Janna Lhota / IHC
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
lObbyist means all persons empwyed or retained, whether paid or not, by a prlndpal who seeks to .ncourage the: passage, defeat
or modification of any ordinance, resolution, action or decision of any Q)Rlmls$loner; any action, dedsiOll, recommendation of the
City Manager or &ny city bOarcl or committee; or any actiOn, decision or recommendation ot any dty personnel defined In any
manner 'n this; section, during the time period of tile entire dedslon-maklng process on such action, decision or recommendat;on
that foreseeably will be heard or reviewed by the city commiSSion, or a dty board or committee. The term spec:itiallV includes the
principal as well as any employee engaged In IobOyjng actIVIties. The term "'Lobbyists- bas sp,clne eXdu'ionl. Please re'.r
to Ordinance 2004-3435.
Imta JaJUli? P.
NAME OF LOBBYIST: (Last) (First) (M.!)
Holland & Knight LLP, cne E. BrcMard Boulevard, Suite 1300, Ft. Lauderdale, FL 33301
BUSINESS NAME AND ADDRESS (Number and Street) .(aty) (Slate) (Zip Code)
954-525-1000
TELEPHONE NUMBER:
954-463-2030
FAX NUMBER:
EMAIL:
I. LOBBYIST RETAINED BY:
IHC,Miami. Beach Corporation
NAME OF PRINCIPAl/CLIENT:
1950 Stermons Freeway, Suite 6001, Dallas, Texas 75207
BUSINESS NAME ANO ADDRESS (Number and Street) (City) (State)
214-863-1285
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (OptlOl1al)
EMAIL: (Optional)
Fill out this ..ctlon if princlp.1 is . Corporation, P.rtn....hip or Trust [S.ctlon 2....82 (e)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRfCTLY, A S"" OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECI~IC LOBBY ISSUE:
ChallerlQ.e to poss:ilil~ designation of ~ r-tiami. Beach Resort
Issue to be lobbied (Describe In detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Till. B) Any Finanel.l, Familial or PfOfesslonal Relationship
Jorqe Gcmez, Directorof Plannin<<I None
William Cary, Director, Design, Pre ~ervation and Neighborh:>od Planning DiIv:
J 'Ihcrnas M:xlney, Design and Preservation ~Sanager None
ision - None
Hi5tonc Pre5ervation Board - NOne
Planning Board - None
City Ccmni.ssiClln and Staff - None
City f.:!anager and Staff - None
lV. DISCLOSURE OF TERMS ANDAMOUNlS OF LDBBYIST COMPEI'ISAnDN (DISCLDSI! WHETHI!R HOURl.Y,
FlAT RATI! OR OTHBl)
$315.00;hour
Hourly $315. OO;hour
A) LOBBYIST DlSQ.OSURE: (-.qulrecl) Hourly
B) PRINOPAL'S DISa.OSURE (OF LOBBYIST COMPENSATION): (bquhd).
The followlnllllnformlltlon must be answered:
1) Pursuant to Miami Beach aty COde 5edion 2-488 Entitled "ProhIbited Campaign ContrIbutIons By lobbyIsts
On Pl'OOJrement Issues":
D VB la No: Are vau lahbvina on . ...-nt IW DlHldlna bid far aoodL ..ulllllllHlt DI' _""'"--- Dr tin .
.......nt or DIIndlna .ward far aood. lHIulDm.nt or ..rvlm7
2) Pursuant to MIami Beach aty Code 2-490 Entitled "Prohibited Campaign ContrIbutions By lobbyists On Real
Estate Development Issues":
DVM fiNo: Are vou IobbYIna on a aendina aDDnratian for. ~IGDnlllnt AanN!llllBlt wRh the CItv or
-.aDUcatlon for dlanCll!! of zonina maD dMianatlan ar dIIIn~ III tM Cltv'. FublN Land u..
HI.IIZ
3) Pursuant to Miami Beach aty Code 2-484 (h) /lIrf person (except those l!I(llmpt from the definition of
"lobbyist" as set forth in section 2-481 above) who only appears as a representative of a not-for-prolit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the derk as required by this
section but, shall not be required to pay any registration fees..
n VB 'RI No: Ani vau rea.....atina a not-fo....arofIt mraoratlan or aMIty without sDBda. lDIna....lkln
or reimbursement. .
