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Steve Sorensen/WCI Comm Miami Hcoxh ~ ~'lIr al03 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, b~ a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or dedsion 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 "LobbyistsH has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: (Last) Steve (First) (M.!) FL 34134 (Zip Code) Sorensen WCI Communities, Inc. BUSINESS NAME AND ADDRESS (239) 498-8443 TELEPHONE NUMBER: 24301 Walden Center Drive. Bonita Snrin2s (Number and.Street) (City) (State) (239) 498-8277 FAX NUMBER: pamelarobinson@Wcicommunities.com EMAIL: I. LOBBYIST RETAINED BY: WCI Communities, Inc. NAME OF PRINCIPAL/CLIENT: 24301 Walden Center Drive Bonita Springs FL 34134 BUSINESS NAME AND ADDRESS (Number and Street) -(City) ,. (State) (Zip Code) (239) 498-8443 (239) 498-8277 pamelarobinson@Wcicommunities.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Jerry Starkey, President IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached n. SPECIFIC LOBBY ISSUE: Real Estate Development Issue to be lobbied (Describe in detail): m. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/ntle B) Any Financial, Familial or Professional Relationship IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) No compensation other than salary as employee. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).No compensation other than employee's salary Yes No: X Are YOU reDresenting a not-for-Drofit col'Doration or entity without soecial comoensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chanter 2. Article VII. Division 5 Thereof Entitled "Camnaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camnaian Contributions Bv Lobbvists On Procurement Issues"; Yes No: X Are YOU lobbying on a Dresent or Dending bid for goods. eauiDment or services, or on a Dresent or oending award for goods, eauiDment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chanter 2. Article VII Division 5 thereof Entitled "Campa ion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camnaian Contributions BY Lobbvists On Real Estate Develonment Issues": Yes No: X Are you lobbying on a oending aDDlication for a DeyelODment Agreement with the City or aDDlication for change of zoning maD designation or change to the City's Future Land Use MaD? V. SIGNATURE UNDER OATH: ON OCTOBER 1 sr OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. .c---K ~ Signature of Lobbyist 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 Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION PRINOPAL IDENl1FICATION: o Produced ID o Produced ID Form of Identification Form of Identification 'rfI. Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: iI' Personally known (Principal) State of Florida, County of Miami-Dade Sworn to iilnd subscribed before me This d'1 day of ~ . 20!!l /~~~.I;.)~j0 Signature of Notary - State of FlOrida Notarization of Lobbyist's signature ~~i.Yi'R.~ Whitney R. Westrick s.! i.E CommiSSion # 00302810 ~~llo !I;r~~ Expires June 13, 2008 'rrl~"""""'Tnr'.."""1ne. .......1019 State of Florida, County of Miami-Dade Sworn and subscribed before me This ....!t..-day of IA<1 200", FORC Annual Registration fee: [ ] Yes [ ] No Arno t d Lobbyist Registration Form received and verified by: Revised 02/10/04 F: MAIlfTZA MUNIZ MY COMMISSION' CC 970526 EXPIRES: Janual'f 26, 2005 _ThN~___ Date Paid 51 J l/b if f Name of Beneficial Owner % of shares owned Wellington Management Co., LLP 5.7% The Alfred Hoffinan, Jr. 2003 Long-Term Trust 11.9% Hotchkis and Wiley Capital Management, LLC 5% Don E. Ackerman 7.75%