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Jose Rodriguez/Pathman Lewis BBf12f2BB4 15:09 9547713636 KEITH AND SCI-t-lARS PA PAGE B2/B3 ...J ".../ lQ' -- , Cty ct Miami Beach OffIce of the CIty Clerk 1700 COnvention Center Drive, Miami Beach, FL 33139 LOBBYIST UGISTRATION FORM Labtr,Ut mIIl1It all p11111ll11l1111llPioVtd or I'ttIInId, wIleIIIllr paid or not, by II p1nc:fpallllllo Mills to llIXXlUI1IgIl the ptIIIgf, der8lII: or II'lOCIIbtlon t:l any onIInBnoe, r8mIutIan, ICtIon or ddlfon dilny COI..,IiSllI\.,W; lIIIY.et:Ion, dtc:I8Ion, reoollll1lllllCllliOn of the Qly HInIgIIr III' IllIV dlY bolIrcl or almIllIlIM; or lIIIV iICtlan, dIcldln or ~t10h t:l iIII\I atv pII'tOnMl MllllIIn .,., menner In thIs~. during the lime perlod III the tilth ~g 1lI\lCIIlIS on such Bellon, dec:I8Ion III' ~ tI1lIt f_"l~ will bIl heMI or I'lMIWe:lI7f die CRy CllmII1IIIIan, or . Cit.y board Ill' CO/lWllltllM. The t1lnn spedftcIIly t~ thIl prln*' . WIllI .. IllY GIllllIoyae ~ In IoIlltiIngllClMllU. ThOl _ "l.DbllylBW' 11_ ..-;fiO *kduslon.. ....... rat.. tD 0nI_ 2llO+3aa. ROdd.guez, NAM!! 01' LOBElVIST: 6500 NO%th Andrews 8USlNli5S NAM! AND ADDReiS (954) 776-1616 laEPHONl! NUMBeR: Jose (lilt) (I'Inl1:) Avenue, Ji't. I.aude:r:dal., FL (NUIllIW Incl5tr8Bt) (CIty) (954) 771-7690 fAX NUMII!R: I.. (M.I) 33309 (State) (ZIp CcxIc) j:r:odriguezlke1thand$Qhnars.com EMAlI.: L LOB"""- RlTAINI!Q 811'. pathman :t.ewil!l, LLP / Wavne pathman NAM! OF PlU:NCIPALlalENT: Pat.1Ull&n t.ewi., LLP one BiI!Ieayne Tower, Suit. BUSH$S NAMI! AND AtlllllESS (Number end street) . (Cly) (305) 379-2425 (305) 379-2420 nlDHONE NUMI!R,: FAX NUMlI!A: (Optlonill) 2400, Miami, FL 33131 (Statal ~ eodt) ~..thmanlipathmanlewis.com !M.AJL: (Optfolllll) PIlI Is . ~0Il, I'BrtMrMIp or Tl'IIst [5 . NAME Clfl 0lI!I' 0MaR, PARTNI!Il, OR Ga'4E1'ICIARY: 2.0482 (e)] . lDfNT1FY' AU. PERSONS HOI.DlNCi, DIltE:CT1.Y Ot( 1l'IDlREC:l'LY, A S'lb OR MORE CWJNER5HIP INT!R!ST IN SUCH CORFORAnON, p~ OR TIll.l$T: n IPICIFlC WilY DlUI. 5th and Alton at !diem! Beach ~ lD Ill! lCIbbIiId (DIIlaibe III dtliIII). Ul. cny AGIlNaD/INDMDUAUl TO 81! LOIlIIDDI A) I'I1II...... Of 1ncIIvId,,'JTItIe ') AIry FlnIndBl, 1'11111'''' Ill' Pror..iOlllll bIIdlatlllllp Miami Beach City COmmission N/A MiMi Beach City ManagJIIJ;' N/A K:l.ami a...en Public Worles N/A O~/!