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Santiago D. Echemendia/Michael Muskat . in "lIIIII:' tv\IAMIBEACH 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 dry board or committee; or any action, decision or recommendation of any city personn~ 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 dty commission, or a city board or committee. The term spedficaUy includes the principal as well as any employee engaged in lobbying activities. ~e term "lobbyists" has spedfic exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: TewCardenas, Echemendia Santiago (Last) (First) LLP 1441 Brickell Avenue, 15 Floor Miami, BUSINESS NAME AND ADDRESS (Number and Street) (City) (305) 536-1116 FAX NUMBER: (State) D (M.I) FL 33131 (Zip Code) (305) 536-1112 TELEPHONE NUMBER: SDE@TewLaw.com EMAIL: I. LOBBYIST RETAINED BY: Michael Muskat NAME OF PRINCIPAl/CLIENT: 10775 SW 133rd Terrace Miami Florida BUSINESS NAME AND ADDRESS (Number and Street) (City) 33176 (State) (Zip Code) (786) 286-2491 TELEPHONE NUMBER: (305) 253-3200 FAX NUMBER: (Optional) 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: . IOENTIFY ALL PERSONS HOLDING, DIREffi Y OR INDIRECfL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Board of Adjustment Application 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 Richard Lorber ,Manager None Diana Rio, None .Jorge Gomez , Director None Antionette Stohl None ---/------.------ - --- ----- ----- ~ , TN. DISCLOSURE Of TERMS AND AMOUNTS Of LOBBYIST COMPENSA1l0N (DISCLOSE WHETHER HOURLY, FlATRATE OR OTlfER): $400.00 hourly $400.00 A) ~ST DISCLOSURE' (Required) B) P.8.INQPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). hourly The following Information must be answered: 1) pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign contrlbutions By Lobbyists On Procurement Issues": DYes I\.K<" A::,,::~ :b::~: ~n ::.,~,:=t or _ncllno, bid far =::.: :;iament or service.. or on a n n II r r aoods. .UIDment Dr urvlee? 2) pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contrlbutlons By Lobbyists On Real Estate Development Issues": DYes WIG: ::~:~:~,:~n.::.::::.. ":,n::~n:a;:~~~o':~t~o~:~~~::~;:e;.~~ ;''::r~~~~ Hu1 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 2-4B1 above) who only appears as a representative of a not.for-proflt corporation or entity without special compensa~on or reimbursement for the appearance, whether direct, or Indirect, to express support of or opposition III any Item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees.. n Yes ~o: Are vou reoreeentlno a not-for-Drom corooration Dr entity wit:ltout sDocia. comnensmon or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBVIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, UmNG LOBBYING EXPENDnuRES, AS WELL AS COMPENSAUON 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 REPORUNG PERIOD. / Signature of Lobbyist ./ I do solemnly swear that all of the foregoing filets are true and correct and that I have read or am familiar with the provisions contained In SectIon 2-482 of the Miami Beach aty Code and all reporting requirements. Sign~ture of Lobbyist: Signature of Prlncipal/Oient:, ~ ~ VI. LOBBYIST IDENTlFICA1l0N~" ' PRINCIPAL IDENTIfICA1l0N: , ",,::. E "'- 8 >~2 ,.: o 'PO'" ~ II: ~.... c "'0 ' _ ~ 0, " c.9~ffi~ 1i) .