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James E. Rauh/Heafey Bentley Hotel, LLCm MIAMIBEACH 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 prinripal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, adton or derision of any commissioner; any action, derision, 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 adton, decision or recommendation that foreseeably will be heard or reviewed by the dty commission, or a city board or committee. The term spedfically Indudes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has speciftc exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST:/'/ BUSINESS NAME AND AI TELEPHONE NUMBER: ~ (Last) ~ ~--- ~P~M r.+ Od I. LOBBYIST RETAINED BY: NAME OF BUSINESS NAME AND ADDRESS ~ci~ ~_~. ~-- ~~~ti TELEPHONE NUMBER: (~~) ,~~9, Z 7~ r/ (M.I) w 3 7th ~4~~ . ~-~l/aM; , ~L (State) (ZipCode) 3313 3 CMAiI .. /6/ oc~.~w 7.~ ~ ~~ , r~ + ~..~ i 'gl~~y FG 333 f and Street) (City) (State) (Zp Code) EMAIL: (Optional) Fill out this sed9on if principal is a Corporation, Partnership or • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICL4RY: II. ~~ Issue to III. A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relatlonshlp l~L~n~N inl ~ 63~~s-a-~ .., n C,~ l( CO~.~ r s S (v N lv o Pc..~N r., „~ ~ ~ ~ n~.,~-~ ~, • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: j L ~ ~~ i T~ t r-F ~~ SPECIFIC LOBBY ISSUE: iD t -.+ A n7L6 ,J4 /~n f='.~ ~~ N (o ( , T Y GO D F ~ I K a - 4 ~(~ ~ `~ r C S ~%r ~ [ -~ rF `~ S -~ •~P e lobbied (Describe in detail): ~{- 6a,~ S 4n v r t S~a w r c.,~ -~ [ A S q [C ~ S 5~ ~ se -~-c~ ~'^ ~' ~ N CITY AGENCIES/INDMDUALS TO BE LOBBIED: i p r M ~ ~~ ~ k S ~ ~ ./~ aR P S ~ ' Z. - 7j G1 rJ Y Z oy~;^~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATEOR OTHERf t A) LOBBYIST DISCLOSURE: ,(Required) ~ // B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). a5 ~~~ ~o ~r• ~ ~~~ 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": pl.~~o,* ~~ ~p~di~n award for goods eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": 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 snot-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.. ^ " '°':yo Are you representing a not for profit coruaration or entity without scecial compensation 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 BEEN NO E~E~DII~RES OR~O~ENSATION DURING THE REPORTING PERIOD. JJ ~ I do solemnly swear that all of the foregoing familiar with the provisions contained in Secti~ requirement -~ Signature of Signature of VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to a subscri i~TIWE ALFON60 This day ofr r ~` x - MISSION N DD 518028 _ - RES: Febn~arv 14, 2010 of J Signatur~df Lobbyist ' true and correct and that I have read or am of the Miami Beach City Code and all reporting PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identlflcation ~nally known {Principal) State of Florida, County of Miami-Dade Swom and subscribed before r~e,~ This L7 day o~s~~' 3_,°~~~ Signature of Pubf Notarization of IOURGeS CECILIA QCAFJIPO Nutar~~ Public - S1o`e of Flor~rl~ ~sbn Fames AFx 11, 2CY~~. ~ Commission # DD309244 Bonded By National Netary Assn ~. ~iFOR CL.ERK'9 USE ONLY Annual Registration fEe: [ ] [ ] No !mount ~tiid ~ ~ MCR # ~ _ - ~ ~"~ Date Paid Lobbyist Registration Form ived and verified.py; / ' F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORMM 05. Julie Grimes Nathalie Heafey Gino Falsetto Anthony N. Petropoulos Bernard Siegel Pierre Heafey