Leo Bonamy/AEG Live
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MIAMI BEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRA nON 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.
~NArM.Y Leo
NAME OF LOBBYIST: (Last) (First). (M.!)
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(Number and Street) (City) (State) (Zip Code)
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EMAIL: ~
BUSINESS NAME AND ADDRESS
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FAX NUMBER:
TELEPHONE NUMBER:
I. LOBBYIST RETAINED BY:
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NAME OF PRINCIPAL/CLIENT:
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BUSINESS NAME AND ADDRESS
(Number and Street)
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(City)
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(State) (Zip Code)
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EMAIL: (Optional)
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TELEPHONE NUMBER: FAX NUMBER: (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:
II. SPECIFIC LOBBY ISSUE:
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Describe 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 DISCLOSURE: (Required) JII~ ~o /~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (ReqUired),.4~ a...-? a.~
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":
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
;t. es . .~o: Are YOU lobbying on a oending aoolication for a Deyelooment Agreement with the City or
'_ aoolication for change of zoning mao designation or change to the City's Future Land Use
Mao?
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..
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V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A 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 C PENSATION DURING THE
REPORTING PERIOD. ~
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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 contained in Section -482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI.
I LOBBYIST IDENTIFICATION:
'G Produced ID ~
;0 tc.......> 1> L Form of Identification
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PRINCIPAL IDENTIFICATION:
c:rProduced ID ,) ILl j; ..."....,LJ 1-fL-=--YV ~E
Form of Identification
u Personally known (Lobbyist)
C Personally known (Principal)
SIGNATURE AND STAMP OF NOTARY:
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State of FIeriml:, County of t1illR'li DIl '
Sworn and subscri ed before me
This:j ay :r ' 20
Signatur lic tary - e of Fler-iela /'r II'
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Notarization of Principal's signature
/ FOR CLERK'S USE ONLY 'e/J
Annual Registration fee: [y'J Yes [ ] No Amount Paid \ ,'5::) MCR # 2~rt\(fi5 Date Paid at . Oto
Lobbyist Registration Form received and verified by: ~~~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM O. c Revised 12/08/04
CALlFORNIA ALL.PURPOSE ACKNOWLEDGMENT
County of
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State of California
On
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Date t
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personally appeared
o personally known to me
~ proved to me on the basis of satisfactory
evidence
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A. LEWISTON
Commission # 1379311
Notary Public - California ~
Los Angeles County -
My Comm. Expires Oct 8. 2006
to be the person(s}. whose name(.st isJa+.e
subscribed to the within instrument and
acknowledged to me that he~y executed
the same in histhoFlthoil' authorized
capacity~ and that by his/Rer.'tRoir
signature(s}-on the instrument the person(~ or
the entity upon behalf of which the person(s1-
acted, executed the instrument.
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
Description of Attached Document
rL
Title or Type of Document:
Doc"meot Date' A '1 0s1
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name: ---l.JJ lUV~11/1'l Va If oVl
[1 Individual
o Corporate Officer - Title(s):
o Partner - 0 Limited D General
o Attorney-in-Fact
[j Trustee
o Guardian or Conservator
2r Other:
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Signer Is Representing:
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A~G Livt(/
@ 1999 National Notary Association. 9350 De 80to Ave., P.O. Box 2402 . Chatsworth, CA 91313-2402 . www.nationalnotary.org
Prod. No. 5907
Reorder: Call Toll-Free 1-800-876-6827