Obiza II Corp.
.
aty of Miami Beach OffIce of the Oty Oerle
1700 Convenllon Center Drive, Miami Beach, FL 33139
Emall: dtyderklllld.miami-beach.tl.us
LOBBYIST REGISTRATION FORM
RECEIVED
03 OCT - 7 AM 9: I 6
CITY CLERK'S OFF fCE
to
-
-
(Oty of Miami Beach, Oty Code Qlapter 2, DMsIon 3, SectIon 2-481)
[J Check Box If an Amendment
~Obb\~..s~e~~ Httrrl~''''
NAME OF LOBBYIST: (last) (Arst) (M.!) DATE QUAUFIED /lS LOB8YIST
.J2.2"1 W4s""A~Io,., Ave.. Mr,o,W'l.1 &~ FL 33/39
BUSINESS ADDRESS: (N ber and Street) (aty) (S tel (Zip Code) }
265 - 5".31-<15 00 3oS-SJ/-OlSO kh(06'e.6eI6olJ''''''~'f
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
.
L L088YI5T Rn"AlNm IV:
..Db I "La. II: Cor ]D-
NAME OF PRINCIPAl/alENT:
$0011. hlf
Fin outthluec:tfon Itprlndplllls a CorpondIon. PlIrtner1h1porTnllt[SectIon 2-482 (e)]
. ~ OF ~IEF OFFICER, PNmlER. OR BENEFICJARY:
<KfJ OCt- J- ~ r ~ Cf '"
. UST All. PERSONS HOLDING, DlRECTty OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
~:'rC:rOR::~
.
Do SPECIFIC LOIIIIY JSSUE:
~$;Bre~faJu" ~e{,l'e: Ji~fo/'tC p,.~fI~~" &1C.nl
to be I (Desaibe in detail): J- P / d ~ "( A.J $1-6..( /
m. CItY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of 1ndIvld..../11tIe
B) Relationship
I I.
.&v. U&:IIl.L"-OU1U: ur IIC""':' "'"1.1 IU'lUUn 1:1 ur ~UDD'.&.:t1 1..UPll""1:n.:aAIJ.Un lUl:M..V QC. W"IC I nICK nUUICLr,
FlAT RATE OR. OTHER.): J }
A) LOBBYlSTDISClOSURE: 350 (cur
I
B) PRINCPAl'S DISClOSURE (OF LOBBYIST COMPENSATION):
0\)./
1) Pursuant to Ordinance ND. 2003-3393 Amendlna Miami Beach atv Code OlaDter 2. Artlcle vn. Division 5
Thereof Entitled -Camoaian Finance Reformw Via The Addition Of Code SectlDn 2-488 Entitled -Prohibited
Camoaion Contributions BY lobbYists On Procurement Issues":
::W"::~I~C:~~=I=~or,:::~:u~Gr servU- Gran a _nt
2) Pursuant to Ordinance No. 2003-3395 Amendlna Miami Beach Cltv Code Chaoter 2. ArtlcIe vn DIvIsion 5
thereof Entitled -Camoaion Finance Reformw. Via The Addition Of Code SectIon 2-490 Entitled -Prohibited
Camoaian Contributions BY L.obbvists On Real Fd':'Ite Develooment r_ -=":
Are YOU IobbvInaon a aendlna aDD11c:ation for a Develooment AGreement wIttI ttHl atv or
a~~ c:ha.- at zonlna maD ~ 'anatlon or chanae ID ttHl Cltv's Future Land U- MaD?
V. SIGNATURE UNom OATH:
ON OCTOBER 1ST OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OTY a.ERK A SIGNED
SfATEMENT UNDER OATH, LJSnNG LOBBYING EXPENDITURES IN THE OTY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
rrect and that I have read or am
, Beach aty Code as amended, and all
7
Signature of Lobbyist:
~ Signature of Principal/alent: d LtC t.. '7'
"ok"r"C\Jrra",) ~~~(.,rl"l ~
VI. LOB8YIST IDEN11FICA11ON:
s-/ Produced ID F Pi..,. ~... 7 &. /#/.;, (- 390 - U Personally Known
Form of Ic2ntification
vu. SIGNATURE AND STAMP OF NOTARY OR DEPUTY a.ERK:
State of Rorida, County of MiamH)ade
Swom to a~ subscri~ befote me
This 1 day of c:tbber. 2003.
OFFlCIALNOfARYSEAL ---7
LILLIAN BEAUCHAMP
NaJ'ARY PUBLIC STATE OF FLORIDA
COMMISSION NO. DD109289
MY COMMISSION EXP. APR, 29.2006
)(
FOR CLERK'S USE ONLY
Registration: ~CEPTED
If rejected, state reason:
Registration fee paid: l:>{ves [ ] No
DATA ENTRY DATE: ! 0/ '7
2nd Revision 3/18/03
[ ] REJECTED
DATE:
lO,-I- 03
~Cash [ ] Check MCR'. f2..~ ~ I
.2003 ENTERED BY~
F:~ :n.\LObbviSlS"~dtlolla03.doc