RK AssociatesCity of Miami Beach Office of the Ob/aerk
1700 Convention Center Drive, Miami Beach, FL 33139
F. mail: db/clerk@d.miami-beach.fl.us
LOBBYI~ST REGISTRATXON FORM
(Cib/of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
O Check Box if an Amendment
Rosen Harold
NAME OF LOBBYIST: (Last)
407 Lincoln Road
(First)
Penthouse S.E.
(M.I) DATE QUAIjFIED AS LOBBY[ST
Miami Beach, Florida 33139
BUSINESS ADDRESS: (Number and Street)
(305) 534-4757
(City) (State) (Zip Code)
TELEPHONE NUMBER:
T. LOBBYIST RETAINED BY:
RK Associates
FAX NUMBER: EMAIL:
NAME OF PRINCIPAL/CLIENT:
17100 Collins Avenue Suite 225 Sunny Isles Beach, Florida 33160
BUSINESS ADDRESS: (Number and Street) (CitY) (State) (Zip Code)
(~051 949-4110 (305) 948-3410
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a CorporaUon, Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Arnold Shevlin
· iI~r ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
SPECZI~C LOBBY TSSUE:
N. Shore Street Scape Improvement/Special Assessment
Issue to be lobbied (Describe in detail):
XXX. ~ AGENCZES/ZNDll/ZDUALS TO BE LOBBXED:
A) Full Name of Xndividual/TiUe B) Relationship
City Manager
City Commi'ssion
Finance Department
DISCLOSURE OF TERMS AND AMOUNTS OF LOBBY[ST COMPENSATTON (DISCLOSE WHETHER HOURI.
FLAT RATE OR OTHER,):.
A) LOBBY[ST DISCLOSURE: $ 4 5 0.0 0 an hour
B) P~NCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
$450.00 an hour
l)
2)
Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled 'Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitted 'Prohibited
Camoaian Contributions Bv Lobbyists On Procurement [~$u¢$":
Are you Iobbvina on a oresent or oendina bid for aoods, eauioment or sewices, or on a oresent
or oendina award for aoods, eauioment or service? D Yes,N9
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled 'Camoaian Finance Reform". Via The Addition Of Code Section 2-490 EntiUed "Prohibited
Camoaian Contributions By Lobbyists On R~al I~te Develooment Issues":
Are you Iobbvina on a aendina aoolication for a Develooment Aareement with the Cit-v or
aoolication for chanae of zonina qlag desianation or chanae to the City's Future Land Use Moo?
V. SZGNATURE UNDER OATH:
ON OCTOBER Is~ OF EACH YEAR, EACH LOBBYZST SHALL SUBMTi' TO THE ~ CLERK A SZGNED
,STATEMENT UNDER OATH, 1 lSiiNG LOBBYING EXPENDZTURES ZN THE CI.I'Y OF MZAM! BEACH FOR
THE PRECEDZNG CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contai~-.~¢~,~of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist: ~//-" ~ ~
Signature of Principal/Client:
LOBBYIST XDENTZFZCATZON:
Produced ID
Form of IdentificaUon
D Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of ~ 2003.
Registration: ~ACCEf'i'I~D
If rejected, state reason:
Registration fee paid: ,~.~: [ ] No
DATA ENTRY DATE:
2nd Revision 3/18/03
FOR CLERK'S USE ONLY
] RE3ELIt:O DATE: (~'/¢/0'-~
F:\~:~R\HATL\Lobbyists\registrationa03.doc
3/3
Are ~ou JM~vina on a oresent or _o~rm~ bid for aoods, eaui~,~,~t or ~'~;~. or ~a ~; ~
~m~ian ~~ ~ Lo~ ~ Real ~ ~m~ I~[
~ I~n~ on a ~dina a~l~flon for a ~~ ~T~ ~e ~,
aoMi~n for ~anae ~ zo~[~p ma~ ~a~ or ~noe Co ~ C~s ~M 1 ~ U~ Ma~?
M[GHJLI~RE UHDER OATH:
ON OCTOBER 1st OF EACH YEAR, EACH LQBBW, ST 9tALL SUBN.~ TO THE CTW CLERK
-b'~ATEMENT UNDER OATH, L~'TT~G LOBBYZNG EXPEND:ZTUla_~( ~ ~E ~J¥ OF M~
I do..soienmly swear that all of the foregoing facts am true and correct and that I have read oT am; ,
~amgkqr with ~e provisions contained in Section 2-482 of the Miami Beach Cib/Code as amended, and 'afl
' reporting requiremenLs. ,.~
a Produced ID
Form of Identification
~[:[. ~aNATUR~ &NO S~AJ4p OF NOTARY O1[ DEPU1~ ~
This
State of Rorida, C~u~/~ Hiami-Dade
Sworn to and subscribed b~rore me
day of ~ 2003.
FOR ~'[FeX'$ US~ ONLY
] I;~JEC'tED DATE:.