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Alfredo J. Gonzalez/Chabad Lubavitch of Venetian Mi_8_ " llIU' lD - - City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined In any manner In this section, during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the prinCipal as well as any employee engaged in lobbying activities. The term ~LobbyistsW has specific exclusions. Please refer to Ordinance 2004-3435. Gonzalez NAME OF LOBBYIST: (Last) 1221 Brickell AVenue, Alfredo (First) Miami FL J. (M.!) 33131 TELEPHONE NUMBER: FAX NUMBER: (State) (Zip Code) gonzalezaj@gtlaw.com EMAIL: BUSINESS NAME AND ADDRESS 305-579...,0588 (Number and Street) (City) 305-961-5588 I. LOBBYIST RETAINED BY: Chabad Lubavitch of Venetian Causeway and Surrounding Islands, Inc. NAME OF PRINCIPAl./CUENT: 115 7th Terrace Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS 305-674-8400 (Number and Street) (City) 305-535-5260 (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)~~ -.{ I rn -< ;0 m Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)) . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: . ;:r: (f; IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN ~H CORPORATION, PARTNERSHIP OR TRUST: ~ ....,,; -J -0 :z J::"" II. SP~CIFlC LpBBY ISSUE: Plannlng Board Issue to be lobbied (Describe In detail): Ill. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Indivldual/TiUe B) Any Financial, Familial or Professional Relationship Planning Board Planning Department 1215/"-4/04 15:1213 I::;REct~BERG TRHLlR I G ..,.. 9312155355260 NO. iff 01214 IV. DISCLOSURE OF TlIlMB AH~ AMOUNTS O~ LoSBYIST COMPj;NSAnON (DISCLOSE 1IIo1lfTIlER HCIJftL Y, FlA T U?i' (JR OrnEII.), A) LO!BY!3T OIS::LOSU~E: (Required) $250.00 flourly HOlJrl,'" BJ Pl'J'/UJoALSO&LOSUIti [CF l.OIl~r.sT COMPe~SATlONi' (Required). $:2 :5 0 . G J J y~ ;.~ AI't\ 'lOll reDrn~Ja!tiLli!.!.nll.t-fr.;t'nmtJt""mrDl)ratltl1.!ILtntltv wlthol..lf: 5~a1 amtllensatiDII or (e mbursemellt. pUI$Jant to Ordinance No. 2004-343:;, 1) l'YL'llJ~nt tllDI'llin811ft1 No, 2003..3203 Amendina f':floml Beac~ Ct.. Code ';:'~~er 2. A~~e 1Incl,?b%:on 5 T3J'.l!It' Entitliid "('~oolan Finance F/a!form" Via jh~ Addition Of Cod" ~C& 00 Entf "F', Y-"1~ ~.;"trlbuti0ll5 Ih Lobt<)ri;ts On FIIY"JJ(I!""'nt lSEuRIl'" Yes f.H;;) Are YOU IaIlobvimul.!1..'lDf'l!S8r1t or Q!!Q!fl~jlj\~""GIJ!mt~g!yt~~ . &It ~n~'n.~ .WIt.HI r.rf' "OC.~. i!c!L:;iDm6~t Or -""'Cll 2) ElilIYg"n.U~_Orriln.nc:e No 2OO~-~~nt!lJl~ ~ Otv Co~.J,:l'IaptE!r ;1,/.";rt~lliQlO~il) thereof EnUled "Camcaiqn Flnaln! r<efolm", Via The Addition Of Cill,je Secrlon i-49C En~tled 'Prohlblred ~~~ions BIf Lobbvists On R'iiEstate ['~opment l.s,,~:;::; -r.::''''' Yell ,I!II:) ~m VIl\l 19h!m.DA..lIII" oendina a_licatllln for ~.IDltIl'lent AC!a!l.lll(,nt W,j;~ the C!l;t.J;l~ --- ~'adi.:Jn fQ~ r.:h~.m~e (If za~l~ ftiali dl!~i&itlftian or dlana.e to the Cltv', Fbtute Land lkA MaD? V. SUlNATUllE UNDfR OATH, ON oc:roam 1ST 01' EAC:H YEAR, EACH LOBBYJ$T SHALL SUBMIT TO THE CITY CLSRk A SIGNED STATEMENT UNDER OATH. UmNG LOBBYING EXPEND UREa. AS WELL AS COMPENSATION RiClIVED, III THE CITY 01' MIAMI BEAC'" FOR THE PRE ING CALE DAR YEAR.. A STATr!I4~T SHALL BE FIUD EVEN II' THERE HAVE HEN NO Pl:N U MPII!NSATlON DUIUNG THE R90ftnNG PERIOD. I do SOlemnly S\'ft!ijr thaI OIl! 0 famJllar witt; tile provlsJ ns co reqlllremenbi. Signature of Lobby' . _ the foregoing facts are true ana corr and that I have read or am on 2-482 of the Miami lleadl City Code and ~Il reporting ? - VI. LOUl'IST IDENTIFICATION, "l%NC:IPAL IlIIlN1lFICATION, ;>radw;ed [D _. PrtJdutai Itl form of Ide~tlflCation G~nillly kno;;XLOllbyillt) VII. SlG~TUIl.E AND STAMP OF NOTAIlY: Sl311l of FlOrida, CoUf1ty of MIami-Dade. Sworn to and Wbsc:rlbed before me TI1ls _. ~""_ d . 2C,Q '-\ Form of Identi"lCll~on ~rlnciPao i "': F', ",' ~ . :- r~: '