Louis J. Terminello/Rendevous Holdings, LLC
.(9
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 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 foreseeablv 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.
Terminello, Louis J.
NAME OF LOBBYIST: (Last)
(First)
(M.!)
33133
(Zip Code)
Terminello & Terminello, P.A., 2700 S.W. 37th Avenue, Miami, FL
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
(305) 444-5002
TELEPHONE NUMBER:
(305) 443-5566
FAX NUMBER:
Ijt@terminello.com
EMAIL:
I. LOBBYIST RETAINED BY:
'Rp:i'lilpvnllA Hnli1invA_ I.T.e
NAME OF PRINCIPAL/CLIENT:
Club Deep/Ruby Lounge 6211-623 Washington Avenue, Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS
(Number and Street)
(City)
(State)
(Zip Code)
(305) 444-5002
TELEPHONE NUMBER:
(305) 448-5566
FAX NUMBER: (Optional)
c/o lit@terminello.com
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:
PJ Patel, Manager
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
PJ Patel
II. SPECIFIC LOBBY ISSUE:
conditional use modification
Issue to be lobbied (Describe in detail):
III. cnv AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
City of Miami Beach Planning Board
NONE
.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLA TRATE OR OTHER).
A) 'LOBBYIST DISCLOSURE: (Required)
to be billed
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), to be billed
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":
o Yes Xl No: Are YOU lobbvinG on a oresent or Dendina bid for Goods. eauioment or services. or on a
oresent or oendina award for Goods. eauioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "'Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes ~ No: Are vou lobbving on a Dending aDDlication for a DeveloDment Agreement with the City or
aoolication for chanGe 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..
n Yes ~ No: Are you reoresentina a not~for~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, 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.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
famiiiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
J'~PoA
,PAf'J AAS ' :s' . P tm::L
Form of Identification
PRINCIPAL IDENTlF~ON:
Produced ID l
Form of Identification
VI.
LOBBYIST IDENTIFICATION:
Produced ID
Personally known (Lobbyist)
Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
.
Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
Signature of Publi
Notarization of
JAY 0, SMITH
MY COMMISSION # DO 312124
EXPIRES: May 29, 2008
I1onClOClThNNOlolI')'PUblicUndeFWriters
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of J anuarv , 20 07
State of Florida, County of Miami-
Swor,\ ~nd subscr' ed before me
This ~day of n 20
FOR CLE
Annual Registration fee: ] Yes [ ] No Amount R "t:J
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.do
Date Paid ~
Revised 12/08/04
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLATRATEOROTHER).
. .
.
A) LOBBYIST DISCLOSURE: (Required)
to be billed
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). to be billed
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitied "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
o Yes XI No: Are you lobbving on a Dresent or Dendina bid for Goods. eauiDment or services. or on a
Dresent or Dendina award for QOods. eouiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes IJNo: Are YOU lobbyinG on a oendinG aDDlication for a DeyelODment AGreement with the City or
aDDlication for chanGe of zonino 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..
DYes 1rl No: Are you reDresentina a not-for-Drofit corDoration or entity without sDecial comDensation
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 reporting
requirements. cP
Signature of Lobbyist: ,---f\
Signature of Principal/Client: )'~ f6A.. 'pAf'JfI<A:::J. ::r'. PIPet.
VI. LOBBYIST IDENTIFICATION:
Produced ID
Form of Identification
PRINCIPALIDENTIF~ON:
Produced ID l
Form of Identification
Personally known (Lobbyist)
Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
Signature of Publi
Notarization of
JAY D. SMITH
MY COMMISSION. DO 312124
EXPIRES, May 29. 2008
IonoOllThI'\lNllIO.l'JPublcUnderwrilers
07
bal
State of Florida, County of Miami-
Swor,\ ~nd subscr" d before me
This ..1l-day of 20
FOR CLERK'S USE ONLY
Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR #
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc
Date Paid
Revised 12/0B/04