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Neisen O. Kasdin/Alberto G. Ribas, A2 Group m ..... MIAMI BEACH 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 cOml11issioner; any action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or tecommendation of any city personnel during the time period of the entire decision-making process on such action, decision or recbmmendation 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. KO\C]J~~ (last) "w"+ (Number and Street) 7j;Zj - 1'7,.- ,,(; . FAX NUMBER: o (M.!) ?~ ':)' (Zip Code) C;V' (('vVl I. LOBBYIST RETAINED BY: Alberto G. Ribas, President NAME OF PRINCIPAL/CLIENT: (City) Florida (State) 33243-2310 (Zip Code) A' Group, Inc. 5001 S,W. 74th Court, Suite 103 BUSINESS NAME AND ADDRESS (Number and Street) Miami 305-668-87939 TELEPHONE NUMBER: 305-668-9454 FAX NUMBER: (Optional) EMAIl: (Optional) Fill out this section if principal is a Corporation, Partnership or Trl.lst [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: A \~k c, ~ 1~01~ IDENTIFY All PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ;bv-''} II. c vw~,^i c) III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship ~ J":i It'l/' , IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), 11(~wL 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": es D No: ment or services or on a 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes 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.. DYes 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 PREC..Ei.D I G CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDl'lIT ES OR COMPENSATION DURING THE REPORTING PERIOD. ; / '~f . //~l'/ Sig ature 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 conta' in Section 2-482 of the Miami Beach City Code and all reporting requirements. . I///;: Signature of Lobbyist: nj Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identificatlon Form of Identific~ticll1Iue( KARLA SALGADO /" ~...~ - """. ~" MY CO,"',"" 100 '"'" V Personally known (Lobb. ~ i My ?ommllllOl1 D0239~ersonallY known (Principal) *", ,.* EXPIRES: April 12, 2008 -'" Expires August 30, 2007 0:., ~'" BondedThru Budget Nolary ServiceB E"OFf'-O VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swom to eod ,"b'''?1::'';,~' This /Io..f)....... day of , 20~ '7 State of Florida, County of Miami-Dade Sworn and subscribed before me This /5.Jh day of ~rCj. ,2007 kt~l.;i~cl_}:1~] Signature of Public Notary - State of Florida Notarization of Principal's signature / FOR CL~S USE ONLY Annual Registration fee: [V] Yes [ ] No Amoun.t Pai S:-oo MCR #~210 Lobbyist Registration Form received and verified bY:~ .v~ F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 , Date Paid \ hta(C';1- I Revised 12/08/04