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Fredrick Webking/AEG Live Miami bc:h '1ft'- z.utl3 & - 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 prindpal 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 dty commission, or a city board or committee. The term specifically includes the prindpal as well as any employee engaged in lobbying activities. The term -Lobbyists" has specifie exclusions. Please refer to Ordinance 2004-3435. Webking Fredrick W. NAME OF LOBBYIST: (Last) (First) 5750 Wilshire Blvd. Suite 501 Los Angeles (Number and Street) (aty) (State) 323-930-5797 rwebking@aeglive.com FAX NUMBER: EMAIL: (M.!) Ca 90036 (Zip Code) AEG Live LLC BUSINESS NAME AND ADDRESS 323-930-5750 TELEPHONE NUMBER: I. LOBBYIST RETAINED BY: AEG Live LLC NAME OF PRINOPAl./CUENT: AEG Live LLC 5750 Wilshire Blvd. Suite 501 Los Angeles Ca 90036 BUSINESS NAME AND ADDRESS (Number and Street) (aty) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if prineipal is a eorporation, Partnership or Trust [Section 2-482 (e)] · 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: I~ k' seJ;.aFIe LQB)JV ISSUE: Jac Ie Uleason Theatre Issue to be lobbied (Describe in detail): III. CITY AGENCES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Mayor, City Commissioner N/A And City Staff ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): Part of regular compensation A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Part ofree;nll'lr c.ompp.m:l'Itlon 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": I Yes l) No: Are YOU lobbyinG on a Dresent or oendinG bid for GOods. eauiDment or services. or on a Dresent or oendinG award for GOods. eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": lIVes 0 No: Are yOU lobbyinG on a DendinG 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 Hu1 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 . No: Are you reDresentinG a not-fof-Drofit corooration or entity without soecial comoensation 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, USTING 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. ~ ??- ~ 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 2-482 of the Miami Beach City Code and all repo . requirements. Signature of Lobbyist. C&:iJ iroY~,'a 0.C. Signature of Principa VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: D Produced ID o Produced ID Form of Identification i Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: Form of Identification ~ersonallY known (Principal) FOR CLE Annual Registration fee: [ ] Yes [ ] No Amount Pai Lobbyist Registration Form received and verified by: F: \CLER\$ALL \MARIA-M\Lobbyist\LOBBYIST fORM 0 Miscellaneous Cash Receipt CITY OF MIAMI BEACH 28681S No. D Cash D Credit Card ~k# 3: C',[ ..$,~D. oJ ~ ~. \7J 2r(~tr~ \ ' . . ~ Received of (THIS INFORMATION MUST BE COMPLETED) Accou~/. P1;1J <3 67. y1L;y ,BY Prepar: ' Dept: c!..-- r! EXT: t/Y'-J.. .