Alexander P. Heckler/Christobal De La Hozm N~IAMIBE~,CH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION I+ORM
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 foreseeabty 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
rn lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
NAME nF i naavrc-r• (Last) (First) # (M.II
5~~~) t ~5 ~ ~ t~u%~~) L~-i~ ::~LC~ F. l~r (~,t_~_ _u~ '~i'~ ~ i v~ ~T ~~ o ~ !~`T.. ~ ~:~C)
- --
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAL/CLIENT:
to
NAME AND ADDRESS
NUMBER:
In~~ l ~W L~~ J1.
and Street) (City)
FAX NUMBER: (Optional)
M,~~-3~
(State) (Zp
EMAIL:
Fill out this section if principal is a Corporation, Partnership or Trust [section 2-482
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:
~OYk
II. SPECIFIC LOBBY ISSUE:
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
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOUR/ Y
FLAT RATE OR OTHER
-2,
A) LOBBYIST DISCLOSURE: (Required) _~1 ~ C' - ~ ~ ~
s". t
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)._ ~ ~ ~ - ? 'i ~
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitied "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
Yes No: Are ou lobb in on a resent or endin bid for oods a ui ment or services or on a
present or aendina 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":
a lication for than a of zonin ma~ desi nation or than ee to the Ci e'stFuturehLand Use
M-
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 anot-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..
or reimbursement. .
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'ate
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4.
~.'•. ~
V• SIGNATURE UNDER OATH:
ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIST LL SUBMIT T THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING PE DITURES, S WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FORT E PR EDING CA ENDAR EAR. A STATEMENT
SHALL BE FILED EVEN IF THERE NAVE BEEN NO E PEN
REPORTING PERIOD. ES OR COMPE TION DURING THE
Signatu- re of Lobbyist
I do solemnly swear that all f the regoin facts re true an correct a:~d that I have read or am
familiar with the provisions co taine n S cti n 2-48 of the is 'Beach City Code and all reporting
requirements.
Signature of Lobbyist: __
- ------=----
Signature of Principal/Client: - ____
VI. LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification ^ Produced ID ___
Form of Identification
r(i Personally known (Lobbyist) ^ Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~~Gfj day ~_ J 20 t~'~
ignature of Pu ~ otary -State of Florida
Notarization of Lobbyist's signature
Annual Registration fee: [ ~/J Yes [ ] No OR CL
Lobbyist Registration Form received and verified`~~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST f0 .dot
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
iLY
MCR # ate Paid
Revised
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY
FLATRATE OR OTHERJ:
`~
A) LOBBYIST DISCLOSURE: (Required) (~S V '- ~j~ ~.y-~ ``I~~(,~p~T'-J~L) GjI'e.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Requirud). 'N7 - 3jC) [/}C!J' t/\p ~' J~f-6tX~.
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":
0 Yes ~ No: Are you lobbvina on a present or pending bid for aoods equipment or services or on a
present or pending award for aoods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
OYes ~NO: Are you lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation or chanae 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 defnition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit
_orporation or entlty 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 IxNo: Are you representing anot-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 a:id 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:
VI. LOBBYIST IDENTIFICATION:
D Produced ID _ _
Form of Identification
rQ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This _day of ___, 2p_
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
-PRiiVCIPAL IDENTIFICATION:
-.
Produced ID n~~c~s L~~~ ~~~ •-1~~ -ab"~
Form of Identification
D Personally known (Principal)
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~.~° lrpzres: Aug 13, 20C
~'~~~ ~o+`'` Iiondcd Thru
State of Florida, County of Miami-Dade ~~~~,,,.~~` ~; ~~.,•;c F;~:,d;nt; Co., Ic
Sworn a d subscribed efore me
This day of _ (1 ~ 200
Signature o u lic No ary - S n a
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised !2/08/04
SHUTTS
B
LLP
ATTORNEYS AND COUNSELLORS AT LAW
ALEXANDER P. }-{F_(~KLF.R
(9~4) 847-3858 Direct "l~elephone
(`)~4) J27-7~)J8 Direct Facsimile
July 10, 2007
Via Courier
Mr. Bob Parcher
City Clerk
City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
Re: Lobbyist Registration
Dear Mr. Parcher:
Please find attached the following documents:
E-MATT. ADDRESS:
aheckler~~shutts-law.com
1 • 2007 Lobbyist Registration form for Alexander P. Heckler, on behalf of our
client, Toby's Concession Services, Inc.
2~ Check #00278877 in the amount of $25.00, covering Alexander P. Heckler's 2007
Lobbyist Registration fee for this client. Please note that Mr. Heckler's 2007 lobbyist
registration in the amount of $155.00 was paid on January 16, 2007. Copy of the receipt is
attached hereto.
We would appreciate your processing this lobbyist registration today as there are a couple
of Agenda items in the July 11`h Miami Beach Co}mnission meeting that relate to Mr. Heckler's
clients.
Thank you for your prompt attention to this request.
Very truly yours,
SHUTTS & BOWEN LLP
/ j~ /~?,y' j // ~ f,
~~'~~
Alexander P. Heckler
Of Counsel
APH:mal
FTLDOCS X250387 I
200 EAST BROWARD BOULEVARD SUITE 2100 FORT LAUDERDALE, FLOR[DA 33301 TELEPHONE (954) 524-5505 FACS[M1I.E (954) 524-5506 WEBSTCE: www.shutts-law.com
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WEST PALM BEACH ORLANDO
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