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Alexandra Deas/2901 Beach Ventures ... "''''<'' filllImIlI:I9C'h '1111 m 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 principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, derision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any manner in this section, 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. NAME OF LOBBYIST: Deas (Last) Alexandra (First) (M.I.) Bilzin Sumberg Baena Price & Axelrod LLP 200 S Biscayne Blvd. Suite 2500 Miami. Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-7241 TELEPHONE NUMBER: 305-351-2176 FAX NUMBER: adeas@bilzin.com EMAIL: n -i -< c-: r- rr; (City) ^ en " a ::J: (State) (ZiAA;od1:t ('") (.,) ___ rn CI1 EMAIL: (Optional) '"" c::::> ~ C7" (I') ,." .." I. LOBBYIST RETAINED BY: 2901 Beach Ventures LLLP Fortune International Mana ement Inc. NAME OF PRINCIPAL/CLIENT: 1300 Brickell Avenue. Miami. Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) < m o 305-351-1000 TELEPHONE NUMBER: 305-371-6213 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: Edgardo Defortuna, Pres. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: n. SPECIFIC LOBBY ISSUE: Review by Historic Preservation Board for property at 2912 Collins Avenue (k/a Seville Hotel) Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Historic Preservation Board & Staff none IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): MIAMI 1160568.1 7348810704 . , A) B) LOBBYIST DISCLOSURE: (Required) Hourly. $240 Hourly. $240.00 PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Yes No:x Are you representin2 a not-for-profit corporation or entity without special compensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2. Article VII. Division 5 Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes No:x Are YOU Iobbyin2 on a present or pendin2 bid for 2oods. equipment or services. or on a present or pendin2 award for 2oods. equipment or service? 2) Pursuant to Ordinance No. 2003-3395 Amending Miami Beach City Code Chapter 2. Article VII Division 5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes No:x Are YOU lobbyin2 on a pendin2 application for a Development A2reement with the City or application for chan2e ofzonin2 map desi2nation or chan2e to the City's Future Land Use Map? V. SIGNATURE UNDER OATH: ON OCTOBER 1 ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK 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 COMPENSATION DURING THE REPORTING PERIOD. S;gnatu~~ft:;';'dm l::f/ 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 reporting requirements. Signature of Lobbyist: Alexan C) -i -< () r- rr. ^' ~ Produced IDo, ~ Form of Identificat~ ..., ""M Signature of Principal/Client: VI. Edgardo LOBBYIST IDENTIFICATION: PAL IDENTIFICATION: o Produced ID Form ofIdentification ~ Personally known (Lobbyist) LV' Personally known (Principal) n fTl ,..., c:::J ClI" -0 :x : ,C') rt1 - .< m o - .. w CJ1 ,20g. O~~i tZf~9l1Date Paid " ./ FOR CLER Annual Registration fee:Wes [] No Amount Paid Lobbyist Registration Form received and verified b Revised 02110/04 F: CLER\ALL\ \LOBBYIST\LOBBYIST FORM 04 MIAMI Il60568.1 7348810704 Page 1 of1 Gibson, Elizabeth From: Gibson, Elizabeth Sent: Thursday, September 28,20063:58 PM To: Planning Department Subject: Lobbyist Registration Form Hi: The below listed individuals have registered with the City Clerk's office to lobby the Historic Preservation Board regarding the below: Alexandra Deas (2901 Beach Ventures, LLP, Fortune International Management Inc.) - Review by HPB for property at 2912 Collins Ave (kla Seville Hotel) Carter McDowell (2901 Beach Ventures, LLP, Fortune International Management Inc.) - Review by HPB for property at 2912 Collins Ave (kla Seville Hotel) The above registration can be viewed on Laserfice. Thank you M[AM[ BEACH Elizabeth A. Gibson, Dam. Aide I CITY CLERK'S OFFICE 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: #305-673-7000 ext. 6143/ Fax: 305-673-7254/ www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. 09/28/2006