Lucia Dougherty/Terra BchsideMiami
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 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.
DOUGHERTY
NAME OF LOBBYIST:
GREENBERG TRAURIG, P.A.
BUSINESS NAME AND ADDRESS
305-579-0500
TELEPHONE NUMBER:
(Last)
(Number and Street) (City)
305-579-0717
FAX NUMBER:
LUCIA A.
(First) (M.I)
(State) (Zip Code)
DOUGH ERTYL@GTLAW.COrv
EMAIL:
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAL/CLIENT:
Terra Beachside Villas, II
BUSINESS NAME AND ADDRESS
cio Chades Sieger
TELEPHONE NUMBER:
13th March
06
(Number and Street) (City)
5996 SW 70 Street_l South Miami
FAX NUMBER: (Optional)
(State) (Zip Code)
FL 33143
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% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
SPECZF]:C LOBBY ISSUE:
HP'B and DRB Representation for Comfort Inn Site (6261 Collins Avenue)
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDTVZDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
Historic Preservation Board
Design Review Board
B) Any Financial, Familial or Professional Relationship
IV. DZSCLOSURE OF TERHS AND AHOUNTS OF LOBBYZST COMPENSATZON (DZSCLOSE WHETHER HOIJRLY~
FI. AT RATE OR OTHER):.
A) LOBBY[ST DISCLOSURE: (Required) $500.00
B) PRINCIPAL'S DISCLOSURE (OF LOBBY[ST COMPENSATION): (Required). $500.00
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":
[] Yes ~/No: Are YOU Iobbvinq on a nresent or nendino bid for ooods, eauioment or services, or on a · ~ presenf; or pendinq ~w~rd for aoods, eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
[]Yes'No: Are you Iobbyinq on a ~endino application for a Development Aareement with the City or
apDIication for chanoe of zonine mad desionation or chanee to the City's Future Land Use
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
ection but, shall not be required to pay any registration fees..
[] Yes ~1o: Are you representinq a not-for-profit corporation or entity without special compensation
or reimbursement..
V, SIGNATURE UNDER OATH:
ON OCTOBER 1; OF EACH YEA~ EACH LOBBY[ST SHALL SUBHTr TO THE CTI'Y CLERK A SZGNED
STATEMENT UNDER OATH, I.]S'I'~NG LOBBY[NG EXPENDITURES, AS WELL AS COMPENSA'F]ON
RECE[VED, IN THE cTrY OF HIAHi BEACH FOR THE PRECEDING CALEN~R YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDTFURES OR ~r4~NSA'I']ON DURZNG THE
REPORTZNG PERZOD.
Sigflature ~f Lobb.)~t
LUCIA A. DOUGRERTY
! 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 C~Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VZ. PRZNCIPAL IDENTZFICATZON:
[] Produced
Form of Identification
[] Personally known (Principal)
Vi]:. SIGNATURE AND STAHP OF NOTARY:
State "~orida, County of Mi~Dade state of Florida, County of Miami-Dade
Swo9 ~larfd subscribej;i'~r(y/me ~ Sworn and subscribed before me
Thi~. ;~1~ da~/l~a~.h/' _, 20.__06 ~ This ~day of ~ 20m
//~i~fl"~ ~' of F(ubi'ic N~{~r~- Stat~ of Florida Signature~orida
No? ~ation of Lobbyist's signat~/.~ ...... Notarization of Principal s signature
~/ '~""~ FO ~' ONLY
Annual Registration fee: ~ ].o A~o~MCR~~! ~DatePai~_~l~---~/6~
Lobbyist Registration Form received and verified by:~ ~'
F:\CLER\$ALL\MARU~-M\Lobbyist\LOBBY[ST fORM 05.1do, t/~,~ ReVised ~2/08/04
LOBBYIST IDENTZFICATZON:
[] Produced I'D
Form of Identification
known (Lobbyist)
[V. DZSCLOSURE OF TERMS AND AMOUNTS OF LOBBYZST COMPENSATION (DISCLOSE WHETHER HOURL Y/
FL4 T RATE OR OTtlER):
A) LOBBYIST DISCLOSURE: (Required) $500.00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $500.00
The following information must be answered:
Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement :[ssues":
[] Yes [] No: Are you Iobbvina on a present or pending bid for qoods, equipment or service; or on a
present or oendina award for aoods, eeuiDment or servi~e?
2)
Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
~Yes [] NO: Are you Iobbvina on a oendina application for a Development Aareement with the City or
application for chan~e of zonin= mad desianation or chan,qe to the CitY'S Future Land Use
Hap?
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 representin.q a not-for-proffi; corporation or entity without speci=_! c0mpe~_~t~ ion
or reimbursement..
v. SZGNATURE UNDER OATH:
ON OCTOBER IsT OF EACH YEAR, EACH LOBBYZST SHALL SUBHZT TO THE CTrY CLERK A SZGNED
STATEIqENT UNDER OATH, LZSI~NG LOBBYZNG EXPENDTrURES, AS WELL AS COHPENSATION
RECEZVED, ZN THE CTfY OF HZAH! BEACH FOR THE PRECEDZNG CALENDAR YEAR. A STATEMENT
SHALL BE F[LED EVEN TF THERE HAVE BEEN NO EXPENDTrURES OR COMPENSATION DUR3NG THE
REPORTZNG PERJOD.
Signature of Lobbyist
LUCIA A. DOUGHERTY
! 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:
Signature of Principal/Client: _ ./~~, ~ . ~~,,)~(' '
VZ. LOBBYZST ZDENTiRCATION:
PItTNCZPAL ZDENTZI=ZCATION:
[] Produced TD
Form of Identification
[] Personally known (Lobbyist)
SZGNATURE AND STAMP OF NOTARY:
[] Produced ID
Form of Tdentiflcation
~e~nally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 13th .dayof March _,20__0t~
Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade ~,,~ vanessa C. B~co
Sworn and subscribed before me ,~,~ My Commission DD211527
This ! '-~ day of ~, 20___~ .~,~.~p. Expires May 12, 2007
Signature of Public Notary - State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR #
Lobbyist Registration Form received and vedfied by:
F:\CLER\$ALL\HARIA-M\Lobbyist\LOBBY[ST fORM 05.doc
Date Paid
Revised 12108104