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Gabriel Nieto/AEG Live, LLC . " ~ ~ MIAMIBEACH 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 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. Nieto, Gabriel E. NAME OF LOBBYIST: (Last) Berger Singerman PA 200 S. Biscayne Blvd., Suite 1000 Miami, Florida 33131 (First) (M.I) BUSINESS NAME AND ADDRESS (Number and Street) 305755-9500 305714-4340 gnieto@bergersingerman.com (City) (State) (Zip Code) TELEPHONE NUMBER FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: AEG Live, LLC NAME OF PRINCIPAUCLlENT: 5750 Wilshire Blvd., Suite 501, Los Angeles, CA 90036 BUSINESS NAME AND ADDRESS 323930-5m (Number and Street) 323 930-5712 (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (OplionaQ 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: Randy Phillips, President IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: AEG Live LLC is controlled by Anschutz Entertainment LLC which is owned and controlled by The Anschutz Company which is 100% owned by Phillip Anschutz ~ II II. SPECIFIC LOBBY ISSUE: Management Agreement for Jackie Gleason Theater * ISS~~~~~d70::te ~t~i~~ MCIA\.-r ~( 0P(tLIO. ~ltQs~ ~~{2( III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of IndividuallTitle B) Any Financial, Familial or Professional Relationship Jorge M. Gonzalez None City Manager Mayor and City Commissioners None (see attached list) Gus Lopez and John Ellis None Procurement 721752-1 . IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $415.00 Der Hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). "tq.IS pH ho\J.(" 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: Are YOU lobbying on a present or pending bid for goods. equipment or services. or on a present or pending award for goods. equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes'Qi.No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change 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 "Iobbyisf' 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 direc~ 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 '!il1 No: Are you representing 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 EXPENDIT;' S WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC I LENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDI UR COMPENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all he with the provisions cont Ined. requirements. Signature of Lobbyist: Signature of Principal/Client: - , VI. LOBBYIST IDENTIFICATION: o Produced ID regoing facts are true and correct and that I have read or am familiar Section 2-482 of the Miami Beach City Code and all reporting " PRINCIPAL IDE l.'/i......:"di'./ o Produced ID Form of Identification I Personally known (Lobbyist) Form of Identification ~ Personally known (Principal) I VII. SIGNATURE AND STAMP OF NOTARY: ~J i.{.~TVI;q L A State of Florida, County of Miami-Dade _ State of-Fl~ County of Miami=Bade 05 r,q;;:/ ?5 swoma~ subsaibed ~re me _ Swom and subscribed before me .. J This 4. day of ,2012.1 This~daYOf~,2007 SignatureofPublicNotary-StateofFlorida )1 _ ! '. P. " ~,ignatureofPublicNotary-StateofFlorida (~t;... 4#-"'~'7d \ Notarization of Lobbyist's signature ,~\.D....f4;ttt. ~-b'V""otarization of Principal's signature _ j FORCL~~SE ONLY Q;I) Ot'l 'l'O Annual Registration fee: [ ] Yes [ ] No Amou Id ~ f':1CR # '" .:J lJT Lobbyist Registration Form received and verified by: \If y, J:. F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc ~ Revised 12/08/04 721752-1 CALlFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California CO"oly of kz A V1Y 117 Do ~ ~~, 1m7/Y1:;'T . ""-'~~:r""'"-'~~'"" personally appeared I V1f' ~ ~ I \ rV" Name(s) of Signer(s) }" ~ersonally known to me o proved to me on the basis of satisfactory evidence J~ ARLYNE LEWISTON ~ - COMM. # 1702357 I/) . -. NOTARY PUBLIC. CAliFORNIA (I) ~ Los ANGELES COUNTY - My COIIII. Exp. OCT. 31, 2010 T to be the person~ whose name(s} is/are- subscribed to the within instrument and acknowledged to me that ~he/tJ:Iey executed the same in Riefher/tl:leir authorized capacity(leS}, and that by Ilisther/tretr signature(s)-on the instrument the person{er, or the entity upon behalf of which the persoo{af acted, executed the instrument. OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document h TItle 0' Type of Doc"meot~d-- ~nJVQ :V1 Document Date: 1"1 q '1 06>, I ~ 007 Signer(s) Other Than Named Above: GO lo ......; 'F IT. (ovm (~I,aWli ~rach I ;L Number of Pages: N~~t-o Capacity(ies) Claimed by Signer Signer's Name: --to od ? ( I VI y :7r:k1JJy V o Individual o Corporate Officer - Title(s): o Partner - 0 Limited 0 General o Attorney-in-Fact o Trustee o Guardian or Conservator p(. . ~ P I I c\ . +- ~ Other: i 1 iIlC I ~ I 'f 1/1 A~ I' I I.J Signer Is Representing: t~' ,r\ V f _ . r C- I Top of thumb here @ 1999 National Notary Association. 9350 De Soto Ave., P.O. Box 2402. Chatsworth, CA 91313-2402. www.nationalnotary.org Prod, No, 5907 Reorder: Call ToU-Free 1-800-876-6827 . Mayor & Commissioners . Page 1 of2 MIAMI B EACl1 1 Resident Visitor Business Employee E-Government Calend MAYOR & COMMISSIONERS The City of Miami Beach is governed by a City Commission/City Manager type government. The City Coml consists of six elected Commissioners and an elected Mayor. Commissioners are elected for a term of fou with a term limit of two terms. Terms are staggered so that half the members of the Commission are electe, two years. The Mayor is elected every two years. The Commission appoints the City Manager, who oversl City Administration. .~ MaY_QLQavidJLe1m~U: Current term: 2005 - 2007 First elected: 2001 Profession: Attorney Telephone: 305-673-7035 Email: mayordermer@mi.amibeachfl.gov Co_mml~slon.eLM_aitLl:le.JL~ra-.6oweL Current term: 2003 - 2007 First elected: 1999 Profession: Commissioner Telephone: 305-673-7107 Email: ill;2tti@miamibeachfl.gov kommis_sioner Simon Cruz Current term: 2003 - 2007 First elected: 1997 Profession: Business/Real Estate Telephone: 305-673-7102 Email: simon@mlC!JIIibeachfl.go..Y GommisslQIlecMlct!a_eLG_Qogoxa Current term: 2006 - 2007 First elected: 2006 Profession: Attorney Telephone: 305-673-7105 Email: michael@miamibeachfl.gov Vice Mayor Saul Gross Current term: 2005 - 2009 First elected: 2001 Profession: Business/Real Estate Telephone: 305-673-7104 Email: saul@miamibeachfl.gov Commissioner Jerry_lib_bin Current term: 2005 - 2009 First elected: 2005 Profession: Financial Planner Telephone: 305-673-7106 Email: ~@miamibeachfl.gov http://www .miamibeachfl. gOY Inewcity I ci tyhalll elected. asp 3/21/2007 ~, . · Mayor & Commissioners " Page 20[2 C_Qmml~,-$lQJJ_~L.Blcha(d_Sj~jJ1b_e-.rg Current term: 2005 - 2009 First elected: 2001 Profession: Attorney Telephone: 305-673-7103 Email: richa(~t@miamibeaGhfl.gov Commissioner Steinberg's Web Page ,- The Mayor or Commissioners may be contacted by Email or by writing to: WebGast of Commission Meeting Commission Meeting Agendas Commission Meeting - After Action Reports Commission Meeting Schedule Commission Committees Election Information Vote Miami Beach Mayor/Commissioners - 1917 to date The Office of the Mayor and Commission City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 http://www .miami beachfl. gov Inewcity I ci ty hall/elected. asp 3/21/2007