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Carter McDowell/Indian Creek Inn AUG. -07' 06 (MON) 11: 08 p, 0021006 ., m T --- City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Mian1i Beach, FL 33139 LOBBYIST REGISTRATJON FORM Lobbyist 1l1C~I1S all pt~rsons clllploycd or n:loined, whether pnicl Or' not, by 0 principQI who seeks III encoLII'~gc the pll~5UgC, delea[ 01' ll1odifil::lllil1ll or any orclillllnce, ,'esoILltion, lll::lion or decision of :IIlY CClI11Il1;ssiol1t:rj lmy OCtiol1, derision, recoml11el1d~lion of the Ciry MilllUgft 01' any city baura Ot c011lmittee; or ony oetion, decision or recOl11ll1endltlil)n ofony cily pcrsClnoel defined in any manner in this section, during lhe time period of lhe entire dccision-muking J>.'ocess on 5UClt omiol1, decision Or recollllllendation tlla[ forcsl:l:l.lbJy will be he:lrd or reviewed by the city commission, or a CilY board or commince. The term s[1l:cificolly includes Ihe principal as well as any employee engaged in lobbying activities. The term "l.obbyists" h~s spccil1c exclusions, Please refer to Ordinallce 2004-3435. NAME or LOBBYIST: MCPOWELL (Labt) CARTlm (F j r~~) N. (M.L) Bjlzin Sumbel g,J~!I~'1 PriL:l' 8: I\} 11.1 lI!.J I.L1'. ~(JO S.q,,.B.isL:aync nlwl..,Sl1i\L: :),5110 1\ I j:lllli,_'ylmic!ll 3) \ J I BUS1NESS NAME AND ADDRESS (NLIlnbL:r and Street) (City) (Sl~le) (Zip Code) 305-350-2355 TELEPHONE NUMBER: 305.351.2239 FAX NUMBER: cmcuowe Il@hi17-iLl.com EMAIL: 1. LOBBYIST RETAINED BY: INDTAN X-:REEK INN. L. L,r:. NAME OF PRINCIPAL/CLIENT: 1.;13 E. Wli St. nUSINESS NAMI~ AND ,\DURESS N~w Yorl" NY (NlImbel' Elnd Street) (C ity) 10016 (Srate) (Zip Code) 212.S45-mOC) TELEPHONE NU MBER: 305-531-565\ FAX NUMDER: (OpUonal) EMAIL: (Op[ional) Fill oullhis section if principal is II CllrporoHloll, Pal.tncrship or Trust rScl:lioll 2-482 (e)] NAMJ:: OF CHTRF OFFICER, PARTNER, OR BENEFICIARY; noney O\'cd and .J11c1~ Avcd rDENTJFY ALL PERSONS HOT.PING, IJIRECTL Y OR INDlRECTL Y, A 5% OR MORE QWNERSIUP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFJIC LOBBY ISSUE: Applicati!ln (Variance) Board of AcjjustmenT - 2727 Tmliun Creek Drive + HPJ::j ~)I\"" Issue 10 be lobbied (DlJ~crjbe in detail): 111. ern' ,V;RNCWS/INIllV/DUALS TO HE LOIiUIIW: An Fiuoncilll, Famililll or l)rofessionl1l Relatlonshi MIAMI 1126389.1 '1696425798 AUG, -07' 06 (MON) II: 08 P. 003/006 IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOnnYJST COMPENSA,!'!ON (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) B) LomWIST DISCLOSURE: (Requir~d) $455.00 ner.hc:!!.lI._ _,._ PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Recluircd). $455 plJr 11011,L- Yes No: X A.1'e ynu. rcnresenling II I1M-fllr-llroI11 cornorlltion or cfllih' without ~pednl cUlllpens:\iioll or reimhurscment. Pmsuanr 10 Onlinllnce No. 2004-3435, 1) EbIL'iilll!ll.!P Ordil1nn'~c Nil. 2003-3393 Amending Miami fkuch City Code Ch~ptcr 2, Arliclt: VII. Division 5 Thereot..'p'lllitlud "Carnp~iSll FiniIP-cc Relorm" Vi~ The ^-c!.rJjliun or Code Secr;Oll 2::188 Entitled "Prohibite!~Il;lil!n Conlriblltions ~y l.obbyiSlS On PI'OClIl'elllem Is~~; YI:!~ No: X Arc you 1.1lhllYilll' Oil l\ l)1'cscnt III' penllinl! bid 1'01' ~oolls, I:!tluiplllCilt or services. nr Illl :Ul.'CSCllt 01' lllJnllil1t! :1W:lrd for ~1l1lC1s- equiplIll.'1I1 Ill" ~~r"i"L~'! 2) f,lLrstlanIIJ) Ordinance No, 2003-3395 Amenc\.iJlg.Migllli Bt:ach City Cflcje C\llll1tcr 2, Article VII l1iviii!lll 5 thewol' Enlilled '~raI1111::jign Finanl~l~ Hel'ilJ:Lll". Via Thi.l Addilion nLrfldll Se-:tion 2.4~)[1 FnILI!gct "Prohibitc:d Cil111p"i~n COIHrilmtions By Lobbyists nIl f(e:J I Estati.l ()t:veIOrml~llr lsslles": Yes No; X Arc VOll lohhyinC IIn a uendinll llVpliclllillfl for :\ ))evclopmen~ Aerccnllmt with the C.Uv or :IOOliclltillll I'llr Challl!l'lIl' tUllilH! 'HolP ucsiuu:llilll1 fll' Chlllll,:C [lllhe Cilv'!> ~'lIH1I'C Lnlul Use M:IU'! V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUAMIT TO THE ClTV CLERK SIGNlm STATEMENT lJl\'DER OATI-T, LISTING LOllTW1NG EXPENDlTURES, AS WELL AS COMPENSATION RECEIVED, IN Tile CITY OF MIAMI HEACll fOrt HiE PRECEI)!NG \LENrMR YEAR, A STATEMENT SHALL AE FILED EVliN IF THERE HAVE BEEN NO EXPRNDIT R COM )ENSATION lUNG TilE REPORTIN(, PERIOD I do solemnly SWC.lr \hllt .111 or Ih,;: loregoi provisions contained in Sllclion 2- 8') VI. RPlll..':' ()\'L'd LOllll\'JST IIH::,~'nF~~'lSO~~.r2.['"~ X · fe, r I 'u ' 1 0 denll Icallon SignaIlll'e of l,ohbyist: CllrL~r N. Ie )\\. Signaturll or Principal/Client: PH. 'ClI',\L WEf'\TIFlCATl V Pl'odllccdlD ~ ~ Form of IdlJnlification n Pcrsoll,llly known (1.obhyisl) n pnsumdly knowll (Princip:lJ) State of Florida, Q:lUllty of Miami-Dade Sworn to 8ml subscribed bL.lfo~u mc This 07 day or r.:J U!jUf'f ,10 () 6 -,~ ~~ - SignuLilrt: of Public Mary - Stale of (;Iorldll Not:l1-i:lalion ll' hh" I. " lure Slale of Flodda. Cou11lY of Miami-Dade Swum ~d suhscribt:i.I bdo'e me This t!!.. Clay of., ' 2~ FOR CU:R "S USB ONLY , ~. AnllulllRegislraliollfee: csl)No Amountl)"i () 1-, MCR#:JWbl. DUlel.[lid__~f}rJ__ LobbYIst Registratiun Form rllccivcd and verillcc.J by; , ' Revisci.I 02/10/04 F: CLER\ALL\ A.M\LOBBYIST\LOn IWIST FORM 04