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Felix Lasarte / IHC/Miami Beach .... I.I.ilr."t1....;:... b:O:d ~iiP m ':"';\,,1; 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, by a princIpal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision or any commissioner; any action, dedslon, recommendatlon of the City Manager or any city boarCl or committee; or any action, dedslon or recommendation of any dty personnel denned in any manner in this section, during the time period or the entire decision-making process on such actIon, decision or recommendation that foreseeably will be heard or reviewed by the crty commIssion, or a city board or committee. The term specifically Includes the principal as well as any employee engagecJ in lobbying activities. The term "LobbyistsH has specific exclusions, Please r.rar to Ordinance 2004-3435. NAME Of LOBBYIST: Holland & Knight LIP, BUSINESS NAME AND ADDRESS Lasarte (Last) 701 Brickell Felix (First) (M,I) Avenue, SUite 3000, Miami, FL 33131 305-374-8500 TELEPHONE NUMBER: (Number and Street) (CIIy) 305-789-7799 FAX NUMBER: (State) (Zip Code) EMAIL I. LOBBYIST RETAINED BY: IHC;Miarri Beach Corporation NAME OF PRINCIPAl/CLIENT: 1950 St€mlOns Freeway, Suite 6001, Dallas, TeXZ;ls 75207 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) 214-863-1285 (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out thi$ section If principill is I Corporation, Partnership or Tru$t [Section 2-482 (e)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIfY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNEIlSHIP OR TRUST: II, SPECIFIC LOBBY ISSUE: Challenge to possible designation of Wyndham HianU Beach Resort Issue to be lobbied (Oescribe in detail): Ill, CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Jorqe Gamez, Director of plarmim;J,,_, None William Cary, Director, Des:i:gn, PrE ~ervation and Neighborhood Plarming D'v I llianas MJoney, Design and Preservation Manager None " ision - None H~ston,c Preservat~,on Board Planning Board - None City CammissiQn and Staff City Hanager and Staff - None None None .... IV. DDClOMIU OP'rlIRM AND AMOUNTI OF u.rtISTCOMPBlIA11OIt (NSC' ~ WHmtEllI/DtJItJ.Y, I'&A r RAn DIf t11HM) A) LOIllM5T DISCI ()SIIIE: (RlIlI....) B) PIUNQPN..'S DISQ.05URE (OF I.OIlBYIST COMPENSATION): (~ Hourly $275.00;hour IbJrly $275.00;hour 11111 fallowing IlII'onnatIon mlllt be .---: 1) Pursuant to MIIIIIII BelIch CIy Code SedIan 1-418 EnlitIIld "PIdIIbIIed Clmpllllgn QJnlr1bulIons Itt lobbyats On PnlaIrement Issus": DVM 'WI Na: Ant vaulAhhulna 8ft . ...-lIt ar ....... hid f'ar~ ...I8M-.I:............... .. DIl . ...-.t Dr IllHllllna ....... far oNAAIIa .......-..nt ftI' ......a'P 2) Plrsuant to Miami BelCh CIty Code 2-490 Entitled -PI\IlIIlJbd Campllllgn COnlrlbullons Itt I.abbyIsls On Real Estllle Development WIles": nY_ IXND: .... VDU kahlnrlna l1li . ......... .aallrMlan far. D...a.tlll'llllnl: ~t ..... at. atv at' .1IdIImtkMI1or ct...... DI mal.. .,..a dMl-..llDn Dr ma.... tit .... atv'a Futa.. Land u.. IbRZ 3) Pursuant to Mlilml BelCh CIy Code 2"*, (h) Any person (~ those ellIIlITlJlt from the defInIIon of -lobbyist" lIS set forth In SectIon 241 1Ibove) who only eppears lIS I '.... .....,tallw of I not-ror-pront c:orporaIIon or entity without spec:IaI compeIlIiIlIon or reimbursement for the IppeilllInce, whether drec:t, or Indtrec%, to express support of or opposition to II1Y IbIm, shal regIstIer wIlh the derlt as requRd by this section but, shal not be requlrwd to pIIIY II1Y F-sl1stnltIon tea. n v_I Hal ArB VDII ........