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Alexandra Deas/Di Lido 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, derision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any manner in this section, 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. Deas Alexandra L. NAME OF LOBBYIST: (Last) (First) (M.I.) Bilzin Sumberg Baena Price & Axelrod LLP 200 S. Biscayne Blvd. Suite 2500 Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-7241 305-351-2176 adeas~bilzin.com TELEPHONE NUMBER: I. LOBBYIST RETAINED BY: Di Lido Beach Resort Ltd FAX NUMBER: EMAIL: NAME OF PRINCIPAL/CLIENT: 605 Lincoln Road, 5th Floor Miami Florida 33139 BUSINESS NAME AND ADDRESS 305-672-5466 (Number and Street) (City) (State) (Zip 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: · IDENTIFY ALL PERSONS HOLDING~ DIRECTLY OR INDIRECTLY, A 5% OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: OR MORE II. SPECIFIC LOBBY ISSUE: Sign Variance ~-I de~tai ).~. ~ ] Issue to be lobbied (Desclllibe in 1 III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) .~ ~ame ~nd~a~~ B) Any Financial, Familial or Professional Relationship MIAMI 972171.1 7594920980 Yes IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): ^, LO YIST I LOSU : qu , C9¢ ' 0 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Requirea). /..~(.d Aa~ mb Are you representing a not-for-profit corporation or entity without special compensation or ursement. Pursuant to Ordinance No. 2004-3435. Yes ~~endin~ Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2. Article VII. Division 5 Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or award for goods~ equipment or service? Yes 2) Pursuant to Ordinance No. 2003-3395 Amending Miami Beach City Code Chapter 2. Article VII Division 5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": 1 Are you lobbying on a pending application for a DeVelopment Agreement with the City or ication for change of zoning map designation or change to the City's Future Land Use Map? V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK 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. S igna~e~o ~o~byis~~t I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-.4592 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: (/ ~/~~ ~ ~ Svi~natureoferinciPal/Client:~ ~/'~5> ~~~.~` ~-'~t~.<~,..r~ · LOBBYIST IDENTIFICATION:' Q~ pRINcIPAL?DEI~IFICATION: [] Produced ID [--] Produced ID Form of Identification Form of Identification ~ Personally known (Lobbyist) ~" Personally known (PrinCipal) State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn to. and subscribed before me ~-~ . Sworn and subscribexl before me This~t'~aY 9( ~'0~q ~r, 2~._~_~:~' This~3a~'ay~of ~~ 20.~ ~~e of ~lic Notary ~ St~of Florida ~n~re of Public Notary - State of Florida Notariz~,[~.of Lobb~t's s~n~re ~rization of Principal's signature A=ual Regis~ation fee:~Yes [] No Amount Pai~~~~CR LobbBst Reg~s~ation Fo~ received and verified by:~ Revised 02/1,0/04 F: CLER~LL~~-~BBYISTLOBBYIST FO~ 04 MIAMI 972171.1 7594920980