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Leslie & Natalie Ziegel City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: dtyderk@d.miami-beach.f1.us LOBBYIST REGISTRATION FORM RECE\VEO 3 \ ~~ \0: \ 9 03 NG~ (' n CLER'r\'S off IcE (City of Miami Beach, City Code Olapter 2, Division 3, Section 2-48~\ to - - [J Check Box if an Amendment NAME OF LOBBYIST: DOUGHERTY (Last) LUCIA (First) A. (M.I) DATE QUAUFIED f>S LOBBYIST Greenberg Traurig, P .A. BUSINESS ADDRESS: 1221 Brickell Avenue (Number and Street) Miami (City) Florida (State) 33131 (Zip Code) 305-579-0603 TELEPHONE NUMBER: 305-961-5603 FAX NUMBER: dougherty!@gtlaw.com EMAIL: I. LOBBYIST RETAINED BY: Leslie. Natalie Zlegel NAME OF PRINCIPAl/WENT: 4335 North Bay Road Miami Beach, Florida 33140 (Zip Code) BUSINESS ADDRESS: (Number and Street) (City) (State) 305-579-0500 TELEPHONE NUMBER: 305-579-0717 FAX NUMBER: (Optional) ziegell@gtlaw.com EMAIL: (Optional) Fill out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (e)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPEaFIC LOBBY ISSUE: Variance for pool setback. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/TItle B) Relationship SEE ATIACHED . IV. U.l::M...LU:tUKII: ur I CKPI:t ""I.' AMUU'" l::t ur LUDa, 1.::U \"UPlt"'CnI::I\R I J.un lU.l:J4,..LU::JlC wnc I "1:1'\ nUUKL r, FLATRATEOR OTHER): None (') A) LOBBYIST DISCLOSURE: B) PRINOPAL'S DISClOSURE (OF LOBBYIST COMPENSATION): o None 1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division 5 Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaion Contributions Bv Lobbvists On Procurement Issues": nt or services or on a nt 2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled "Camoaion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaion Contributions Bv Lobbvists On Real Estate Develooment Issues": V. SIGNATURE UNDER OATH: ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING 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 contained in Section 2-482 of the Miami ach City Code as amended, and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: [J Produced ID Form of lcentification YD. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: i) ~M. Luo. . . My Cornlrnelon C0201132 ~ ~~... Sep_nb.. 24. 2005 State of Florida, County of Miami-Dade Sworn tynd SUbscri~ beforbi.e This / day of VflnJ r2003. Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY Registration: t><1 ACCEPTED [ ] REJECTED DATE: \tt-\ '- 0"3 If rejected, state reason: Registration fee paid: ~es [ ] No DATA ENlRY DATE: -J '2 -) [ ] Cash ~ Check MCR # . . 2003 ENTERED BY: ~ F:\ct.Ei\HAll\Lobbyists\registrationa03.doc ~b 134:'1. 2nd Revision 3/18/03