Thomas Telesco/Luis Gajer
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.
Telesco Thomas J.
NAME OF LOBBYIST: (Last) (First) (M.I)
Telesco Associates, Inc., 1111 Kane Concourse, Suite 301, Bay Harbor Islands, FL 33154
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-866-1014 305-866-3317 tom@nightclub-design.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Luis Gayer
NAME OF PRINCIPAUCLIENT:
Parrillada Las Vacas Gordas, Inc. 933 Normandy Dr., Miami Beach, FL 33141
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
305-972-7272 305-864-8888 eat@lasvacasgordas.com
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:
L vtS ~c/S1 ~'~.
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~vt-5 C.,~~`c~ ~°`?a ~k05 (fL.M~~-`'1 ~~'1A'~~`~l SU``1a
II. SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail): 0 F ~ ~l~S-{'~.N 4 V, l d ~, ,
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title ~ B) Any Financial, Familial or Professional Relationship
~c C~t(~~
Design Review Board
DIV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLgTRATEOR OTHERJ:
1~5 ° ~ (~V2L
A) LOBBYIST DISCLOSURE: (Required)
!1 b~°i
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ 'fi ~ ~ ~ Y- '~`" ~~
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":
^ Yes B'No• Are you lobbvina on a present or oendina bid for aoods eauioment or services or on a
uresent or oendina award for aoods eauioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes ~lo• Are you lobbvina on a uendina application for a Development Agreement with the City or
application for chanae of zoning man designation or chanae to the Citv's Future Land Use
Ma°?
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..
^ Yes ~'No• Are you reuresentina anot-for-urofit corporation or entity without suecial comuensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ 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 BEEF NO EXPENDIT~ES OR COMPENSATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the forec
familiar with the prov' ons contained in ~
requirements.
Signature of Lobbyist: ~`~"
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of
'Personally known (Lobbyist)
facts are true and correct and that I have read or am
n 2-482 of the Miami Beach City Code and all reporting
PRINCIPAL IDENTIFICATION:
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade ~ y0ti`~c
Sworn to a d subscribe before me ~.~sz'#oo tio~,,
This 20ob P ~o~ s~ ~~'
Signature - a ,~
Notariz ion of Lobbyists si '~`•.:;_: 0`~
^ Produced ID
Form of Identification
^~rsonally known (Principal)
St'~te of Flori ,County of Mia 'Dade
~orn ands cri e
This ~l~ y f 20 O~
9'~
Signature o lic Notap ~Statge o n~~\~SQv~Q
Notari tion Princi al s si na
v~OR CLER 'S US (~~LY ~ ~ ~.''tv!!~F {•s
Annual Registration fee: [ ~s [ Amount Paid ---MCR # ~ (7 e'~' ~~'- ~ 1
Lobbyist Registration Form receroed and veri ed by: •'•.
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.do~ ~~,` d 12/08/04