Alfredo Gonzalez/Lido Spa City of IVliami 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
/n lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Gonzalez Alfredo J
NAME OF LOBBYIST: (Last) (First) (M.I)
Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 - 579-0588 305-961 - 5588 gonzalezaj ~gtlaw. cum
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Lido Spa / The Standard
NAME OF PRINCIPAL/CLIENT:
40 Island Avenue,
Miami Beach,
Florida
BUSINESS NAME AND ADDRESS (Number and Street) (City)
(State)
(;qp Code)
TELEPHONE NUMBER:
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:
Andre Balazs
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
C°de Vi°lati°ns / C'O' & C'O' IssueS//--'/j0 ~~/~
Issue to be Iobbi~ (De~ribe in detail):
,
C~ AGENCIES/IND~IDUALS TO BE LOBBIED:
A) Full Name of Individual/TiUe
City Manager / Commission
Public Works
Planning Dept / Zoning Depart and Code Enforcement
B) Any Financial, Familial or Professional Relationship
D~LOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
FLA.T RA TE OR
^) LO~¥~ST DISCLOSURE: (eequ~red) $3]5.00,
8) PRiNCiPAL'S DZSCLOSURE (OF LOBBYTST COHPENSAT[ON): (.ReqUired), $3t5,00 ~tourlv ...............
The following information .must be answered:
Pursuant'to Miami Beach CiLy Code 5ectJon 2-488 ~titied "Prohibited Campaign Con~butions By Lobbyists
.On Procurement' Issues":
2)
ia, ....present.or oendina award for' _cm...eds, eauioment or service?
Pursuant to Miami Beach City Code 2-490 Entitled ~Prohibited Campaign'Contrtbutions By Lobbyists On Real
Estate. Development ISsues":
3).
amflication for chanae of zonina mad deskanation or chanae to.the.Ci~'S FUture Land U~..-.
Mao?
Pumuant to Miami Beach Ci~ Code 2-484 (h) Any person (except those exempt from the definition of
"lob
by,st' as set forth m ~n 2~81 above)'who only ap0ears as a repre~ntative Of'a not-for*profit
corporation or enUty withou~ special compensation or reimbursement for the appearance, Whether.direct, or
indirect, ~o express support of or opposition to .any item, shall register with ~he clerk as requi~ by this
section bu~ shall not be required to pay any registration fees..
or reimbursement.
V. SZGNATURE UNDER OATH:
ON OCTOBER ].ST OF EACH YEAR~ EACH LOBBYIST SHALL SUBM~ TO' THE CZTY CLERK A $~GNED
STATEMENT UNDER OATH, I~STXNG LOBBYING EXPENDTTU~S, AS WELL AS ~MPENSATXON
RECEXIi/ED~ ~N THE ~ OF MXAM! .BEACH A STATEMENT
SHALL 1
REPORTTNG PER~OD. ....
I do solemnly.
familiar with U~e
requirement.
in ~on 2-482
'and that I have read or am
'Miami Beach Qb/~e::and alt .rePorUng
LOBBYXST IDENTIFICATION:
PRINCIPAL ZDENTII~CATXON:
FOrm of Identification
'~ ~rsonally kn~n (LobbY,st)
VZZ. SZGNATURE AND"STAMP OF NOTARY:
State of Florida, CoUnty of'Mlami~Dade
Form of :[dentification
State of ~, County
SwOrn and subscribed before me
This
Signatumof Pubtic I
FOR CLERK'S USE ONLY
[ ] Yes [ ] No Amount paid MCR #
Date Paid
ReVised. 12108/04
TV. DXSCLOSURE OF TERMS AND AMOUNTS OF LOBBY/ST COMPENSATZON (DXSCLOSE WHETHER HOURLY~
FL4 T RATE OR OTHER.):.
A) LOBBYIST DISCLOSURE: (Required) $315.00 Hourly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSA'I-[ON): (Required). $315.00 Hourly
The following information must be answered:
Pursuant to Miami Beach City Code Section 2-488 Entitled "prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
[] Yes ~lfNo: Are you Iobbvin= on a present or aendina bid for aoods, eauipment or services, or on a
1~ present or oendino award for aoods, eauioment or s~rvj~?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Tssues":
~No: Are you Iobbvin~ on a pending application for a Development AQreement with the City or
[]Yes
aoolication for chan,qe of zonin,q map desi,qnation or chan,qe to the City's Future Land Us~
MaD?
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 ~';?o: Are vou reoresentJnQ a not-for-profit c_o_._rooration or entity without special com~en~tion
or reimbursement..
V. STGNATURE UNDER OATH:
ON OCTOBER Isz OF EACH YEAR, EACH LOBBYZST SHALL SUBt4Tr TO THE CTrY CLERK A STGNED
STATEMENT UNDER OATH, LISTTNG LOBBYZNG EXPENDTTURES, AS WELL AS COMPENSA'rZON
RECEZVED, TN THE cTrY OF MTAM! BEACH FOR THE PR~X~DTNG CALENDAR YEAR. A STATEMENT
SHALL BE FZLED EVEN TF THERE HAVE BEEN NO EXPEND~ErURES,4OR COMPENSA'r/ON DURZNG THE
/// -
familiar with the provisions,.co, Bt~j~'ed in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of PrinQpal/Client:
VT. LOBBY/ST ZDENTZFZCATZON:
[] Produced ID
Form of Identification
~L,_Personally known (Lobbyist)
VZT. STGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
No~rizat~on of ~bbyi~s Signat~?e
PRINCZPAL IDENTZFICATZON:
Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of ,2005
Signature of Public Notary - State of Florida
Notarization of Principal's signature
. / FOR CLEIZ~(2~E ONLY
Annual Registration fee: [ ~ Yes [ ] No Amoun.t Paid~_~ MCR Cf
Lobbyist Registration Form received and verified by: \C~-I~-..~::~ "
F: \CLER\$ALL\MAR~A-M\Lobbyist\LOBBY~ST fORM
Date Paid
Revised 12/08/04