~u... g c:~..<c ~lg: 1:! <.>.lS~ ~""'~~~~'t",. ':>~~",.~o'-' oii!'~~' ~~.~)~~ ";,,~dN:~~"~ "'1111'." o Produced ID IJ Produced 10 Form of Identffication ~sonally known (Principal) Form of Identification br i'ersonally known (Labbylst) vn. SIGNATURE AND STAMP OF NOTARY' State of Florida, County of Miami-Dade swom to ~nd subscrlb.<:/l befol"\! ~~ This _. ; _day of ~ --" 20_ State of Florida, COunty of Miami-Dade Sworn 8{1d sub or e This ~day of 2 Signature of PubHc Notary - State of Aorlda NotllrtZlltion of lobbyist's slgnlltUre FOR~LY UKlif(";, AnnUllI Registration fee: [] No Amount Pai MeR # Date Paid Lobbyist Reglstratlon Form celved and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYlST fORM OS.d Re e~.... .. '3\ ... ~ ;.c= ~'1.: ::b~ ~ #....~;-~ ;'" .,'....:; ii'" >m_.~ ~ '"III '5 i .."g'~ ~~""G") ~_go :., ..~U'lg. j:oe: ~ ~'"< -N C> N , --------- ---- --_.--- ----------~-_.- IV. . DISCLOSURE OF 'nRMS AND AMOUNTS OF LOBBVIST COMPENSATION (DISCLOSE WIIETHER HOURLY, RATRATfOR 071lER): A) LOBBYIST DISCLOSURE: (Required) B) PRlNOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $400.00 hourly $400.00 hourly The following information must be answered: 1) pursuant to Miami Beach City Code Section 2-48l1 Entitled "Prohibited Campaign Contributions By Lobbyists On ProCUrement Issues": o Yes ~o: A::': :b=:.::.n ~~r:'=:: oencll~ ~~::.~ ::ioment or .e<VI,.... or on a !!_ _ r ___ __, __ :-o.ts. 8GUlDm!nt or urv~ce? 2) pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": [lYes -dNO: ::~:::':~:::.. ":,n:;n:o;:~:~~:::~~~~:: ~::~:~ ;''::~~U':e HIJl1 3) Pursuant to Miami Beach City Code 2-484 (11) MY person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without spedal compensaljon or reimbursement for the appearance, whether direct, or Indirect, to express support of or opposition l.ll any Item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees.. n Yes JNO: Are you reoresentina a not-for-Drof"1t eorooratian Dr entity without sDee;al eom....nsation or reimbursement. w V. SlGNAlVRE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTlNG LOBBYING EXPENDITURES. AS WELL AS COMPENSAUON RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSAUON DUllING THE REPORUNG PEIlIOD. ~ Signature of Lobbyist I do solemnly swear that all of the foregoing filets are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach Oty Code and all reporting requirements. --t.Signature of Lobbyist: ~ ~ lSlgnature of Prlnclpal/aient: >.CDQ 0 OC::N ~ "C~cv;-~. oo-S Cl'l!,ffi2: 15 .~LA.. ~ c:: ~ ..,; ~"" .~~ V:i~ __ w,' _= :l: o ~;;: w... " .....,\ ~1I ~ lit".. .:-,~~':.r!,/~"" VII. ~$Jffi~\~i ,<:<'..""'. "','f,oN:Si~.l "'"11"\ L" ProdUced ID Form of Identification ~ Personally known (lobbyist) o Produced 10 Fonn of Identification ~~ g :>.~ ~ ~ o ~t:'?~ r:r: "0 CJ _ i5 Oc> 0 Cl 'l!, a:i 2: ....... c:::t! ~ Q).2 r:r: c:: ~ '" C1J .!!! en <( >= E Q) . E'=:: 3: o~" ww" .....\\0.~~~Qt", ':-~'Q"""'~o~ ~;'{~i"~ -;.~~g... ....'~6N:s:r.