Arthur H. Hertz/Orange Bowl Committee09!14!2007 18:15 305-529-1485 WDhETCO ENT 5 FLOOR
a~ nne~r~}g~~,ct~
~~
City of Miami Beach gffice of the City Ciel•k
Z70Q Convention Center prive, Miarni Beach, F1_ 3313
Lpir{iiYIS"~' RECT.~iTRATION rC1RM
Lol)bylst means ail personb employ8d ar rEtalned, whether p81d or not, by a prinGpal who seeks ro ent6Urage the passage, defeat
or modification of anY ordinance, re~eluUon, actl°n or deds[on r)i' any Cornmissioner; any action, ded~on, rectxnnlendatlon of kht
City Manager or enY city board or committee; w any action, decision ar recommendation M any city personnel during the time
period of the entlre decision-nlaking process on suds atClon, decision or reCOm[nendatlon that fore52oably v~il1 be heel'd or reviewed
by the city cprnmisslon, or 8 dty board or tgmmitt88. The t@rm spedflcaAy inciude5 the principal as well as any employee engaged
irr Ipbbying actiVldes. 'ihe terttt "Lobbyists'' has spBCiRc exCluslvns, Plaa~~2 refer tC Ordi0E1t1cs 30D4-3435,
Street)
i. LC?$RYIfi'C R~rAiNED EYt
PAGE 02/03
^...ie1 ~
NAME OF PRINCI[7AL/CLIENT: ~~/~~-'~~ ~
-~ -'7a (.,1.-~c.-~"~-~r~ (,t. j'y~ c.A..~n~ ~l X31
(~GLYt ~~,11~ r ~smt) (~P Cie)
BUSIN>;5S E AND AdDRES$ (tnimber and Street) (i7N)
FAX
gut this section f! ptinclpal is a Corporatwon, Partnership or Tres[
NAME OF CHIEF t7FFICER, PARTNER, OR BENEFICIARY:
EMAIL:
IDi_NTIFY ALL PERSONS HOIDING, DIRECrI,Y OR INDIREOf'LY, A 5% OR MOkI; OWN7=RSHIP IM11T7•RE3T jN SLfCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SP'ECIF>CC LOBBY I55Uk;
IsSUe ro be lohbled'(pesrxibe in detail):
TII. CITY AGENCxRS/INDIVIDUALS T4 B$ L09SIED:
A) Full Name of Irtdividuai/Titlo
~1~1 ~~~t~ U ~
B} Any Flna~tcial, Fa~Ilia[ or Professional Itelarlonship
PAGE 213 ~ RCUD AT 911412007 ~;10,~4 PM ~Easfarn Daylight Timed"SVR:OBCMAIN210 k DN1S:5"CSID,30~ ~2914S5t DURATIQN (mm'ss);01.38
09/14/2007 18:15 305-529-1485 WOMETCO ENT 5 FLDOR PAGE 03!03
Iy, pxscLO5tJR1; pP i'~RMS ANp AMOUNTS aF LpsSYLSI coMPE,~N~S7A7xan (~ISC60SR yyfµgTti;ER HauR~Y,
/SAT 1PAT~ 4R OT1yERJ: ~ vp +/ti ~,'
A) LOBSYISr D1SCI.C?SU{tE; (Required)
8) PRINCIPAL'S DISCLOSURE (OF L98BYI5T COMi'EN5ATION)~ (Required).
The fallowPn9 lnformat~n must be answered; , n Contributions By tobbYlsts
1) Pursuant to Miami Seach City Code Section ~-4t38 Entitled "Prohibited Gampa•9
Un Procurement Issues": __ ,_ 3
. es e u by ~ ~ a= .._ s
e a e a or a .
2) Pursuant to Miami Beach City CodE 2-990 Entit{cd "prohibited Campaign Contrlbuk9ons ray Lobbyists pn Real
'`state taevelopment IssUES": ._..._ _ „~. _..
Jib
Pursuant to Miami Beach City Code 2-484 (h) Any person {except Chose exempt from the definitlort of
3} rs as a rep~'esQntative of a nGC-for-profiC
`yobbyist" as .set fpifYi in $ectlon Z~81 above) who only appea
corporation or entity without special compensation or raimbghalmegisKertwith Chea~lerk as req lredl by this
Indirect, to express support of or opposition m any Item,
sect[°n but, shall not be required to pay any registration fee$.. - - ~__~^wF.h„
nr rei~~
V. gIC,aNA'fURE UNT>'ER OATii:
4N tyGTOt3kIi 3.sI QF EACH YLiSTrIN~C LDB YlNG XF~NQxTUt~S, A5 WF1-LL. ASCCOMi'EIIISATi<ON
5TA7EMENT UND~It bAThi, r~t
R1EC6IIfR~, ~INLEDH~EVEN~P Tl'1ERE HAV)nAB EN NO ~ pNNDITUItf=~ C CA1MP NSA ON pU~ NG THp
sWA6t B
~C~PaRTirua Pl~ftlap. . y--~
Signature of Lobbyist
i do salsmnly swear that aH of the foregoing facts are true and correct and that I have read or am
famlllar with the provisions eontained In Section 2-41~Z pf ChB Mlal'tli Beac ity Code and all reporting
requirements. ~~,_~~-
Slgnature oP Lobbyist:
Slgnatvre of PrinGipallClie _
VI. f,QgS1fXST Ip~NTiPxCAT1CdN PRINCIPAL ZpENTIPZCATION:
I ~, Produced ID i 1 FrdducQd ID 1iAAR1A,ADELA~E CAYA00
Farm of TdentiflcaCion FOrrr~ o s Nobly Publfcc - SYM d Fb1id~
personally known (Ft'ir ~ E>Ip~i ~ ~' ~
LL ~ Personally known (l,ebhyisE} ~ CannYNubn~1K~ I~D~D 50$`9..,
U Il N~tlond ~
Q
~ ~ vIL. 6IC~NATtIFtE AND STAMF 4F NOTARY:
~ •~ ~ State of Florida, County of Miami-Dade
cti~ w ~ s State of Florida, County of Miami-Dade Sworn Hd subscr cd baf re me
~'~ ~ . &worn to and Subscri d ofore me y~ - ~~20 0~'
w ~w: This `~~day of , 21J~/ This ~L' ~,d~ajyafi~ ~~,/~ Q
rq ~ 1/~",+""`°"" vim."[ ~~'>!C'
~~
ty~'4 Signature of Public Notary - Statc of Fforida Signature of public Notary -- Stata of Florida
fir, },~` Notnrization of LaE~by9st's slgnaCUre NaYarlxation of Prlrtcipal`s ~'sgnatur '
,{ -~' fDR C '~ LI LX ~, ~ ~
Annual iiegistra#i0n fee: [ ~ Yes ['~'.l No Amount P MCR e
LobrlYlst f~eglstratlon Farm received and verlfled bY: ~ Re d 1~ B/0~
F:\Q.ER\$ALL\MARIA-M1Lobbylst\LOSF3YI5T fORM ~5.dd
PAGE 3!3 ~ RC1f D AT 9f9912007 5,10;54 PM ~Easter~ Daylight Time]"SVR,OBCMRIN O t DNIS, CSID,305 529 9985 % DURATION (mm•ss).01•~8