Robert Switkes/Brothers Vending
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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, resoiution, 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' dty personnel defined In any
manner In this section, during the time period of the entire dedslon-maklng process on such action, decision or recommendation
that foreseeably will be heard or reviewed by the dty commission, or a city board or committee. The tenm speCifically indudes the
principal as well as any employee engaged in lobbying activities. The term "LobbYlstsn has specific exclusions. Please refer
to Ordinance 2004-3435. .
LOBBYIST REGISTRATION FORM
FAX NUMBER: (Optional)
EMAIL: (OPtional)
FiI/ out this section If principal is a Corporation, Partnership or Trust [Section 2-482 (c))
.
NAME OF CHIEF OFFICER, PARTN,R, OR BENEFIOARY:
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IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
.
II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Descrlbe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of IndiVidual/Title
B) Any Financial, Familial or ProfeSSional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER).
A) LOBBYIST OISCLOSURE: (Required)
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RINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~')().C)() I MOl Q A
, .
No: Are' ou re resentin n -f r- rofit cor ora'
reimbursement, Pursuant to Ordinance No. 2004-3435.
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1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division S
Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Procurement Issuesn:
Are 0 I bb in on a r n r ndin bid for 0 s
or Dendina award for aoods. eauiDment or service?
i m nt or ervices or 0 a resen
2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaoter 2. Article VII Division S
thereof Entitled "Camoaion Finance Reform". Via The Addition Of Code Section 2-490 Entitied "Prohibited
Camoaion Contributions Bv Lobbvists On Real Estate Develooment Issues":
Ar u lobb in on n in a Ii ation f r D v 10 m ntA reemen w' h he Ci or
aDDllcation for chanae of zonina maD desianation or chanoe to the City's Future Land Use MaD?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CllY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CllY OF MIAMI BEACH FOR THE PRECEDING C NDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITUR OR C PENSATION DURING THE
REPORTING PERIOD.
yist
I do solemnly swear that ail of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in .-SectIon 482 of the Miami Beach City Code and ail reporting
requirements. " /'
Signature of LObbYistL
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
o Produced ID
o Prod uced ID
Form of Identification
~rSOnallY known (Lobbyist)
Form of Identification
o Personally known (Principal)
VU. SIGNATURE AND STAMP OF NOTARY:
State of Fiorida, County of Miami-Dade
Sworn and subscribed before me
This _day of , 20_
Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
Signature of Public Notary - State of Florida
Notarization of Principal's signature
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, ~ FOR CLERK'S
Annual Registration fee:, Yes [ ] No Amount Paid '.2!;
Lobbyist Registration Form ece;ved and verified by:
Revised 02/10/04 R\ALL\
~N~R#282;'iL~ DatePald ;3/23/c?>
-M\LOBBYIST\LOBBYlST FORM 04