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Maxson Investments, LLC ;.. MiM1i Beath '<<if .KIll' ~ -..-... 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 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. Fine Robert S. NAME OF LOBBYIST: (Last) (First) (M.!) Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0826 305-691-5826 finer@gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Maxim Szarf NAME OF PRINCIPAljCUENT: Maxson Investments, LLC BUSINESS NAME AND ADDRESS (305) 864-4803 TELEPHONE NUMBER: 7124 Abott Avenue, Suite A Miami Beach, FL (Number and Street) (City) (305) 864-4803 FAX NUMBER: (Optional) 33141 (State) (Zip Code) 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: Maxim Szarf . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Maxim, Szarf, Maxson Investments, LLC, Sonia Gruenwurzel and Leo Gruenwurzel " II. SPECIFIC LOBBY ISSUE: Board Approvals Issue to be lobbied (De 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 Adjustment Building Department Planning Department IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL r; FLA T RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) 420.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $420.00 Hourlv The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": o Yes ~ No: Are YOU lobbyina on a Dresent or Dendina bid for aoods. eauiDment or services. or on a present or Dendina award for aoods. eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": oYes NNo: 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees.. n Yes \X.No: Are YOU reDresentina a not-for-Drofit corDoration or entity without sDecial comDensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ~~ _ ~ Sign~- Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Form of Identification Form of Identification De", .;r n 0.... o~"\ ;~~ (\3 :2 \0 (5 ~ u: f2 '0 8 .$NOcO g 2S. c: (f) 0,2 ~~~ :::l 1Il E o..~E ~,~8. ~~~ [J Produced 10 c Produced 10 State of Florida, County of Miami-Dade Sworn and subscribed before me This~d ",2 ~~~~ ~ g~.~ (/135'" ~~.$ ~ ~ ~., S. (')' 8g"i~ OOClN<'D ~ ~ U) " ~ Q '" 0: Q) .~Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: ~ersonally known (Principal) FOR CLERK'S USE ONLY . Annual Registration fee: 0 Yes [ ] No Amount Paid .2S-oo MCR # .2=J.C1~Date Paid 8JI9/l""\C:: Lobbyist Registration Form received and verified by: ~c::::::>\...k~ . t F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05. Revised 12/08/04