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Clifford Schulman/PMG Collins IIlIIllmI _n ~'W 1003 m - City of Miami Beach ~~(g1f!~~l<i!D=lerk 1700 Convention Center Drive, Miami Beach, FL 33139 OS AUG I 8 M110: 4 I LOBBYIST REGISTRATION FORM .... , . . I '~',J' (' 1"'1';;F ICE .i; 1 i,Lf C'q\ J.:...1.I v Lobbyist means all persons employed or retained, whether paid or not, by if 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 tenn "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435. Schulman Clifford A NAME OF LOBBYIST: Greenberg Traurig BUSINESS NAME AND ADDRESS 305-579-0613 TELEPHONE NUMBER: (Last) (First) 1221 Brickell Avenue, Miami (Number and Street) (City) 305-961-5613 FAX NUMBER: FL (State) (M.I) 33131 (Zip Code) schulmanc@gtlaw.com EMAIL: I. LOBBYIST RETAINED BY: PMG Collins, LLC NAME OF PRINOPAL./CUENT: Property Markets Group BUSINESS NAME AND ADDRESS 5 East 17th Street (Number and Street) New York (City) NY (State) 10003 (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Bruce Goldstein · IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: , Planning Approvals Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Design Review Board Board of Adjustments Planning and Building Department IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $500.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $500.00 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 lX No: Are YOU lobbyinG on a Dresent or oendinG bid for GOods. eauiDment or services. or on a Dresent or oendinG award for Goods. eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes IX No: Are you lobbyinG on a oendinG aDDlication for a DeyeloDment AGreement with the City or aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use .MiR1 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.. D Yes ~No: Are you reDresentinG a not-for-Drofit corooration or entity without sDecial comDensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1 Sf 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 REPOR'lING PERIOD. L C 1 0----. ~gn~re of Lobbyist I do solemnly swear that all of the fo going facts are true and correct and that I have read or am familiar with the provisions contained i ect' n 2-482 of the Miami Beach City Code and all reporting uirements. ignature of Lobbyist: LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: :g It) o ('oj iL: ~ - ...... o .., Q) 0 -NOCO .l!lQ)c:~ (I) CL 0 (.) 0._ =-':gM & ~E~ ~78l3 .m.~ <->.!::; oro>.Q. Z:2':2'.n ] Produced ID D Produced ID .=:: V) 00 . &J~8 ~ O~N . ~8~~8 ~ > .~ en g ~'i'S .;l'131 .. <<:8'8 c:8 cu.~ ~ u s::l .....;;1 s::l ..... lil cu _~ ';:l ~8~ <( .>>' . "~ ;)"'~~ \.. 4IlfJ:~ "o",.s'I~ Form of Identification /perSOnallY known (Lobbyist) Form of Identification [~aIlY known (Principal) I. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This \ ~ day of >-J ~ 20-ill State of Florida, County of Miami-Dade Sworn and subscribed before me This ~day of 7Tl/~Y .20-.1l5 . J;;~~ Signature of Public Notary - State of Florida Notarization of Principal's signature ,\\\l~'~", ,'..:Y. . . . !Iv- 2!Y-'fP' '.~~ -"'" ...- ~:..' .:al '<~""'~" """/I~I~\" FOR CLE Annual Registration fee: )>< ] Yes [ ] No Amount Paid Lobbyist Registration Form received and verified by' F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 . oc Revised 12/08/04 K'~SE ONLY r"'hQL("..d. - MCR # "'-- .,- u.tr'-'\ Date Paid E3 NB/oS .