Rick Delgado/Global Sports
to
~
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive. Miami Beach. Fl33139
Email: cityderk@cj.miami-beach.f1.us
LOBBYIST REGISTRATION FORM
(City of Miami Beach. City Code Chapter 2, Division 3, Section 2-481)
o C~(fa~AcGndment R\ uk
NAME OF LOBBYIST: (Last) to.. . . ~~s~)
Z ~ 7.- 0 -s w "J 1 trVO'Il-t.e
BUSINESS ADDRESS: (Number and Street) (City)
-Z~-' Ltt!.:J o15g ~(7-) bIt-
TELEPHONE NUMBER: FAX NUMBER:
rr (M.I)
\ q nil
(State)
Z;w2-
DATE QUALIFIED AS LOBBYIST
f~ 7711f~
(Zip Code)
EMAIL:
I. LOBBYIST RETAINED BY:
&-\.0 bJ S1q,..-t s
NAME OF PRINCIPAUCLlENT:
~ VO\+ ~
u,G
'L l.( 2-9 5w J-
~; ~YV1\ B-
(State)
)Jll.j'')
BUSINESS ADDRESS:
l~i\.1 Dl'S~
TELEPHONE NUMBER:
(Zip Code)
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section If principal Is a Corporation. Partnership or Trust [Section 2.....2 (c)]
. NAME OF CHIEF OFFICER. PARTNER, OR BENEFICIARY:
. LIST All PERSONS HOLDING. DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~t'\I\} \3e-o.c 5 Ql"'t.$ -t r,hW'j \=( ~4.1
I II. CITY AGENCIES/INDIVIDUALS TO BE LOBBlm:
A) Full Name of Indlvldual/Tltle B) Relatlonlhlp
Kto..M\ ~C~ V;-5'.}.oW" -I: Cl>l-IVGhh.:"1 h-t/..~ ;~ 6r a:,J.e ('/
I
_.
.
IV. UI:M"LU~KC. ur I~KlWDIINU AMUUNI:t VI" LUDD":'I "UMt"C.~.IIUN.'U.I:M"."'u:M:. wnE:.I nl:.K I'alUlCLr,
FLAT RATE OR OTHER):
A) LOBBYIST DISQOSURE:
.M
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
~\ (~~o.~ ~ ~\.Vht ~/(7)O b
1) Pursuant to Ordinance No. 7Iln.'-3393 Amendino Miami Beach City Code Chanter 2 Alticle VII DIVISion 5
Thereof Entitted "eamaaion Finance Reform- Via The Addition Of Code Sllction 2-488 Entitled 'Prohibited
Camaaion Contributions Bv Lobbvists On Procurement Issues".
:'N ..::==~ 0;:: ~:::::':rb~~=1;"tor services. or on a .01" --t
2) Pursuant to Ordinance No 2003-3395 Amendino Miami Beach City Code Chaater 2 Article VII Division 5
thereof Fntitled "Camoaion Finance Reform". Via The Addition Of Code Section 2-490 Entitled 'Prohibited
eamaaien Contributions Bvl obbvists On Real FstateDevelaumentlssues"
AreWJU l#"I.,a on. UQI.dh.... aaoIIcatIon fora Dewoloon--.t A...._ll8lltwlth theatvor
.~.:"''''~ ....-'7 of zonlna- ...~.. ......~........ or chanae to the Citv'~ 1'. ...- ~ u.... 11......,
V. SIGNATURE UNDER OATH:
ON- OCTOBER 1ST OF E:ACH YE:AA. EACH 1.OBBYIST SHALL SUBIIIIT TO THE CITY ClERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
t do solemnly swear that all of the foregoing facts are true and correct and that '1 have read or am
familiar with the provisions cant' d in i -482 of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of lobbyist:
Signature of Principal/C .
Vi. LOBBYIST IDENTIFICATION:
QProdUced 10 P-L#--lJ L.1r/{'}? 7 *' 7 k r~~~
Form of lrentification
PetsnnaltyKnOwn
State of Florida,Countyof Miammade
Sworn to and subscribed before me
This YJ day of .~ t/ , 2003.
/
,"'\\,.V~t;...J' Ar: 1n":'"'c, 1
f'-\~_.",,~~:~, ,,__,:-~(.~,. -~ ,)n_~ CaSrri-<
~jJ:~~lt} ']':',;;;~~"~~:C;6~~~:~f
~","jiff(~"':........, DO:l'~~ Tt,l.fU
1IJml\\\"- AiL:..'ltic E~neing Co., Jnc
vn. SIGNATURE ~NDSTAMP-OF NOTARY OR DEPUTY CLERK,
Print. stamp or type na!l1e of Notary Public
,
Registration: D{ ACCEPTED
If r~ed, stat& reason-: /'
Registration fee paid: KJ. Yes ( I No
DATAE&1m' DATE:
FOR CLERK'S USE ONLY
[ I REJECTED DATE:
[ I Cash l'<:! Check MeR /I
. 2OQ3. ENTEREOB.Y:
2nd Revision 3118103
f: \ClER\HAll \Lobbyists"..gbtl atiot raro.doc