Thomas Daly TRG Alaska I & III
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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 aU persons empI~ or retained, whether paid or not, by a principii who seeks to encounI04I the passage, defeat
or modification cI any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
CIly Manager or any city board or c:onvnIttee; or any action, decision or recommendation rI any city personnef 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 c:ornmssion, or a city board or committee. The term specifically Includes the principal as well as any employee ~
in lobbying activities, The term "Lo..,." ........1fIc exclu8lon.. Plea.. refer to Ord....nce 2004-3435.
::tJAJy
NAME OF L08fMST: (LaSt) (First)
7he. JJevejt::J Jlm t!.,,-t. (],rD~ IV)" A ~
'I) ::Lnc... 1~'9 ,'ce 1l),~A) Ve.. 'Yf"9c
BUSI SS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) t,?c1- 131 0 (,305 )~':I-S>OIt/ -i:DMdt'4/~~;~~ d~ve~p~nVM'{PPI, I! IJ)YJ
TELEPHONE 'NUMBER: FAX NUMBER: vEL:
~mAS
F-
(M.I)
I. LOBBYIST RETAINED BY:
NAME OF PRlNCPALlCLIENT:
"1'JtG- AJaaJca....z; u..c...
~.. A/a S~A. 'tIL, t....c...C,
7l.td.. ~Dd<. ~^f6U::.d
BUSINESS NAME AND DRESS
(.dOS) u':1-lJ-R3ID
TELEPHONE NUMBER:
J('~R meit.JtH'~1V Ave... -I: 9() "-,
(Number and Street) (aty)
(305')l.10'/- ~OJtf
FAX NUMBER: (Optional)
m,c.mi J3e~, FL 3~/39
(State) (ZJp Code)
EMAlL: (Optional)
FIR out this lIed:Ion If principal Is a Corporation, Partnership or Trust [SectIon 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. IDENTIFY ALL PERSONS HOLDING, OIRECTL Y OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
1:JJOcJc. .t.) 5.1. 4 t')d. 5;t) Ala..slca./ (Joodm~A) / J+,n,stJ/'J 'PArct/6 J $l>tJ!:A 'Pe)Ji>k.. 'i?4h/~
Issue to be lobbied (Describe In clemU):' .
m. em AGENCII!S/INDMDUALS 10 IE LOBBIED:
A) Full Name of lndIYIdual/Tltle
B) Any Runelal, FamHlal or Prote......1 RelatIo.....1p
.J)c:si9/') ~ev"ew ~OClR~
NO n e-
NOf)~
NO(')~
N'OT)
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPfNSAnoN (DISO.OSE WHEnER HOIIRL~
R.A T RATE OR OTHER):
A) lOBBYIST OlSQ.OSURE: (Required) ;, 51000.C~ / mon"=l)
~ '
B) PRINCPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), ..".. liCc(14uJ .
The following information mIlK be anawerecl:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited campaign Contributions By Lobbyists
L On PIoaJrement Issues":
o No: AN YOU lobbYina on . al'M8ftt or Mlndlna bid for aoods. 8ClulamMt or S81"viCM. or on .
at -t or D8IIdIna award for aoodL -.iD......t or ..vIc:e?
22) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
a No: Are YOU IobbYina on . aend.na aaal.cation for . o.v.loament Aar_lMInt with th. C.tv or
aDDllClltlon ~ chanG. of zonIna maD clMlanation or c:hanae to tit. Cltv'. 'ubi... Land Use
!WlZ
3) PlI"SUallt 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 reimbu-sement 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
~on but, shall not be reqUired to pay any registration fees..
a YM ~o: AN you r.......ntina a not-for-arofit comoration or 8lltitv without SD8Clal comaen..tion
or ....mbu....ment. .
Y. SIGNATURE UNDER OA11t:
ON OCfOBER 1ST 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 CALl!NDAR YIAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEN RES PENSATION DURING THE
REPORl'ING PERIOD.
I do solemnly swear that all of the
familiar with the proviso i
requirements.
Signature of Lob
Signature of Principal/Client:
are true and and that I have read or am
2-482 of the Miami Beach City Code and all reporting
VI.
u Produced 10
uProducedIO
Fonn of Identification
Fonn of Identification
X Personally known (PrIncIt*)
~t1''( PlJ~ DELILA A. 1v1BYBR
~ "MY COMMISSION jfDD340179
IRES' October 19,2008
State of Florida, COUlty OF -~ Fl. N~tal'Y Discount Assoc.. Co.
Sworn and subscri d ARY
This~day of.
J<Jersonally known (lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Signature of Ie Notary - State of Florida
Notarization of PrIncipal'. 8Ignatunt
FO
Annual Registration fee: [\..-jYes [ ] No Amou t
Lobbyist Registration Form received and verified by:
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EONLY 2'L>t?:!t fp
MeR # I-', Date Paid '-"I