~:l "IfI"'" LOBBYIST IDENTIFICATION: PRINCIPAL IDENllFlCATION: L1 Personally known (Principal) SIGNATURE AND STAMP OF NOTARY: 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 FOR CLERK'S USE ONLY Annual RegIstration fee: [ ] Yes [ ] No Amount Paid MeR # lobbyist Registration Form received and ve!ified by: F:\CUR\$ALL\MARIA-M\lDbbylst\LOBBYlST fORM OS.doc Oate Paid Revised 12/08/04 -" ----~~-- --------- - ------------ IV. . Dl5CI.OSURE Of TERMS AND AMOUNTS Of lOBB'(1ST COMPENSAllotl (Dl5CI.OSE WlIETHU HOURL Y, .FlAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRlNOPAL'S DISClOSURE (OF LOBBYIST COMPENSATION): (Required). $400.00 hourly $400.00 hourly The following information must be answered: I) pursuant to Miami Beach City Code Section 2-4811 Entitled "Prohibited Campaign Contributions By Lobbyists On PrOCUrement Issues": D Yes ~o: A::::': ::::::.::.n :.== or ......~"".::.::: ~.:;-Dment or ......vices. or on a 2...-- _ __ __ a __ IIftftlfIs. .lHllm!!d; nr set'V!ce1 2) pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes .dNO: ~:~~:';:~::::.. ,,;:;..:o:=,::::::::'':'':~;''7''a:: :::~~U-:' HuI 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 2-4B1 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 -dNO: Are YOU reoresentino a not-for-oroflt cornoration or entity without soecial comoensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 15" OF EACH YEAR, EACH lOBBYIST SHAll SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNOER OATH, usnNG lOBBYIlIG EXPENOIlURES, 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 ll1e foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of ll1e Miami Beach Oty Code and all reporting requirements. SIgnature of Lobbyist: /l-> ~~o ~gnature of Princlpal/dlent: 51:: ~ ~~ 3 >~N> 0- .- 0- -= "0 ." ~. LOBBYIST IDENTlFICAllOll: 'U :3 ~:! PRINCPAlIDENTlFICAllON: og 8 00 .~ o~mZ ~~ffiz ~ c UJ Z 11 Produced ID c...... <> 0 Produced 10 C) _Q I.L. ~ Form of Identification ~ -~ ~. ~ Fonn of Identification c:t::..~ ~ -.- -j!!. 'E ~ ~ ~ -E CD . E . i3. " . Personaily known (lobbyist) ~ -~ ~ U personaily known (principal) o~~ ~~> c-: lLJ 3 ....\1.._...~ ~,\,'l ~""I, ~~.~ .:'",-!".~~",,_. YO. SIGNATURE AND STAMP OF NOTAR:_-'1if'......-':'b}~_ ;.,,~. '..0;, __:::.:..JiIf..'.::_- ;>-: ;10-:;: '~:o ~'>j" ;,i!;, State of Florida, County of Miami-Dade \~...::...~j State of Florida, COunty of Miami-Dade '"..o.v:S1~....~..",.:' .,. '3~'~'; "hmll'" Swam to and subsai ed fore,)T1, I, . ........ ... swom and subscribed before me This d of ([ 'c 2 . This _day of ' 20_ ignature of Public Notary - State of Florida Notarization of Principal's signature f:j~ E <00 0 >.,..... C"o.I ;:! au:; ..a:: -o_M< 0_-.... c <> (9 'lj,cO Z ..... c~ 6 Q) _~ a:: c:: ~ '" co .~ en <( r Ell> . E'!::: S: a~::: '-' UJ 3: ,,''''~~~:\:~'''' "9)V'" ~'.o ';;~.. '.0- ;:Q,.: '.it.~ ~~ :i!;~ -:.......o....~f ",,,~;~~,,.., FOR Cl,.ERK'S USE ONLY Annual Registration fee: [ 1 Yes I ] No AmoUnt Paid MCR # Lobbyist Registra~on Form received and velified by: F:\CLER\$ALL\MARlA-M\LObbylst\LOBBYIST fORM OS.doc Date Paid Revised 1<108/04 , . .. .. /(; .s _,f) ~ ...r 0 N C t'-- , CX) ~ C::J N '", '0 "', ci J~ '11, - :z 8 "- ~ J c1 ~ III '"'b ~. --- ~ C"'! ~~ - cr) \)\ c! <"\ 1.11 u.. Q~ ~ .~ a E~ - '! ! ,c:z: 12 Ii; , B~ aI U ::l :::I! :!: ~ .11I "'0 ~- l!! ~ i~ u t-o 0 .. i::E II:: 0 e =1&. .s::. II. :s 30 U) J i!l z III U (I) C L: .!2~ I " ~ :s l! 0 .. J J :l!u II:: ~ : a.