~ntlna _ n~r-IH'DIIt: aM IIftIwIIen Dr.ndtv.dlhnut .~I ftIftI.....-tInn or ..1m............... . V. SlClNAlURI! UNDEIt OATH: ON OCTOUR lIlT OF EAOt YI!AR. I!AOt LOIBYIST SHALL SUIIMIT 10 THI CRY C1I!ItIC A SlGNm STATEM2NT UNDER OATH, USTING LOBaYDIG EXPINDITURB, AS WB.L AS COMPINSATION RECEIVED, IN THE CJTY OF MlAMlIII!ACIl FOR 1HI! PRECIDDIG CALl!NDAR YEAR. A STA'lEMENT SHALL lIE FILED EVEN IF THERI HAVE RI!N NO~OR~ DURDIG THE UPOIUINGPERlOD. ~ ~ / d_ I do solemnly swear that all of the foIegolng fads are and correc.t I have read or am familiar with the provlslons contained In Section Z Miami COde and all reporting requirements. SIgniIture d lobbyIst: Signatll'e of PrlndpalfCI\ent: VI. LOUYISI'IDINnFlCA11OIt: o Produced III PRINCIPAL .""", ar&CA11ON: ~\\'\l"""I/~~Jj o Produced III ~~'(. \'.. R08li1!~ Form of ldentJfIcatlon #~~(~Vi>(;;:W% :F J'''tl'*'tl.. ~ ~ - . . - Iy known (Prlndpel) ~: : ~ - . . - - . . - i:".~ ~;i ~ .. 4f~Of ... ~ '\ ...~IR€.. ~ State of FlorIda, County of Mlaml-Dede ~ 1........ ~ sworn and sublal me ~'"", 1?'7.~ """. lIaY of "IImll\l" Form of Idenlifk:atton ~ Personaly known (I.obbrIlIt) _ Roopl>.IIu.' rea: ) Yes [ ] No labbylot LyIoL.tb, farm recoIved lIIId verIled br: F:\C1ER\$AU.\J'WlL\-M\LObbYIIt\l.O l'ORM 0 o.te ""Id RftIIed l2/O8/04 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOURL Y, FLA T RATE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly $275. OOjhour Hourly $275.00jhour The following Information must be answered: 1) Pursuant to Miami Beach City Code Section 1-488 Entitled "Prohibited Campaign Contributions By lobbyists On PrOOJrement Issues": o Yes 111 No: Are YOU lobbyinG on a oresent or _ndlnG bid for aoocIs. eauloment Dr ..rv!...... or on a Dresent or aendlna award for GOOds. eauioment Dr service? 2) Pursuant to Miami Beach City COde 2-490 Entitled 'Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes IXNo: Are you lobbyinG on a oendina .oollatlon for a Develooment AGreement with the CItv or aooliClltlon for chanoe of zoninG maD deslonation or chanGe to the City's Future Land Use HARZ 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.. n Yes ~ No: Are YOU reDresentina a not-for-Drofit coraoration or .ntltv without .DeC... aHIlDensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST 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. 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 IDENTlFICAnON: o Produced 10 o Produced 10 ,,\\111111111111/// ~,~~ ~;~qP!-1'%II/~ ~ ~,:..~~~y PU8..~4'% ~ .~(;)*\:'0. "" ~ ... -. ~ ~ ~ ~ ~ ~..r.P/: ~:~ ~ -.. 4"cOF~~ ... ~ ~... ....~XPIRt.~.... ~ '';:; ...... i::-'" "III/ 72'7,2fjSl """ /1/11/111111111\\' PRINCIPAL IDENTlFICAnON: Fonn of Identification Fonn of Identification ~rsonally known (Prindpal) o Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of . 20_ Signature of Public Notary - State of Rorida Notarization of Lobbyist's signature FOR CLERK'S USE ONLY Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # lobbyist Reglslralion Fonn received and verified by: F:\CLER\$ALL\MARlA-M\lobbyist\LOBBYIST fORM OS.doc Date Paid Revised 12/08/04