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Dougherty Lucia/Fisher Isl Hldg .J J-' -- Miami lIcKh '"' ~D3 in - - 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 of any commissioner; any action, decision, recommendation of the City Manager or any dty board or committee; or any action, dedsion or recommendation of any dty personnel during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a dty board or committee. The term spedfically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: Greenberg Traung BUSINESS NAME AND ADDRESS 305-579-0603 TELEPHONE NUMBER: Dougherty Lucia (Last) (Rrst) 1221 Brickell Avenue, Miami (Number and Street) (City) 305-961-5603 FAX NUMBER: A. (M.I) FL 33131 (State) (Zip Code) dougherty1@gtlaw.com EMAIL: I. LOBBYIST RETAINED BY: Fisher Island Holdings, LLC NAME OF PRINOPALjCUENT: BUSINESS NAME AND ADDRESS 305-535-6046 TELEPHONE NUMBER: 1 Fisher Island Drive (Number and Street) Fisher Island (City) Florida (State) 33109 (Zip Code) 305-535-6036 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: Cedrick Denain . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: David Aim n. bfZ m. CITY AGENClES/INDIVlDUALS TO BE LOBBIED: A) Full Name of Individual/lltle B) Any Financial, Familial or Professional Relationship Planning and Zonning Department Building Department "., ..... .- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOllRL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $480.00 Hourly B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $480.00 Hourlv 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": DYes 13 No: Are YOU lobbying on a Dresent or Dending bid for goods. eauiDment or selVices. or on a Dresent or Dendina award for aoods. eauiDment or selVice? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes IK No: Are YOU lobbyina on a Dendina aDDlication for a DeyeloDment Aareement with the City or aDDlication for change of zonina maD designation or change to the City's Future Land Use HmZ 3) Pursuant to Miami Beach aty 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.. DYes li:No: Are you reDresenting a not-for-Drofit corDOration or entity without sDecial comDensation 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 ~nON 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 ion 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDE .cooofnsr<< 1-sICtld ~t9~LLC o Produced ID o Produced ID ~....""'.""'''''''''''''..............I Form of Identificationl CATHERINE', COLONNESE : ea..nt DOO283317 E tJ Personally known (Principal) (ft. g............~ 112!J2OO8 E f\ ~" __lhru (800)432-4254: ~~ Florida Nola", Assn Inc : .............................." .~,. ~ "<l' to; ~ll ~...l: ...s .... ~n 0\ fJ.'J.W '.. ~~I 'A." Form of Identification ~ersonallY known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: W~~~ l2 (") iij' 6l" ;;l 0 ' -< <n3'--u ~~ ~' ! ~ (5" 51 ::>lISen gN~ ~ ~ ~ <5" r1l ~ FOR CLERK'S .Y!,E ONLY Annual Registration fee: rnves [ ] No Amount Paid 25 MCR # ~1f.,.fD'"PI. Lobbyist Registration Form received and verified ~~ F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fOR . DC Date Paid ~ Revised 12/08/04