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Greater Miami & The Beach Hotel r.1'l'>ITIIIl"...;h t:rt!td ~iiP ro - 2OU3 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 prindpal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or dedsion of any commissioner; any action, dedsion, recommendation of the aty Manager or any dty board or committee; or any action, decision or recommendation of anY' dty 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 city board or committee. The term spedfically indudes the principal as well as any employee engaged in lobbying activities. The tenn "Lobbyists" ha~ific exclusions. Please refer to Ordinance 2004-3435. 'c. / ROSEN HAROLD , NAME OF LOBBYIST: (Last) (First) 3 (M1;!) 9 407 LINCOLN ROAD PENTHOUSE S.E. MIAMI BEACH, FLORIDA 3 3 BUSINESS NAME AND ADDRESS (Number and Street) (305) 534-4757 (aty) (State) (305) 538-5504 (Zip Code) TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: GREATER MIAMI & THE BEACH HOTEL ASSOCIATION, INC. NAME OF PRINCIPAL/CUENT: 407 LINCOLN ROAD SUITE lOG MIAMI BEACH, FLORIDA 33139 BUSINESS NAME AND ADDRESS (305) 531-3553 TELEPHONE NUMBER: (Number and Street) (aty) (305) 531-8954 (State) (Zip Code) 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: STUART BLUMBERG · IDENTIFY ALL PERSONS HOLDING, DIRECTlY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: ORDINANCE REGARDING NOISE AND ,HOTEL USE Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title PLANNING iBOAiID'lOC ."',"~ ::. I 8':".,;-,,3 B) Any Financial, Fam~iILw.Rmf_JRnfJ"~!!!!!2nshl : 01-'\-'0 AR r' ~ :'1':':0(;)::: ilI~w",.:J l". ,< ,. t .J..~- ,_ '"j CITY MANAGER IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER I-IOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $O.OO/PRO-BONO B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $0.00 /PRO-BONO DYes Q{No: Are YOU reDresentina a not-for-Drofit corDoration or entity without sDecial comJensation or . reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Article VII. Division 5 Thereof Entitled "Camoaiqn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issues": No: 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions Bv Lobbyists On Real Estate Develooment Issues": DYes ~ No: Are YOU lobbyina on a Dendina aDolication for a Deyelooment Aareement with the City or aoplication 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, 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 EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD. /~. y' '/",,/1 ./ / ---t'/ L..--' I do solemnly swear that all of the foregoing cts are true and correct and that I have read or am familiar with the provisions contained in Se n 2-482 of the Mia . Beach City Code and all reporting reql,Jirements. Signature of Lobbyist: Signature of Principal/Client: VI. D Produced ID D Produced ID Form of Identification Form of Identification lY'6ersonally known (Principal) W Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn .to and sUbsc~efore me . This \<1'; day 0 '^~ 20Q5 %~ ~ ~ C!:lNID Signature of Public Notary - State of Florida Notarization of Lobb . . ture LAUM CANO ~ Cornmtl 0D02I0111 . ,~.., . ~.... expn. 1/1312008 : Ii' ~$ Bonded thN (800\432-4254i : ~Ofl\~~ FIoridli Notary Assn,. Inc . i....::~~,~'........ ...... ... ........ I'" ......1 State of Florida, County of Miami-Dade Sworn. and sUbSCr~before re _ This l~c!l:u;:~ Signature of Public Notary - State of Florida Notarization of Principal's sianature re-""-I""'-'''' LAURA CANO : , CornmlJ 000280111 5 expn. 1/1312008 : - -...-! i......!:.........~.~.~....I~.i Annual Registration fee:.. ] Yes [ ] No Lobbyist Registration Form received and verified b Revised 02/10/04 · ~ONLY" . . i2) ! MeR # C 7C) lpate Paid 7- q, tsr : CLER ALL\MARIA-M\LOBBYI5T\LOBBYIST FORM 04