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Robert Cherry .. fA ~ City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons empioyed 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, dedsion 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, dedslon 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 ULobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: Bercow (Last) Jeffrev (First) (M.I.) DATE QUALIFIED AS LOBBYIST 200 S, Biscavne Boulevard Suite 850 BUSINESS ADDRESS: (Number and Street) Miami (City) Florida (State) 33131 (Zip Code) 305-374-5300 TELEPHONE NUMBER: 305-377-6222 FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Robert CherrY NAME OF PRINCIPAUCLlENT: c/o LNR Prooertv Corooration 1601 Washinaton Avenue Suite 800 Miami Beach Florida 33139 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) 305-695-5555 TELEPHONE NUMBER: 305-695-5449 FAX NUMBER: (Optional) EMAiL: (Optional) Fill out this section if principal is a Corporation, Partnership, or Trust [Section 2-482 (c)] ? NAME OF CHIEF OFFICER, PARTNER OF BENEFICIARY: ? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP iNTEREST IN SUCH CORPORATION. PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: c;, ..1 _-1.~ Cl .>;". :i: III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: 1"1 :::c ;:,;; u:. -< r", U'> :::0 m (') rn 5645 North Bav Road Miami Beach Issue to be iobbied (Describe In detail): c; r :~ '1 '? d A) Full Name of IndividuallTitle B) Relationship -n - r;;. ("'") m City Staff None Mavor None Citv Commissioners None ;po ::It < co ~ !~t I~~* I:!:!~~~ ~u;&jtl o~w:z <JIi::;~~ ::J~X~ <';>UJ >- ::; IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $420.00/hourlv basis B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST' COMPENSATION): (Required), $420.00/hourlv basis i01 Yes ~ No: Are vou reDresentinG a not-for-Drofit coraoration or entity without saecial comDensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendlna Miami Beach City Code Chaoter 2. Article VII Division 5 Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions BY Lobbvists On Procurement Issues": 111 Yes ~ No: Are YOU 10bbvinG on a Dresent or DendinG bid for Goods. eauiDment or services. or on a Dresent or aendinG award for Goods. eGUiDment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Oty Code Chaoter 2. Article VII DIVision 5 thereof Entitled "Camoalan Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions BY Lobbvlsts On Real Estate Develooment Issues": ~Yes ~ No: Are vou lobbvinG on a aendinG aDDlication for a DeveloDment 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: CLERK A SIGNED COMPENSATION RECEIVED, NT SHALL BE FILED RE G PERIOD. I do solemnly swear that all of th am familiar with the provisions 0 reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. ON: Produced ID Produced ID Form of Identification Form of Identification ~ Personally known (Lobbyist) Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me , I Th~ ~~'V ,2&L"f LA - Signature of Public Notary - State of Florida Notarization of Lobbyist's signature FOR CLER USE Y Annual Registration fee: [] Yes"H:No Amount Paid ~~,()() M<;R # 1.~ Lobbyist Registration Form received and verified by: ~J I A ,~ I .I~ Revised 02/10/04 F: CLER LL\MARIA- OBBYIST\LOB 1 First Revision - 05-17-02 NN\O 0 Q)~g .5 ~;:!:N , - .28 .2: 2S~F= ~ <"" ~.,,'6 . r:::0, 0 s::: ~.~ ..g~ x.~ ~a:l:.~ :.::= e.;: ~ <Ll E "'" _ ~8~ .:;: ,\\\I~I~/JJ ~':;J?""!':'40:"''''''' ...!J.eY' .0...... ~~. ~ .:~~ .......:...o.v...fi.r..~ '1"Ifilll'"