Alexander I Tachmes/Beach Hotel
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
WBBYIST REGISTRATION FORM
LobbyIst means all persons employed 01' retained, whether paid or not, by a principal who seeks to enoourage the passage, defeat
or modIftcation of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
Oty Manager 01' any dty board or oornmlttee; or any action, dedsion or recommendation of any dty petSOnnel defined in any
manner in this section, during the time period of the entire dedslon-making process on such action, decision or recommendation
that foreseeably will be heard 01' reviewed by the city commission, 01' a dty board Of committee. The term specifically Includes the
principal as well as any employee engaged in lobbying activities. The tenn "lobbyIsts" has .peclfic exclusion.. Please refer
to Ordinance 2004-3435.
1Acf;'lMf5' 1tt...Q'lrtJ1JGrL X.
NAME OF LOBBYIST: (Last) (Arst) (M.I)
At.~YA+Jl)U -:::c. --n+c/Tro1GS/- -fr. .2. 5'. r?/fSCItYN[ 1?LVD. .JYf. :zc.Jo Mtlt"4f{,fL- 3313/
BUSINESS NAME AND ADDRESS (Number and Street) (Oty) , (State) (Zip Code)
'3z>5- s5o-I"t 4-0 3oS'- 3:;0- If'lo Vl:::rTi'\-Otv11~~(t.iilkoL. 1!.e,W\
TElEPHONE NUMBER: FAX NUMBER: EMAlL:
I. LOBBYIST RETAINED BY:
!JGACt4 f../.o-rE-i- A-r.9f)Cflrr~S . LL <::-
NAME OF PRINCPAl/OlENT: '
BUSINESS NAME AND ADDRESS
305- t,a.-~OOO
TELEPHONE NUMBER:
/ ft,Rs C>>'..LI N S' 4-v~.. f{ {PrM 1 8b Itc H ,rz.. 3'3/ J'l
(Number and Street) (Oty) , (State)' (Zip Code)
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out thl. section if principal I. a Corporation, Partnership or Trust [SectIon 2-4a2 (e)]
. NAME OF CHIEF OffiCER, PARTNER, OR BENEFIaARY: M A IlfL -rtt"'fI S I @-eNf{ZIrL rt'I/Wl!(;trz-
. IDENTIFY All PERSONS HOLDING, DIRECTl. Y OR INDIRECTl. Y, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: .sEE. f10lf I t3 J7 u II" kTfA-ct1Et> ff ~(lt-r()
/+rib (llc()(lPOIt.IPrf3D ff~l.EIf.J .
II. SPECIFIC LOBBY ISSUE:
(</fz..-Pt.A"Z-A f./or-fL ~1(4i~ . i~~ fur '1.-0-1- [;1.AA-.e.4 +> C4xJ~
Issue to be lobbied (Describe in detail): ' 1 ~.J.u-r.
m. CITY AGENOES/INDIVIDUALS TO BE LOBBIED:
A) full Nama of Indlvldual/TItle
B) Any financial, familial or Professional RelationshIp
'1DIL r CO/O"1~ISJ'1 III Ie IT'Y 11'oMlt.I-
1'i:-rtUH"IOtJ C-Iry krrr)"!-~Er '.) ()t:frcE
tb-vIM-OS <t- C6,M.fIo11 (-ro f".lc
PWtA-l.SS'/13L-b'
f1 ON e.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
..st:r3oo
luc.vr
JIF 360
~
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
Yes No: Are ou re resen in a not- r- rofit cor ration or enti without s cial com ensation or
bursement. Pursuant to Ordinance No. 2004-3435.
1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division S
Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Procurement Issues":
Yes
0:
A ou lobb in on a resent r n in bid for oods e ui ment or services or on a resent
or Dending award for goods. egUiDment or service?
2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaoter 2. Article VII Division S
thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues":
Yes No'
A ou lobb in on a n in lication for a Develo ment A reement wi h he Ci or
aDDlication for change of zoning maD designation or change to the City's Future Land Use MaD?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING 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.