~/~~~4 Ib:~9 9547713636 KEITH AND SCHNARS PA PAGE 03/03 . ....... ,-'" IV. DlSCL.D!IltlU OF 1DMS AND AMCJUfflS OF LOIIYJSTCOMPENSAnON (D1.SCl OS! WHErH~ HOURLY, I"LAT IrA ~ OR OTHER)1 ~ A) LOBII\'li'rDl5lCl.OSUllE: (bqIllNd' hourlv enQ"inae:rinq feu \\; .00 I.l) pRXMCtPAI.'S tl1SCl 0S\JIll! (OP l.08IMSTCOMPENSA'nON): (~./ff' v_ ~ == .-r- ltlna _ not..rar..1IftIflt mrDllnltlon Dr.ntItv wlthaut ........, .......DBllatJan 1M' IIuI Pul'!llllllll: to 0nlIn.1ICII No. 2.004-3435. 1) .. PuI'lll8nt to 01'111_ Na. 2D03-3Iln Amendlno MIOml ~ Ql.Y coq, "'~ ~. Artide vtI. DIviIlIcn 5 1'hl!rM EntIIIt!d "CIImpalgn RrIaI'Io! Reform" VIa Tha Ad<lJticn 01 CQs!1iI ~-ifl8 ~ "Prnhlhihwl c.rnPJIan qJnIributlorlllllv l1Ibbvistll <;Ip PftlgIl'IIITIllI'lI: r.... -. v_@ ANI VIII.Ilnhbvlna an _ ~nt or DmIIIIna htd IlV' ftftIUIe_ "ulpmmtt or ~ ill' ftn . D.... l1li' aardllll ...... fIIIr JUUUt. IHIlIl11mMnt or ~ 2) ~nt t.q OnIIMftIl8 No. 2OO~-3JM Amllndrnc MiBmJ - Ot\l.Code CbaDIer 2. ArMde VII DnII5ton S therec:l !:nlllfl!d "ClIIl\'lOlIlltJn Ar'IIll'lO!! bl'orm". Vm 'The ~Ilgn Of C"iW! ~ 2~O ~HtlAd "Pl'llhlblll!d Ctm"""'" enntrlbotions !'Iv lobtwlsls On ~11"stabI OIMI!IqpmIont ~~fgC ~ ~~~IGI't!.l1MIDDmlUlt"'l'IIIIIII&nt:wtthth8C1tviDl' ,DDIcatIGn for dlBnae of mill.. tn_ dMlalCltlmt Dr ehIInaelm tile. Cltv's FutuM Land 11M MaD? SlGNATURI UNDM OATHI v. ON OCTO" :1.11' oP lAaf YEM, l!Aat LOBBYIST SHAll. SUBMIT TO TffEl CI1Y a.auc: A SIGNED 5rATlMDIT UNDlR. OATH, LISTING LOBBYING EXPENDI11IRi5. AS MLL ItS COMPlNSAlION REC!1VID, IN 1HE CITY OF MIAMI llIlAaf !'OR THE PRECmlNG CALENDAR YEAR. A STA'I'1!MflIiIT SHALL BE FJLED EVEN IF 1HEU NAVE lEEN NO !XII ITURE8 COMPENSAtION IMIIUNG TIt! REPORTDIG PIiIUOD. ,..--' "AL IDl!RTIFlCAnON: I do solemnly llWMt t:haI: all d tf1e foregolng familiar with the provisions contained In 5eIctlon requirements. Signature of LobbyIst: SIgnature of PrlnclpaV \IX, Prcc:II.tCed 10 ProcIUCl!dID FormrlIdentll'lcatlon .Alel'SOllll/ly known ~) VII. srGNATUR!~Nm'ARYI ~stalerlA~ Olunly belbreme ThIs rI r 20.Q.,4 - Stit1iI rll'Ial1d1 N I'IItlCQC lit lXJlMIlIsOt. DO 28m4 ~I; ""'1Y11, llIlO8 _1IW"'1'LIli~ Fonn of Idllltllialtlon Personally known (PrlndfIaI) ....-.. [~ ,.. ...~,.;;;.11 W ,-... 9:/,'(/0<( 1..IibIIv1lt~ 1'aIm~.nd~ by: RIIIIMd 02/10/0+ F: \ M\LOIl8Vm\LOaIMS'l' I'ORH 04