VZDUALS TO BE LOBBZED:
A) Full Name of ZmJividual/lltJe
B) Relationship
l) Pursuant to Ordinance No. 2003-3393 Amendir~ Miami Beach atv Code Chaoter 2. Article VH, Division 5
Thereof Entitled ~Camoaian Finance Reform" Via The Addition Of Code Section 2-~88 Entitled ~Pmhibited
Camoaian Contributions BY Lobbyists ~)rl Procurement Issues";
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chapter 2, Article V[! Division 5
thereof Entitled "Camoaian Rnance Reform", Via The Addition Of Code Section 2490 Entitled ~Pmhibited
C~moaian Contributions By Lobbyists On Real F. st~te Develooment Issues":
Ar~ ¥c~u Iobbvina on a oendina aoolication for a Develooment Aareement with the atv or
L_r chanae of zonina mad cl~!anatbn or chanae to the City', Future Land Use HaD?
ON OCTOBER IsT OF EACH YEAR, EACH LOBBYT. ST SHALL SUBMIT TO THE CZTY CLERK A SZGNED
STATEHENT UNDER OATH, LZSTXNG LOBBYZNG EXPENDZ11JRES IN THE C3TY OF MZA/4X BEACH r-OR
THE PRECEDZNG ~DAR YEAR.
! do solemnly swear that all foregoing facts are tree and correct and that ! have read or am
familiar with the 2-482 City Code as amended, and all
reporting reqt
Signature of Lobbyist:
Signature of Principal/Client:
c3 Produced ID
Form of Idantificafion
VXZ. SZGNATURE AND STAJqP OF NOTARY OR DEPUTY CLEI~
State of Rodda, County of Miami-Dade
Swom to and subscribed beforq me
This _e'~,~day of ~-VL.~ . 2003. /
,:. ~,~g,.,. Debrah Resto
Signature of Public Notary - State of Rorida
~nt, ~'~amp or ~pe name of Notary Public
Registration: L~lrf .~.~ [ : I ' ~ ~
' ' /- /'/ ' ~'~)
2nd Revision 3/3.8/03 F:\C~R/HATL~LobbytstsVeglstrationaO3.d°c