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Carter McDowell/Fontainebleau Resort 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 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. NAME OF LOBBYIST: McDowell (Last) Carter (First) N. (M.I) Bilzin Sumberq Baena Price & Axelrod LLP, 200 South Biscavne Blvd., Suite 2500, Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code) 305-350-2355 TELEPHONE NUMBER: 305-351-2239 FAX NUMBER: cmcdowell@bilzin.com EMAIL: I. LOBBYIST RETAINED BY: Fontainebleau Resorts NAME OF PRINCIPAL/CLIENT: - Glenn Schaeffer 4441 Collins Avenue, Miami Beach, Florida 33140 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-538-2000 TELEPHONE NUMBER: 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: . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II, SPECIFIC LOBBY ISSUE: Master Plan for Fontainebleu Hotel 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 Planning and Zoning Department none Historic Preservation Board none c> ,....:) = - = ..,., -l Planning Board none -<. ::J: r_ City Manager's Office (") ~ m I .....J rr N \"'11 ..... ::~.. -r, -0 :::E W .. o -.J "C:: rn o U: C) (! MIAMI1263845.! 7650823990 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RA TE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) $500/hourIV B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $500/hourlv 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": DYes I)<jNo: Are you 10bbyinQ on a present or pendinQ bid for Qoods, equipment or services, or on a present or pendinQ award for Qoods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": D Yes ~ No: Are YOU 10bbyinQ on a pendinQ application for a Development AQreement 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 ~ No: 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 EVE HERE HAVE BEEN NO E ENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. / I do solemnly swear that all of the foregoing facts are true and correct and that I have in Section 2-482 of the Miami Beach City Code and all reporting requirements. -") ions contained Signature of Lobbyist: Signature of Principal/Client: VI. PRINCIPAL IDENTIFICATION: Produced 10 Produced 10 /" Form of Identification LV" Personally known (f):,.. :1'4) 1...0 ~_,\~-\- 7' Signature 0 ublic Notary - Stat lorida Notarization of Fl. :..v:......~ signature )..0\0" \~~ ,K'S ~E ONLY i2lf; L ..-j\ ) J ) U MCR # ~J (j Date paid!), 'J-I, ~ 7 Revised 12/08/04 8' VERONICAMNlU ... Notary Public-StlIte of NeVIllII APPT. NO. 02.7e3te-f .... . My App. ......IUM It. ... MIAMI 1263845. I 7650823990