Sandy Lane Residential LLC
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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, derision, 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 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.
MCDOWELL
NAME OF LOBBYIST:
(Last)
CARTER
(First)
N.
(M.l.)
Bilzin Sumberg Baena Price & Axelrod LLP. 200 So. Biscayne Blvd.. Suite 2500. Miami. Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-350-2355
TELEPHONE NUMBER:
305-351-2239
FAX NUMBER:
cmcdowell@bilzin.com
EMAIL:
I. LOBBYIST RETAINED BY:
SANDY LANE RESIDENTIAL. LLC.
NAME OF PRINCIP ALlCLIENT:
2399 COLLINS AVENUE
BUSINESS NAME AND ADDRESS
MIAMI BEACH. FL 33139
(Number and Street) (City) (State) (Zip Code)
305-6046796
TELEPHONE NUMBER:
(305) 747-6408
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)J
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Juda Chetrit
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
HISTORIC PRESESRV A TION BOARD APPROVAL OF MODIFICATIONS TO RONEY PLAZA
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDlVIDUALS TO BE LOBBIED:
A) Full Name ofIndividual/Title B) Any Financial, Familial or Professional Relationship
Historic Preservation Board & Staff NONE
MIAMI 884799.1 7319010200
'iv. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE
WHETHER HOURLY, FLAT RATE OR OTHER):
A)
B)
LOBBYIST DISCLOSURE: (Required)
$425.00 per hour
PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
$425.00 per hour
Yes No: X Are YOU representin!! a not-for-profit corporation or entity without special compensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2. Article VII. Division
5 Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled
"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
Yes No: X Are you lobbyin!! on a present or pendin!! bid for !!oods. equipment or services. or on a present or
pendin!! award for !!oods. equipment or service?
2) Pursuant to Ordinance No. 2003-3395 Amending Miami Beach City Code Chapter 2. Article VII Division
5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled
"Prohibited Cawaign Contributions By Lobbyists On Red Estate Development Issues":
Yes No: X Are yOU lobbyin!! on a pendin!! application for a Development Al!reement with the City or
application for chan!!e of zonin!! map desi!!nation or chan!!e to the City'S Future Land Use Map?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECED CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDI S OR COMPENSATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist:
egoing facts are true and correct and that I have read or am familiar with the
of the Miami B c ity Code and all reporting requirements.
I do solemnly swear that all of the
provisions contained in Sectio
Signature of Principal/Client:
VI. LOBBYIST IDENTI
o Produced ID
Form ofIdentification
~ Produced ID ILls f) fL-wr &5 L. ,LeN S~ II,)
Form of Identification
g/. Personally kno"vn (Principal)
~ Personally known (Lobbyist)
State of Florida, County of Miami-Dade
SWOfll to and subscribed before me "...
ThiS1~~~f~ ,20~
Si ida
No
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This Ll day of A!//?Y ,20 tJS-
MY COMMISSION 1/ DD 113548
EXPIRES: May 18, 2006
Bonded 111m Pichard Insurance AI:JerCf
FOR CLE
Annual Registration fee: es [ ] No Amount Pai
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER\ALL
ONLY
McI&11Wnate Paid
~LOBBYIST\LOBBYIST FORM 04