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Louis Terminello/Nero Enterp ~........ Ilr:-.'\f,ll ~ rqiTi m 2(IU3 - 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 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. Termine 110 NAME OF LOBBYIST: Louis J. (Last) (First) (M .I) 33133 (Zip Code) Termine110 & Termine11o, P.A., 2700 S.W. 37th Avenue, Miami, FL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (305) 444-5002 TELEPHONE NUMBER: (305) 448-5566 FAX NUMBER: Ijt@terrnine11o.com EMAIL: I. LOBBYIST RETAINED BY: Nero Enterprises Gro~p, LLC NAME OF PRINCIPAL/CUENT: INK MIAMI 717-721 Washington Avenue, Miami Beach. FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 444-5002 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] .. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: rn~ C.. ~ f ~ \" J?<I ~. J- r fJldllll. t.t'J? Co .. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: J II. SPECIFIC LOBBY ISSUE: V~CL Issue to be lobbied (Describe in detail): YlAI f- III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: &.h;~ ~ rA.- ~ h-I</hA. ;, ~ . L __ r.,~ r/~ ~.A-L;, ~ .J<JA tc, (~J (1, /1) hl.l,l.J B) Any Financial, Familial or Professional Relationship . IV. UI:>>l;LU:>>UKt: Uf TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL~ FLA T RATE OR OTHER): B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ /CJ/ v-rJ ". A) LOBBYIST DISCLOSURE: (Required) .. W/d,nrJ . 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5 Thereof Entitled "Camoaian Finance Reform" Via Th Addition Of Code Section 2-488 Entitled "Prohibited Camoaign Contributions Bv Lobbyists On-Procurement Issues": 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled "Campaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions B Lobb ists On Real Estate Develo ment Issues"; 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 EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. <t....--... 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 contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. ~.._____ Signature of Lobbyist:_ ~ Signature of Principal/Client: -----------.-:-- ~--::::::::::- ~..-::::--- VI. LOBBYIST IDENTIFI~~':: o Produced 10 L!. Form of Identification PRINCIPAL IDENTIFICATION: o Produced 10 Form of Identification obbyist) /(personallY known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: :-.. Signature of Public Notary S of Florida Notarization of Lobbyis '5 ture ~"\~~}~;'-"" qtannin! M zaga :: ~.' ~ '.'f, ':. C - . , # DD3-D24- : . : ~ '. .: OIllllllSSlon :):) ~~~. ..:.~:lE1.pins: AUG, 26,2008 ".,;~ 0'.' ()V,,' ""'~Ir.;\\ W\liW .A\RosN OT.-\RY,com ~\\\,"III"""'II. 1\1 ~ ~II..: Signature of Public otary - State of FI ..........~e,~ ., ..~ ..:('\~"'ISSI04tR~..XO.~ Notarization of PrinCIpal 5 signat~ V'" '1:. ~_ ~ l~ '<.~~ary 6, "''l> ~\ 'i =*: (pm: = =z:, .... :*= i~~ #00281401 ;~~ ~-~.~ &_. .~;::: ~ ~..~~.Q."'1l1ed\ll1\l ~,<t'... ~~ - '" ,0,. ..~ublicUnde~... <~* ~ v8/ .......0<;;" ~ '11111~C, STA~ 1\\\\~ FOR C~ERK).'5~::pNL Y 2; . Annual Registration fee:--r-] Yes [ ] No Amount Pard MCR # :t-'1lA 12- Date Paid Lobbyist Registration Form received and verified by: ~ Revised 02/10/04 F: CLER\Ar:t'\MARIA-M\LOBBYIST\LOBBYIST FORM 04 ~