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Alexander Tachmes/CABI 301 Residential LLLP lD MIAMIBEAC'H 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. 1 {lCN\Me<; f( le~ I. . NAME OF LOBBYIST: (Last) (First) (M.I) ~S~ ~ lLP/f5DO Mialflli cel\tu. aD' S. 8~14lf~e PbJva., H-ia"~'1 FL 3~{lJ BUSINESS NAME AND ADDRESS (Number and Street) · (City) (State) I (Zip Code) C30~) ,'tl-T3'tl f3d;) ~~7-77S't a-r-401'IItl1eS@<bv."rls . CdW' TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: ~~ 1 30\ (l.e5 i tlt'lIl't\a I LLL P NAME OF PRINCIPAL/CLIENT: C l\f!iL ?;x> \ ~es,aclllna\ LLJ..e__~q S-O W. ~ Cll.tlo BUSINESS NAME AN[)"A3DRESS (Number and Street) (City) ~) lt~0 -I ctl 0 BoS) ~"-1<l.77 TELEPHONE NUMBER: FAX NUMBER: (Optional) [M~, Suite 'fOD / ^lI'eN1tuva I pL 3~/~ (State) (Zip Code) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: 'J a [o'tJo (a ba'oi e IDENTIFY ALL PERSONS .HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Elias (a~a~e j l\\oaz\JlaWl (tJ \DolDie II. SPECIFIC LOBBY ~SUE:. ~ . oI'te ct"",J.7 I ~~ ~ 00 ((:WlddiC>\AaJ_ Use {e\lleW O~l""al/l.le rec;jcJ...O(~. ,. _W J ."'&.I\.--....,~ 7"'10 s<ll1aYe tfet 411lt,( 0\14'" H\ {OMM(:.raa.1 D,'-tVll-ts 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 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) ~ (X) fel VZOUV B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (ReqUired).J 4'00 ee ( VI 0 U. If 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 lobbvinq on a present or pendinq bid for qoods. equipment or services. or on a present or pendinq award for qoods. eauipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes~: Are yOU lobbvinq on a pendina application for a Development Aareement with the City or application for chanqe of zoninq map desiqnation or chanqe to the City's Future Land Use Map? 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 ~ Are yOU representinq a not-for-profit corporation or entity without special compensation 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, 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 ~PENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. (~4~iA~ 1 . Signature of Lobbyist I do solemnly swear that al r the foregoing facts are true and correct and that I have read or am familiar with the provisions ontained in Section 2-482 of the Miami Beach City Code and all reporting requirements. ... n ~ Signature of Lobbyist: ~ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification ~rSOnallY known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: Form of Identification I Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This _day of , 20_ Signature of Public Notary - State of Florida Notarization of Principal's signature Annual Registration fee: [v{'Yes [ ] No Amount Lobbyist Registration Form received and verified by: F:\CLER\$ALL \MARIA-M\Lobbyist\LOBBYIST fORM OS.do Date Paid / Revised 12/08/04 12/04/2006 MON 9:35 FAX I4J 001/001 DEC-04-2006 09157 CITY MIAMI BCH CLERK DEPT 305 6737254 P.02 lV. D1SClOSU~ OF TERMS AND AMOUNTS OF LOBBYIST COMPfHSA'TlON (DlSCl.OSE W"ElltEk HOURLY, FLArRATEOR017fER}: A) LOBBYIST DISCLOSURE: (Required) -1i:t lX:J f~.f \,iOUV' e) PRINClPAI:S OISO-OSuru: (OF LOBBYIST COMPENSATION): (Required).~OO ft( VlO\lv .The fol1owing infonnation must be answered: '1) Pursuant to Miami Beach Cfty Code Section 2-488 fntitled "Prohibited Campaign Contributions By lobbyists On Procurement Issues": o Yes ~Ol Are YOU Iobbvina on :II Dresent or nendinQ bid far qDDds, equh)ment ot services. or on it DNSent or IMndlna award for GOods. eouiDment or se~ic:e? 2) Pursuant to Miami Beactl Oty Code 2-490 Entil1ed ~Prohlblted campaign COntributions By l.obbylsts On Real Estate Development Issues"; DYes~: ~ ~~:~~n~ ::~ ~n:na n:Do~;1on for a DeVelOlSment Aq~ent with the City or 80 L_':__ __.....!L_ , f _fti _ ",___~i(J"ation or chanae to the Citv's Future Htnd use f!Wil 3) Pursuant to Miami Beach aty COde 2-484 (h) Any person (except those exempt from the definition of "lobbyiSt" as llet fortn in section 2-4S1 above) who only appea~ as a representative of a not-for-profit corporation or entity without spedClI compensation or reimbursement for the appearance, whether direct, or Indirect, to express Sl.lpport of or opposition to any item, shall n:gister with the clerk as required by t.hls sectlon but, shall not be required to pay any registnltion fees.. . L\ Yes ru<:: Are YO" re~ntinq a "ot-for-~ror.t corporation Gr entttv without soecial comoenption or reimbursement. . V. SlGN.ATURE UNDER OATH: ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SKALL SUBMIT TO THE CITY ClERK A SIGNED ,$TAnNEN1 LlNPErt. OATH, U$nNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, !N THE aTY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YeAR.. A STATEMENT SHAll BE mEO EVEN IF llIERE HAVE BEEN NO qENOrruRES OR COMPENSAnON DURING llIE ....pORnNGPERlOO. 4 ...~ ~ture of lobbYist the foregoing facts are true and correct and that I have read or am ined in Section 2-4S2 or the Miamf Beacl1 aty Code and all reporting I do solemnly swear that al familiar with the provisions requirements. Signature of lobbyist: Signature of Prlndpal/Olent: PRINCIPAL IDENTIFICATION: VI. LOBBYIST IbEHTlftCATION: rl Produced 10 I I Produced ID Form of ldentlflcatlon ~rsona(1y known (Lobbyist) .~. SIGNATURE AND STAMP OF NOTARY: Form of Identlfication ~rwnally known (Principal) State of Florida, County of MIami-Dade Sworn .rOd subscribed before me This 1. day ) , l{;fir 20....Q 0 ty." . . ! ^ V Signature of Public N~ - State of Florida Notarization of Prlndpal's signature \,\nltll I _--;,~.Y.i)U~'" GIselle Gonza [",:., 4t ..~~Commlssion !!DD41 ~~~~:~;, # ~;?-"'" ...:,,~{ Expires: MAR. 27 " OF f\..\,y....' J ""tI"'" WWW.AARONNOTAR FOR elf Annilal Registratlo" fee: [ ] Ye$ C ] No Amount i Lobbyist Registration Form received and verlfled by: ,f; \CI.ER\$All. \MARIA-M\l.obbyist\LOBBYIST fORM 05.d Data Paid Revisl!d 12/08/04 TOTAL P.02