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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:
~Ql--
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
u Produced ID
,: Produced ID
Form of Identification
.rPe'rsonally known (Lobbyist)
Form of Identification
[I Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to ~ sUbsc~f:~_;e ~tl
Th~ d~YG'~~= .2lPJ
(-r.::.... . -.I
Signature of Public Notary - State of Aorida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This _day of .20_
Signature of Public Notary - State of Fiorida
Notarization of Principal's signature
'il; :==ODOmu
~.!:'I Ellplr8I &.,Ae..obeI23. 2001
/' FOR CLERK'
Annual Registration fee: [ VJ Yes [ ] No Amount PO
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER\ALL\MARlA-M\LOBBYlST\LOBBYlST FORM 04
SEONLY . /. I ./
.00 MCR#.)7.?P<09Datepaid 9/,(~g)<;I'
[1/. DISCLOSURE OF TERMS AND AMOUNTS OF lOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER). .
II) LOIIIIYlST D1SClOSURf: (RequIred) if ;] () 0 / t'-'1JU f
(
B) PRINCIPAl'S DISClOSIJRE (OF LOBBYIST COMPENSATION): (Required).
re 0
.t 300 / ~-'..
t
with
y No'
b
1)
Yes
2)
Yes <:;>
V.
On a t tion r
Pursuant to Ordinance No. 2004-3435.
~ ~~j'~nce No. 2003-3393 Amendina Miami Beach Otv COde ClaDlei' 2. Article VII. IlMsian 5
_----..:___moalan RnanM: R:~rm'" Via The Addition Of Code Section 2--488 Entitled ~ibitP..d
Camoafan Cnntributions ,BY Lnbbvists On Proturement Issues":
'alcom
ati
u in a nt or in b"
or oendina award for GOOds. eauioment or service?
pursuant to Ordinan~ No 2003-3395 Amendina Miami Beach atv' COde ChaoMr 2. Article VII Division 5
ttv.a;eot Fntitled'Y'...amoalan Finance Reform.... Via The Addition Of r..ndA Section 2-490 Entitled "Prohibited
Cammio" Contributions BY Lobbvi~ On Real ~.llPNP.Inmnent k.~.s":
ui ent or
ana
nt
Are vou lobbvina on a DeI1dino aDDlication for a Develooment AGreement with the Ci:: or
a~lIcation for c:ha_ of :<oilinG maD desiGnation or manae tD theCitY's Future Land Use Mao?
SIGNATURE UNOER OATH:
ON OCTOBER 1ST O~ EAot YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY ClERK A SIGNED
STATEMENT UNDER OATH, U5nNG LOBBYING nPENOITURES, AS welL AS 1:OMPENSATlON
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 COMPENSAnON DURING THE
REPORnNG PERIOD.
,
Signature of~
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: L
Signature of Principal/CIientY rr-1.:..--->
VI. LOBBYIST IDENTIFICATION: i PRINOPAL IDENTIFICATION:
I I Produced 10
u Produced 10
Form of Identification
" Personally known (L.cIbbyist)
VIt. SIGNATURE AND STAMP OF NOTARY'
Form of Identification
, i Personally known (Principal)
State of Rarida, County of Miami-Dade
Swam and subscribed before me
This _day of . 20_
t.\AAIA E. ARMENTA
My Comm.~. 512Z/05
No. DO 028245
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Signature of Public Notary - Slate of Randa
NOtarization of Principal's signature
./ FOR USl: ONL\' ) )8-/
Annual Regi_onfee: IV'] Yes [ ]No AmountPaI....Jl.'\.a....> MCR#.?7,;l.:;lt"'9DatepaidC3;, J.~ .
Lobbyist Regist<ation Form 'received and verified by: ( ,-" '
Revised 02/10/04 F: CLER\ -M\LOB8YI51iL06BY1ST FORM 04
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