Raul Mateu Comedy Festival
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MIAMI BEACH
City of Miami Beach Office of the ~~~, \1 F 0
1700 Convention Center Drive, Miami Beach, FL 33139
05 NOY 22 At, to: 09
LOBBYIST REGISTRATION FORM
. ; I,.., __ L i < i'\ · S e F F i ~E
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.
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NAME OF LOBBYIST: (Last) (First)
L...o~J.'-l re5T'v.41..- PiO~CT IcJU!:;" LLL<
BUSINESS NAME AND ADDRESS (Number and Street) (City)
..)05- Sf;- 5~'6
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1:_
(M.!)
111/ L(J4!tJ ~el. ~vqC 4~:>
(State) (Zip Code)
(2r:v-\fZ W P\.A . C-l)'
EMAIL:
TELEPHONE NUMBER:
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FAX NUMBER:
I, LOBBYIST RETAINED BY:
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NAME OF PRINCIPAL/CUENT:
( -(J ~.:1-( rc-'=>f1 J A;.J PI D~c"'7(lD.J S ( (, Lc
BUSINESS NAME AND ADDRESS (Number and Street) (City)
3>o5--sII- 54-~q ~~6-J.16~J55-5
TELEPHONE NUMBER: FAX NUMBER: (Optional)
"II L'vcJJ~J. ~iC"'4CV
(State) (Zip Code)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l
. NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Describe in detail):
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III, CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
V,{.A.
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IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL)j
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
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o
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
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 ro: Are YOU lobbyinG on a Dresent or DendinG bid for Goods. eGuiDment or services. or on a
Dresent or DendinG award for Goods. eGUiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
OYll/i r,f.o: Are you IQbbvlna liD a oenllina aDpllcatioD for a D\:veloDmll:Dl Aa~ment \Yilb the C;itv Qr
aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use
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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..
DYes JJNo: Are YOU reDresentinG 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 EXPEND URES, AS ELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE, PRE E ING E AR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEND U ES 0 PENSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all
familiar with the provisions
requirements,
Signature of Lobbyist:
Signature of Principal/Client:
ing facts are true and correct and that I have read or am
ion 2-482 of the Miami Beach City Code and all reporting
VI,
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
o Produced ID
iJ Produced ID
Form of Identification
Form of Identification
~ersonally known (Principal)
j( Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and sUbscribmv: me c..
This 17 day of I#' ,20 () ~ /
I
State of Florida, County of Miami-Dade
swan;, subscribed before me
This day of No".. , 20 0
.
Date Paid "-\1'.22/~
Revised 12/08/04
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