Robert Switkes/GMBHA
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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 defined in any
manner in this section, 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. .
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NAME OF LOBBYIST: (Last)
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(First)
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BUSINESS NAME AND ADDRESS
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TELEPHONE NUMBER:
1..9\,('(')\X\ y.[-\ VY'-.A)?
(Number and Street) (City)
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FAX NUMBER: .
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(State)
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(Zip Code)
EMAIL:
I. LOBBYIST RETAINED BY:
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NAME OF PRINCIPAL/CUENT:
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BUSINESS NAME AND ADDRESS (Number and Street)
( :?i.J"o.53\ - ~J.t55~
TELEPHONE NUMBER:
(City)
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(State)
~\ 32)\ 29i
(Zip Code)
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 BENEFIOARY:
<~E::.l.0~R""\- b\0\'\\:.::Q;\~~
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
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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
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL r,;
FLA T RA TE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required)
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DYes
B) .., PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 0
~,,to: Are you reoresentina a not-for-profit corooration or entity without soecial comJensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1)
Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach Citv Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaion Contributions By Lobbvists On Procurement Issues":
;'
DYes Q' No:
Are YOU lobbvina on a oresent or oendina bid for aoods, eauioment or services, or on a oresent
or pendina award for coods, eauioment or service?
2)
Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaiqn Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaiqn Contributions By Lobbvists On Real Estate Develooment Issues":
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 PRECEDING~DAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURi;SOR CJMPENSATION DURING THE
REPORTING PERIOD. / ~
..:.: / . "
;. ~g~at of LObbYiS;" . - .
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.
Signature of Lobbyist:
D Produced
i
D Produced 10
VI.
Form of Identification
Form of Identification
~sonally known (Principal)
af Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and SUbSCri~d ~efOfe1J1e _,_
This \ \ day of ).j:lNl \J . 20LL 7
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Signature of Public Notary - State of Florida
N,.,.rzm~'t.~S~'!lt9!'ature
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: !~'t!:. Expires 1/13/2008 :
: i~ if Bonded thru (8C0)432-4254:
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State of Florida, County of Miami-Dade
Sworn. and sUbscr~~nVme
This -1...L-day of " 20.0.'1
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Signature of Public Notary - State of Florida
Nota riz~J;i.CM\.af.P.r~9.!J;gnfture
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'. FOR C RK'S USE ONLY ..""I tA.~ C..~.
Annual Registration fee: (vrYes [ ] No Amount ai ~ MCR ~ 2 d .I
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: cti R\
Date Paid L/...., ).- 0 7