Ned Colliett/Live Nation Worldwide
e MIAMIBEACH
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 dty board or committee; or any action, dedslon or recommendation of any dty personnel during the time
period of the entire dedsion-maklng process on such action, dedsion or recommendation that foreseeably will be heard or reviewed
by the dty commission, or a city board or committee. The tenn specifically includes the prindpal as well as any employee engaged
in lobbying activities. The term "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435.
NAME OF LOBBYIST:
(Last)
C QL UE iT
(M.!)
(First)
/y tEl)
BUSINESS NAME AND ADDRESS (Number and Street) (aty) (State) (Zip Code)
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TELEPHONE NUMBER: :lIt? __ g{?,_ .,cx;c,lAX NUMBER: EMAIL: #.€.Qt'oUli!"~ l.J;
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LOBBYIST RETAINED BY:
NAME OF PRINCIPAl/CUE NT:
(Zip Code)
(0
TELEPHONE NUMBER:
'3/(/ -g{ 1- 7~
Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (c)l
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
J1tIe NilE! /(!1lr,PO
IDENTIFY ALL PERSONS HOLDING, DIRECTlY OR INDIREO"L Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
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U. SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail): FcJ:r'()//~ ur/C: A.(./) dlfG"I'/f/f;,v 011= ;rl9u~g 6-(.~4Jc~ 71/1G11.~
m. crrv AGENCIES/INDMDUALS 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 HOURLY,
FLATRATEOR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
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B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). A/tl ~rl:.
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":
D Yes ~o: Are YOU lobbyina on a oresent or oendinG bid for Goods, eGUiDment or services, or on a
Dresent or oendina award for GOods, eGuloment or service?
2) Pursuant to Miami Beach aty Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes ~o: Are YOU lobbyinG on a oendinG aODlication for a DeveloDment Agreement with the City or
aoolication for chanae of zonina maD desiGnation or chanGe to the City's Future Land Use
MaD?
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..
D Yes ~o: Are YOU reDresentina a not-for-Drofit comoration or entitY without sDecial comDensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 151 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSAnON
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECED NG CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDIT S OR COMPENS rION DURING THE
REPORTING PERIOD. ~
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Aproduced ID _~ ~
Form of IdentifICation
nd correct and that I have read or am
Miami Beach City Code and all reporting
PRINOPAL IDENTIFICATION:
ExecutlveVlce,,*and
Chief Accounting OffICer
o Produced ID
o Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identification
~rSOnallY known (Principal)
~--
S gnature of Pulj Ic No - State of Florida
Notarization of LobbVist's signature
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This d't
./ FOR CLER{S ~E ONLY e-;
Annual Registration fee: [V1Yes[ lNo Amount Paid ~ MCR#2 ~DatePaid Jr-./,o/fY"
Lobbyist Registration Form received and verified bY~ V ~ ~
F:\CL~fi} ALL\MARIA-M\Lobbylst\LOBBYIST fORM . Revised 12/08/04
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~f~,.t.&-'}~~CO":1mission #00547686
~":~~cli Expires: MAY 02,2010
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KATHERINE WETMORE
Notary Public. State of Texas
My Commission Expires
March 16. 2010