ON OCl'OBI!R lIT OF EACH YEAR, EACH LOBBYIST SHAU. SUBMIT TO THE CITY CLERK A SIGNED
SfATD4ENT UNDER OATH, LI5I1NG LOBBYING EXPENDnultfS, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI Bl!ACH FOR THE PRECEDING CALENDAR Y!AR. A SfATEMENT
SHAll IE FILED EVEN IF THERE HAVE BEEN NO ~. NDIIVeS OR. COMPENSATION. DURING THE
REPORTING PERIOD. _/P1A-11 A^'-_
S1gnatureof~
I do solemnly swear that all of the foregoing facts are true and CXlITeCl: and that I have read or am
~~\I~:.the provisions ~Inedln Section) ~of. th "e / M .laml Beach aty Code and all reporting
Signature of Lobbyist: _ _( r ~
Signature of Prlndpal/Cllent:
VI. LDBBYJIT IDENTIfiCATION: PRINCIPAL IDI!N11FICATlON:
~\\\\\l1Il"'1/1111.
o Produced 10 0 Produced 10 l<~\~~' R0861/"~
Form of Identification Form of Identlfk3tlon ~'tt:4..~~Y'puiJ:~~
)fon ~ l~"'*~.. ~
ally known (prtndJlllI) ~ r .. \ '%
~ : : =
i\~ ii
le,>(4S T::>.iolfJA .~ ... '1~Of-#.... !
State of Refftfe;County of ~-;;-{..:b~de % ...~!~~~... ~
S\YOm and subscrl before me ~111!1. 12-7-~ ~\\~~
ThIs ~ of 111/11111111\1\1
V. SIGNAnJRE UNDER GATtI:
FOR CLE
Annual Registrlll:fon fee: [ Yes [ ] No Am Pal
Lobbyist Reglstrallon Form racelved and verified by:
F:\I:1..ER\$ALL\MARIA'M\LObbyIst\LOB8YIST fORM
~~~q~~:r~~i~-:. Cheryl M.C. Chudnow
;.f . . MY COMMISSION" 00087813 EXPIRES
;.~. April 14. 2006
~. " !lONDED THRU TROY FAIN rNSURANC~ INC
Date Pai
Revlsedl2/08/04
"
lV. DISO.OSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURl.Y,
FLAT RA~ OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) Hourly $315.00;hour
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly
$315.00;hour
The following Information must be answered:
1) Pursuant to Miami Beach City Code SectIon 2-488 Entitled .Prohibited Campaign Contributions By Lobbyists
On Procurement Issues.:
o Yes l!I No: Are YOU IobbvinG on a oresent or oendlna bid for aoods. eaulDment or services. or on a
Dresent or aendina award for aoods. eauiament or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues.:
nYes 'KNo: Are you IobbvinG on a oendinG aDDlication for a DevelDoment Aoreement with the City or
aDDllcatlGn for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use
MiRl
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in SectIon 2-481 above) who only appears as a representative of a not-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
o Yes 1lI No: Are you reDresentlno a not-for-Drofit mrDoration or entity without soed.1 comDensatlon
or reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
SfATEMENT UNDER OATH, USTlNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A SfATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
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 Prlndpal/Client: ~~ ~
VI. LOBBYIST IDENTIFICATION:
o Produced ID
Form of Identification
PRINCIPAL IDENTIFICATION' ~,\\\I"lil""""
. ~",~ \'I. R08/~, Iii;.
~\.~\. "",' 'Y'p...:v'.sQ~~
P d ced ID s '-'0;- .- 1\1 U,rr.-. ;i'.:
o ro u ~ ,..~,\.... a('. ~
Form of IdentiflCatk!P ...~~i'>... ~
~ersonally known (Principal) ~ { ,~ ]~
~ ...cJl~ ~~... i
~ .. !eOF\~I- .. ~
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State of Florida, County of Miami-Dade '/i11f,f,:r,-7.2OO1,,\I""""
Swom and subscribed before me _1-0."'- filII
This day of . 2~
I
bllc Notary - State of Florida
of Prlndpal's signature
o Personally known (lobbyist)
VII.
SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to and subscribed before me
This day of . 20_
Signature of Public Notary - State of Florida
Notarization of lobbyist's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR #
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\lObbyIst\LOBBYIST fORM OS.doc
Date Paid
Revised 12/08/04