Art Edelstein/Festival ProductMia~ni~Be~-~h ~
III
2~JU$
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33:[39
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, resoluUon, 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
/n lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
NAME OF LOBBYIST: (Last) (First) (M.I)
~..~A,~o.~ ~o6u0.Jnons, Int.
BUSINESS NAME AND ADDRESS (Number and Street) (City) ~ (State) ' (Zip Code)
(~l~) '-t. qc~-qooo (.c?~a')-vqq ...~%~ arq.~d¢ls-kir~ ~_~. ,r~y.~rn
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
'~¢_~vo,,.t f::V~.,~or~, laC..
NAME OF PRINCIPAL/CLIENT:
BUSINESS NAME AND ADDRESS
"I'ELEPHONE NUMBER:
(Number and Street)
I',,1,-¢ u,) ¥ ofF-...
(aty)
FAX NUMBER: (Optional)
NY
(state)
100o1~
(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:
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 50/0 OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II, SPECIFIC LOBBY ISSUE:
Vf'.A -r'~ur,~rn A~vanc_.errn~ orar~ ~r eh¢ dVC 3aV'L
Issue to be lobbied (Describe in detail): tJ
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
XV. DXSCLOSURE OF TERMS AND AMOUNTS OF LOBBYZST COMPENSATION (DZSCLOSE WHETHER HOURL Y~
FI-4 T R.4 TE OR OTHER~
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
The following information must be answered:
Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
0 Yes ~No: Are you Iobbvina on a present or pqndinq bid for aoods, eauiDment or services, or on a
present or pendinq award for qoods, eouioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
[]Yes J~o: Are you Iobbyinq on a oendinQ al~Dlication for a Development Aqreemqnt with the City or
· ' aDI)lication for chanqe of zoninq mao desianation or chanqe to the City's F~Jture Land Us~
Map?
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..
[] Yes ~No: Are you representinq a not-for-profit corporation or entity without special compensation
or reimbursement. ·
V. SI'GNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR~ EACH LOBBY]:ST SHALL SUBMI'T TO THE CZTY CLERK A STGNED
STATEHENT UNDER OATH, LZSTZNG LOBBYING EXPENDZTURES, AS WELL AS COHPENSA'rZON
RECE]:VED, ]:N THE cTrY OF t4ZAH! BEACH FOR THE PRECED]:N,~i CALENDAR YEAR. A STATEMENT
SHALL BE FZLED EVEN ZF THERE HAVE BEEN NO EXPENDZ'rURF-~ OR COHPENSAT]:ON DURZNG THE
REPORTZNG PERZOD. ~
Signature of Lobbyist
1: do solemnly swear that all of the foregoing facts are true and correct and that ! 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: ./~"/~,'/ ~" ",, .
SignatureofPrincipal/Client: /~'~-"/~/~--~/2/7.h /~, '/~5/' ~,~ J/'~'/.'~7~/
v,. /"
~'L~~ []~roduced ID
Form of Identification
ersonally known (Lobbyist)
VtZ. StGNATURE AND STAHP OF NOTARY:
[] Produced 1~D
Form of l~dentification
ersonally known (Principal)
State orca, Coun~ of M',~,,m', ~.~- State o~Coun~ of~
Sworn to and subscribed before me Sworn and subscribed before me
~ da' 20~ ' ' , --
No~rization of Lobbyist's signature No~rization of Principal's signature
Annual Regi~ation f~: ~Yes [ ] NO ~o~~ U'u~ NCR Paid
Lobbyist R~is~ation Form r~eiv~ and verified by~
F:~CLER~$ALL~NAR[A-N~Lobbyist~LOBBY~ ~RN~~ Revis~ ~2/08/