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Cesar Molina/Altos Del Mar Ltd ~ Apr 07 05 02:53p , Wi 2il1l3 AIf!'Xander I. Tachmes, PA (305) 350-1890 p.3 '\ lQ City of Miami Beach Office of Ule Oty Clerk 1700 Convention Center Drive, Miami Beach, Fl33139 LOBBYlSI' REGISTRATION FORM - Lobbvlst means all persons employed or retained, whether paid or not, by a prfndpaI who seeks to encourage the passage, defeat or modlficatlon of any ordinance, resollJtlon, action or dedslon of any commfssioner; any actIon, decision, recommendation of the Cty Manager or any city board or committee; or any aCljon, dedslon or recommendation of any dty personnel defined in any manner In this section, during the time periOd of the entire deciSion-making process on such actlon, dedsion or recommendation ttlat foreseeably will be heard or reviewed by the city commlssJon, or a dtv board or commIttee, The term spectfiC2l1y IrlCJudes the prlndpal as well as any employee engaged in lobbying activities. The tenn "Lobbyists'" has specific exdusions. Please refer to OrdInllnCle 2004-3435. NAME OF LOBBYIST: b.o~~ "'.... -. No..rC:"s..r.e BUSINESS NAME AND ADDRESS 'B ., 'i' -c.{. q. fj - rf ~ n TELEPHONE NUMBER: ;V\. 0 ( '"lit A. c...~ S t:..-t... (last) (F~ , 0 , :t:V\c.. . ..2~.;l.AKJ.A{&c.${'" .~~ ~i"""( Number and Street) (Cfty) 3D~q.If~.. IfJ/!J- FAX NUMBER: A" (M.l) ~i. L, s Fl. ~ , 7 (State)' (Zip Code) C c!'S 4.... (p JI1 na. rc.L.. ;t~ '- 0 ~ EMAIL: I. LOBBYIST RETAINED BY: AL Tc>S NAME OF PRlNClPAL/CUENT: bEL H A-f{, L Tl::l . ,4.liw\ 0...1 f'f._. I-t.J.. BUSINESS NAME AND ADDRESS 3(J ~-.... .2 G- ~- (,5'3? TELEPHONE NUMBER: ~ ~5"~ su) f--PlStvu.'f '23'r, , (Number and Street) (atv) 1'11~'M{ , p" '3? 1(/..,/ (State) (Zip Code) 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, OR BENEFICIARY: A if t.( sf.; '" 4 L of' V" A. l"\ · IDENTIFY ALL PERSONS HOLDlNG, DIRECTlY OR INDIRECTlY, A. 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Se.L t. IC- ~ .-b,'T "A I ItA. t+li.c...L..c...R.. hL\"L-h ~ ",.Q. l~(.....Q" llr...'T'.c...Q ~J1rt. i.... SPEClFICLOBBYISSUE: 7P"3 ~ e../I/J'fS ,4.i~j'.c..u.. hj.)I(~h:"" -M J.1,";"'I\;, t7Y'UMII'c.k,'_ ~'A.n( ~'1. d..z 1-,-1,;""<...,..( "t' .1,."0; r'L~~~ Issue to be lobbied (Describe in detail): II. m. CITY AGE NOES/INDIVIDUAlS TO BE LOBBIED: A) Full Name or IndiVidual/Title A....... l A-iA4 i 'ft, 1 fr... 4-t '01'\ "I'\~o(', 0 f-fi,c ",111...., B) Any Financia', Familial or Professional Relationship .11 ..... '50S I (j'1J c;., { c... ~ fA.y~ S ~ lOne- .e. 'If..-l-a..,, t- tu 1\ 1M : ~ s.l..", f'DnL no rte:-- Apr 07 05 02:53p' AIe'J{ander I. Tachmes, PA IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): ( "\ A) LOBBYIST DISCLOSURE: (Required) t=t:::tt.ec=..t re.- l Q'n'E) ~ B) PRINCIPAl'S DISCLOSURE (OF LOBBYIST COMPENSATION): (ReqUired). ~ 4-0 I r::xx:J , .. ~ Yes ~,::,:~~ rearesentina a not-for-arofit corDOl"ation or entity without soelia. :o~oensation or ----=- _____ Pursuant to Ordinance No. 2004-3435. (305) 350-1890 p,4 1) Yes No: / I 2) Yes No: I ( v. Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach aty c:: Ch~~ 2. nArti~e VII. D~v;:~on 5 Thereof Entitled "Camoaian Rnance Refonnn Via The Addition Of cOde 5 'on E tiU "Prohi it Campaign Contributions By Lobbvists On Procurement Issues": :~U.~b::;n:::. on a :res:~ or.oendinG bid ~r Goods. eauioment or services. or on a Dresent or Dendlna awa.rd for GOods. eaUIDment or saMCS? Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Charlter 2E:e ~~n 5 thereof Entitled "Camoaicn Finance Reform". Via The Addition Of Code Sectlo~ 2=490 . d" 'b' Camoaign Conbibutions By Lobbvists On Real Estate Development Issues": Are YOU loblwina on a oendina aoolication for a DevelODment AGreement with th:. c:" u: aDDlication for chctnae of zonina maD desiGnation or change to the City's Fu~~ _n__ MaD? SJGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR,. EACH LOBBYIST SffALL SUBMIT TO THE CITY CLERK A SIGNED SfATEMENT UNDER OATH, USDNG 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 EXPENDnuRES OR CO ENSAnON DURING THE REPORTING PERIOD. I do solemnly swear that all of the foregoing facts are tnJe 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/~I:~C. ~~ VI. LOBBYIST IDENnfICA110N: [l Produced ID PRINCIPAL IDENTIFICA110N: -I () y, -r,,)/JO_t;~~-&/.rd93-O f Produced ID rf",~ ~ / (TV Form of IcIentification Form of Identification ~ Personally known (Lobbyist) VIL SIGNATURE AND STAMP OF NOTARY: CJ Personally known CPrln . ::f~.. KERRY HERNANDEZ f,,: ..;>;. MY COMMISSION # DD 175491 ~i". : ,i EXPIRES: May 3, 2007 "'/'~,9f,. Bonded Thru Notary Public UndelWriters State of Aorida, County of Miami-Dade Swor~d SUbsc:ribt.f,efot.e me This rr- day of 'f, ( . 200~ ~~B- ~ Signature of Public Notary - State Of Aorida Notarization of Lobbyist's signature ~~ DMf ~ ,)I; My~IiWvn~ ..." e.,.. A..- 06, 2001 FORCLE~NLY !l.77(,lQ AlVlUaI Registration fee: [ Yes [ ] No Amount Paid. MeR # . Data Paid Lobbyist RegIstration Fonn received and verified by: Revised 02110/04 F: Q.ER\ALL\MARIA-M\lOBlNlST\LOBBYIST FORM 04