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Andrew Frey - Gaston Safar ~a~ 27 as 06:01p Gs 6172673686 p.2 Mt:r.'r-i Br;)ch ... .J1O>-'" ~~"J;.,.';"-" qup & - - ..:1JU~ City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL.33139 LOBBYIST REGISTRATION FORM Lobbyist means an pe~ns employed or retained, whether paid or not, by a principaL who seeks to encourage {\'Ie passagE!, defeat or modiflGltlon of iJnf orlfmance, resolution, action or decision of any commi$SlOner; anv action, decision, recommendation of lhe City Manager or any city board or committee; or any action, decision or recommendation of any dty pe~onnel during tile time period of the entire cIeCisIon-maklng process on such action, decision or recommendation that li:Jreseeably will be heard or reviewed b"l' the city commission, or a dty board or committee. The term specifically Includes tl"oe principal as well as any employee engi1ged in lobbying activitles. The term -LobbyistsW lias specifiC exduslons. Please refer to Ordin31'1Ce ~004-3435. NAME OF L086YISi: 2 south Biscayne BUSINESS NAfolE AND ADDRESS (305) 376-6069 TELEPHONE NUMBER: FREY, (Last) ANDREW {First} vL (State) (M.l) 33131 (Zip Code) Boulevard, suite 3400 Miami, (Number and street) (City) (305) 376-6010 FAX NUMBER.: FL afre~ gunster.com EMAIl: I. L08BYlST RETAINED BY: Gaston Safar NAME OF PRINOPAl/CUENT: Miami Beach, LLC BUS!NESS NAME AND ADDRESS (857) 891-4262 TELEPHONE NUMBER: 132 Newberry Street (Number and Street) (City) (617) 267-3686 FAX NUMBER.: (Optional) Boston, ~m 02116 (Sl<Ite) (Zip COde) gast.onsafarC)). earth1.ink. net EMAll: (Optional) Fill out this section ifprincipaf Is OJ Corporation, Partnership or Trust [Section 2-482 {e)l NAME OF OlifF OFFICER, PARTNER, OR BfNEFlCIAAY: Gaston Safar I I IDENTIFY ALL PERSONS HOLDING, DIREcn.V OR INDIREC1l.Y. AS% OR MORE: OWNERSHIP INTEREST IN SUCH I CORPORATION, PARn~fRSHtP OR. TRUST: Gaston Safar 60%; Alexander Sa far J 0% ; ~oelle Safar 10%: Allison Safar 10~; stephane Safar.10~_ II. SPECIfIC LOBBY ISSUE: Dispute reaardinCT access across a city parcel. Issue to be lobbied (Oescrille In dera;l): m. CIlY AGENCIES/INDIVIDUALS TO BE LOB BlED: ! I ~ I I i A) Full Name of Individual/Title ! B} Any Financial, Familial or Professional Relationship Ci ty L"lanager No planning Eoard No OS/27/05 FRI 17:52 [TX/RX NO 8145] Aa~ 27 05 06:01p Gs 6172673686 p.3 jl~ c u..~~~ ...i:- ~ 'Is 1- ~ OSlO:!: >-s 0- Z 11>' .. ~ <, e;:l ~~I.;~ >~. .!!,?;' i:-.~"2 .!!J.3a~ ~~t.)~. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYlST COMPENSATION (DISCLOSE WHETHER HOUR! ~ FLATRATE OR OTHER): A) LOBBYIST DISClOSURe: {Required} Hour I v $180.00 B} PR1NCIPAl'S DISClOSURE (OF LOB8YIST COMPENSATION); (Required). $'80.00 - hourI V The following information must be answered: 2) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": C Yes I~No: Are YOU lobbvinq on a oresent: or oendinq bid forqoods, equipment or services. or on a present 01' pendinG award for GOods. eaU;Dment or senrlce? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By lobbyists On Real Estate Development Issues"': nYes Xl No: Are YOU lobbYinG on a PendinG 3DI)Iication fol' a DeveloDment Aaree7;:.nt w: the City or ~'p'Dlication for chanGe of zoninG map desi~nation or chanoe to tI1e C:_'s Fu_1'e ~nd Use :-~4I..; -;; 3) Pursuant to Miami Beach City Code 2-"184 (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 tor the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the derk as required by this section but, shall not be required to pay any registration fees.. " Yes Xl No: Ate YOU reoresentino a not-for-profit coroorat/on or entitv wi'thout special compensation or reimbursement. V. SIGNA"TURE UNDER. OAlli: 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 CrN OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENOITURES OR COM~e"'SJ'.T!ON OU?..!NG THE REPORTING PERIOD. ~fkt. ~ W -A ~d~ I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am :;~::~:~~.the provisions ~contained in Secti~.on 2-4~82 of the Mlamf Beadl City Code and all reporting Signature of Lobbyist: 4...-" Signatu,. of P,lndpalfOi..{ _ - ~ . 111. LOBBYIST IDENT.IFICAnON: . .5 PRINCIPAL IDENTlFIC'..ATION: C Produced ID [J Produced ZD SllfUNOER SINGH fornI of IdentificatlqqOTARY PUBUC . Personally known (P~WEAlTH OF MASSACHUSETTS ~;;Y-e'C5MMISSION EXPIRES ON.10129/201 0 Form of Jdentitication lX,Personany known (LObbyist) SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Mjami-Dude SW~ ~!lc1 subscriblld Qefore me ;-- ThiS---:- q-+~ay of J'- . ZO.s.:Q .. ~ State of Florida, Countr of Miaml'Dade Swom and subsalbed before me This !1:1......day of 204S- - FORCLE~tNLY Annual Registration rr.e; [><rYes [ ] No Amount Paid _ MCR I; ~ Loate Paid I Lobbyist Registratlon Form reCl!lved and verified by; b I F:\ClER\$.AlL\MARIA.M\LobbY~\LOBBY!ST fORM Q~ Revised 12/08/04 OS/27/05 FRI 17:52 [TX/RX NO 8145J