Frank Demandt/Walgreen Company
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MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, Fl33139
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 -LobbJlsts'" hu specific exclusion.. Plea. refer to Ordinance 2004-3435.
DEM ANOT
~~lo lliB~'1)E t-tANDT A~, TtIGT~, pA.
(01'0 ~\,c..\ 60 s-ref.fT ""Ot t'-1lAl1'
BUSINESS NAME AND ADDRESS (Number and Street) (City)
'305-~" Z - \ '3 ZGt
FAX NUMBER:
rc,4~ ti.
(First)
'FL.
(State)
(M.I)
~~'4~
(Zip Code)
~S-lo~ 2.- \'146
TELEPHONE NUMBER:
F"~NI4 e SlZOwfJ O€M PeNDT
EMAIL: 4 .c::::.O~
I. LOBBYIST RETAINED BY:
vJ~CoC2EeIJ CO. fAN 'j:U;\.LO~ Co~~1J~
NAME OF PRINCIPAL/CLIENT:
~ AL. c;. 2 ef tV {.o.
BUSINESS NAME AND ADDRESS
~-3\5 ~ Ll-910
TELEPHONE NUMBER:
,~~ JJ I L r1\6T et>. 1> €E2. F \ 'EL.D It ·
(Number and Street) (Oty) (State)
'0015
(Zip Code)
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section If prlnd..11s a Corporation, Partnership or Trust [Section 2-482 (e)]
II. SPECIFIC LOBBY ISSUE:
. NAME OF CHIEF OFFICER, PARlNER, OR BENEFICIARY:
.:JEfF "R~l tJ I Cto
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARlNERSHIP OR TRUST:
'"SEe &;~E b~~e .i A~Ct1E[) -\\~o
rOe. .. ~ 1 &, \N~ \o..IAI-Gw Itee:~~ :!>TO&~
,;6.. ~,oo ~ol~ It'\)~ AvE.N~E..
'51GrrJ VA2lAfJCE. -
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individllal/TltIe
B) Any Financial, Familial or Professional Rellllionshlp
~~'D cp Al>~U~TME:.A.1T~
NoNE
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHEllIER HOURLY,
FIA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) J OU, L l' - .,. l Z S · C> 0
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (ReqUlred)..tJ ZS,(fJ vet ~oJ\2-
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Conbibutions By Lobbyists
On Procurement Issues":
DYes 'f.rJo: Are YOU lobbYinG on a Dresent or !)endinG bid for Goods. eauiDment or services. or on a
Dresent or !)endinG award for GOOds. eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Conbibutions By Lobbyists On Real
Estate Development Issues":
DYes ~o: Are YOU lobbyinG on a !)endinG aDDlication for a DeyeloDment AGreement with the City or
aDDlication for chanGe of zoning maD desiGnation or chanGe to the City's Future Land Use
HuZ
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..
o Yes ~o: Are YOU reoresentinG a not-for-Drofit comoration or entity without .!)ecial comDenSation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, U5nNG 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. A 1\ .Q,o....._ A.
~ Signature of Lobbyist
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 on ined in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION
U Produced ID
U Produced 10
CIlfICW.8M.
8UlNIE KOUG
NOTARY 1I\8JC. STAlE OF UIIQIS
'" CQtMSSION DP'RES:OMIIlD7
Fonn of Identification
Fonn of Ide
)fPersonally known {PrindlHli
U personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
orida, County of Miami-Dade
and SUbsCriJ-~:e
day of 20D-'.
(,
Jl.l-',..b\~ . .....
State of~, County of Mie~ i)JQe-
Sworn and subscri~ed before me L
This ;lO...... day cr~ . 20~
SCHEDULE 1
Walgreen Co. , an Illinois corporation is a publicly traded company on the
New York Stock Exchange and the NASDAQ. No shareholder holds more
than 10% of the company stock.