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Clifford Schulman/T. Morgan 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 dudng 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, Schulman Clifford NAME OF LOBBYIST: (Last) (First) Greenberg Traurig, P.A., 1221 Brickell Avenue, Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) 305-579-0613 305-961-5613 TELEPHONE NUMBER: FAX NUMBER: (M.I) (State) schulmanc@gtlaw.com EMATL: (Zip Code) I. LOBBYIST RETAINED BY: Thomas H. Morgan NAME OF PRINCIPAL/CI3ENT: Morgan Energy Company, 3333 S. BannOck Street, Ste. 950, Englewood, CO 80110 BUSINESS NAME AND ADDRESS 303-296-9270 TELEPHONE NUMBER: (Number and Street) (City) 303-294-9077 FAX NUMBER: (Optional) (State) EMA~L: (Optional) (Tip Code) 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% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SPECIFIC LOBBY ISSUE: Star Island Privatization Issue to be lobbied (Describe in detail): CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title City Commission and City Staff B) Any Financial, Familial or Professional Relationship ~V~. DISCLOSURE OF TERHS AND AHOUNTS OF LOBBYZST COHPENSAI'ZON (DISCLOSE WHETHER tlOIJRLY~ FL4 T RR TE OR 07'H£R~, A) LOBBYIST DISCLOSURE: (Required) Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $§35.00 The following information must be answered: l) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": [] Yes X) No: Are you Iobbvina on a Present or pendinq bid for qoods, equipment or services, or on a Present or Dendina award for aoods, eauiament or service? 2)¸ Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": oYes 33 No: Are you Iobbvina on a ~endina a~Dlication fgr i~ Development Aqr~ement with the City or aD=lication for chan,qe ef zoninq map desiqnation or chanqe tO the City'S Future Land 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 j~ No: Are YOU representinq a not-for-profit corporation or entity without special compensation or reimbursement.. V. SIGNATURE UNDER OATH: ON OCTOBER Isr OF EACH YEAR, EACH LOBBYIST SHALL SUBHiT TO THE CiTY CLERK A SIGNED STATEMENT UNDER OATH, LiSTiNG LOBBYING EXPENDTTURES, AS WELL AS COMPENSATION RECEIVED, TN THE CiTY OF MTAM! BEACH FOR THE PRECEDTNG CALENDAR YEAR. A STATEMENT SHALL BE FTLED EVEN iF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATTON DUR/NG THE %- sign~-~e o7 Lobbyist ! do solemnly swear that all of the facts are true and correct and that ! have read or am familiar with the provisions contained 2-482 of the Miami Beach City Code and all reporting requirements. ~nature of Lobbyist: ~ 'L Signature of Principal/Client: ~ [] Produced ID //-'- Form of Identification ;rso.a Ily known (Lobbyist) forgoing LOBBYIST IDENTZFICA'FLON: ~RZNCIPAL IDEN'r~FZCATZON: [] Produced Form of Identification VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade ~worj~'~ ~ll~d subscrib~t~l before_l~e ;i~,~f~'~'f-P'~blJ~ N~otary---State of Florida ~o~ion of Lobbyi~s signature [] Personally known (Principal) State of Florida, County of IVliami- Sworn and subscribed before me ~-~-~...--- . ..... -- This day of ,20 Signature o~c Notary - St,a(e of Florida Notarization of Principal's ~ignature ~~Yes FOR CLERK'S USE ONLY /.2..~/~.(~ mnual Registration fee: [ ]No Amount Paid ~ MCR # ~__ ~Jr~"-Date Paidt Lobbyist Registration Form received and verified by: ~ ~~ F:~CLER~$ALL~MARIA-M~Lobbyist~LOBBYIST ~RM 0~ ~ - ~ Revised 12/08/04