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Carter McDowell/UIA Management LLC By. Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeksllH'~II\';uUli:lyt:: lilt:: 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. City of Miami Beach Office of the City Clerk ~~2E~J'YD~P~ 1700 Convention Center Drive, Miami Beach, FL 33139 JUN 7 - 2007 LOBBYIST REGISTRATION FORM (First) N. (M.I) NAME OF LOBBYIST: McDowell (Last) Carter Bilzin Sumberq - 200 South Biscavne Boulevard. 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: UIA Manaqement. LLC. MBeach 1, LLLP. MBeach 3. LLC, and Robert Wennett NAME OF PRINCIPAUCLlENT: c/o UIA Manaqement. LLC 1111 Lincoln Road, Suite 760, BUSINESS NAME AND ADDRESS (Number and Street) Miami Beach, Florida (City) (State) :::> < ::J: rn C{.I 0 n W rr. 305/538-9320 TELEPHONE NUMBER: 305/552-0016 FAX NUMBER: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Robert Wennett . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: , . II. SPECIFIC LOBBY ISSUE: Development Aqreement for propertv at 1111 Lincoln Road 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 City Commission, City Manager, City Attorney None Department Staff " " IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLA T RA TE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) Hourly $500 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly $500 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": D Yes [KINo: 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": [KI Yes D 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 "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 [KINo: 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 LERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSAT ~ECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALLBE FILED EVEN IF THERE HAVE BEEN NO EXP~NOITURES DR COMPENSATION DURING THE REPORTI~ERI~ j Signatu~bYlst I do ~olem.nly sw~ar that all of the .for~going fac.~s a. re t.:!}l7'.".and correc.t and th~~~~.ha e read or am familiar with the provisions contained In Section 2-482 of the Miami Beach ~Ity ~~).nd all repqrtlng/r'~J ts. Signature of Lobbyist: ~/ .~,/ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: D Produced ID ~ Form of Identification IV' Personally known (Lobbyist) D Produced ID Form of Identification D Personally known (Principal) State of Florida, County of Miami-Dade worn and subscribed before me his _ day of , 20_ Signature of Public Notary - State of Florida Notarization of Principal's signature Y -Jr?aCI.r-- MCR ~ Date Paid '7 IAMI133 ;/30/07 I 1 ,I I I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, '. FLA T RA TE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) Hourlv $500 - B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourlv $500 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": ' I J Yes l8INo: 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 Entitl~d "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": 18I Yes II 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'definltlon 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.. ' . !'! Yes l&INo: 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 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. Signature of Lobbyist: Signature of Principal/Client ~ \. ~ .. ~~. ~~l~ VI. LOBBYIST IDENTIFICATION:' .\ .. i ~ ----=- , ... , ~'-I:: PRINCIPAL IDENTIFIC TION: II produced 10 Ll Produced 10 Form of Identification I~ Personally known (Principal) A Leigh ,\\\I''''tt Heather . ,,"l;l::.'V.~!'l", . 9185-' :~",:" "~~Commisslon #DD4 '. -~. . . - 17 2"'\1.1 . . ;0.:. ..:~gExpires: NOV. , \'U7 State of Flonda, County of Mlal11'l:; 'If-.~':- , " !\ 'r."";~OT\R'i, 1; Sworn Wd subscribed before me "t""",,\' WI,"i,,, ro This b y a. 20 0 T Form of Identification II Personally known (LobbyIst) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swom to and subscribed before me This _ day'of ,20_ Signature of Public Notary - State of Florida Notarization of Lobbyist's signature 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\Lobbylst\LOBBYIST FORM OS.doc Date Paid Revised 12/08/04 .11AMI125