Moore Regina B/Pedro Pablo Pena
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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 dedsion 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 defined in any
manner In this section, 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 dty commission, or a dty 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.
BUSINESS NAME AND ADDRESS
~Oj~
(First)
M I ~l tft ~ Pm.J\ C ~LG\ l>>J.f. 900 c;u) {~ ~,
(Number and Street) (City)
;?oS' ~ 919 1-1-:t I
FAX NUMBER:
h oot.k:
(Last)
1>
NAME OF LOBBYIsT:
(M .I)
H.O\+.U I PL. '3 ~ ~
(State) (Zip Code)
~M-LE\@.~~' ~
EMAIL:
t2..e-SI~6l'Vl~ ~~. ~
305 - 51jCJ -=t-~ 11
TELEPHONE NUMBER:
I. LOBBYIST RETAINED BY:
~0 f'kBLO f~ A
NAME OF PRINCPAL/CUENT:
k ( Prlvt ( fu ~ t? Atv \. c..-
BUSINESS NAME AND ADDRESS
i?-Pt.tE1- {f)pf~ 9oo$W {~ sf l ~ (R- '"33/~()
(Number and Street) (City) (State) (Zip Code)
315 - 549 =t::r1" I Itfu.{~ e .QQI\.({...fk.k - ~
FAX NUMBER: (Optional) EMAIL: (Optional)
3J:i) - ':>LJ0Ci:t1.1
TELEPHONE NUMBER:
Fill out this section If principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPEaFlC LOBBY ISSUE:
Mf~r ~ VL~~& COtJ\J~O~ ~1"Y C>>LiUUci- frF>F*t~SP(lo~P-Pr+1
Issue to be lobbied (Desoibe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional RelationShip
J..1 C ~ e,~ vCA- ~AtJ~ /V(A-
., .' .,
Grty \SIP H I A-M \ ~<A- ~ L-1V~ I\PPPrtt
p ('(;(;. (2. A-M. kt-J-E..-L.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) f.J ( p.... (A: tJO\ ~ft. PPo Pt T 0 ~ PrM ~\\ 0 '-J )
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). tJ I A
~es 0 No: Are YOU reDresentina a not-for-Drofitcorporation or entity without sDecial comJensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1)
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaian Contributions BY Lobbyists On Procurement Issues":
DYes [J(iio:
Are YOU lobbyina on a Dresent or Dendina bid for aoods. eauiDment or services. or on a Dresent
or pendina award for aoods. eauiDment or service?
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaian Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions By LobbYists On Real Estate Deyelooment Issues":
DYes ~o:
Are you lobbyina on a oendina aDplication for a DeveloDment Aareement with the City or
aDDlication for chanae of zonina maD desianation or chanae to the City's Future Land Use MaD?
v.
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING 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.
PRINCIPAL IDENTIFICATION:
D Produced ID
[J Personally known (Lobbyist)
Form of Identification
~sonallY known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to a!W SUbSCribe~me __
This y of . 20~
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State of Florida, County of Miami-Dade
Sworncr.PR subscribed before me S"
This ....:.!..:.-day: of M~ , 2 .Q.
Sign~IIC Notary - 5 to o~ Rood.
Notarization of Principal's i9nature
'" Eileen MOna
.~ ",;" My COIMIlIIlIn De251173
. ... E~ Odober 1'. 2017
FOR CL~I\K'~U~~9NLY "-bY\_. ~f\L
Annual Registration fee: K] Yes [ ] No Amount Paid\.b~~ MeR # 2. -=tC.tf9 Date Paid -:1\ IGos
Lobbyist Registration Form received and verified b'(= ~~
Revised 02/10/04 F':CLER\ALL\MARIA-M\LOBBYIST\LOBBYIST FORM 04