Dougherty Lucia/Charles Dascal
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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 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 city board or committee; or any action, decision or recommendation of any city 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 city board or committee. The term specifically 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 Traurig
BUSINESS NAME AND ADDRESS
305-579-0603
TELEPHONE NUMBER:
Dougherty Lucia
(Last) (First)
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:
Charles Dascal
NAME OF PRlNCIPAl/CUENT:
BUSINESS NAME AND ADDRESS
1500 Daytonia Road
(Number and Street)
Miami Beach
(City)
Florida
(State)
33141
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
U. SPECIFIC LOBBY ISSUE:
Planning Board - Dock Issues
Issue to be lobbied (Describe in detail):
m. CITY AGENCES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Indlvldual/llt1e B) Any Financial, Familial or Professional Relationship
Planning Department
Planning Board
Building Department
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B.
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOIJRL Y,
FLA T RA TE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required) $480.00 Hourly
B) PRINCIPAL'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":
D Yes ~ No: Are yOU lobbvina on a present or pendina bid for aoods, eauipment or services, or on a
present or Dendina award for aoods. eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes t!{ No: Are you lobbvina on a pendina application for a Development Aareement with the City or
application for chanae of zonina map desianation or chanae to the City's Future Land Use
Map?
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..
DYes \}tNo: Are you representina a not-for-profit corporation or entity without special compensation
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 E~PEN TURES 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 co . ed in Sect,ion 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
VI.
. ~~ IPAL IDENTIFICATION:
}i{Produced ID ffa..J)Y'I~(S l/(linCl C~ l04d 'dsqa-01D
Form of Identification
D Produced ID
Form of Identification
.kt Personally known (Lobbyist)
C Personally known (Principal)
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VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
9Nom~ :~.Jl5 __. (
This
Signature of Public Notary - State of Florida
Notarization of Principal's signature
ature of Public Notary - State of Florida
Notarization of Lobbyist's signature
FOR CLERK'S U~ ONLY
Annual Registration fee: [)4' Yes [ ] No Amount Paid 52&. MCR #
Lobbyist Registration Form received and verified by: ~ ~~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM O. c
2-:ttoG::a% Date Paid 4J2!5/otj
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Revised 12/08/04