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James W. Howard/Bear Stearns & Co., Inc.m MIAMIBEACH NAME OF LOBBYIST: 3~a,~, S Y ~Y'V1-~ ~~~ BUSINESS NAME AND ADDRESS TELEPHONE NUMBER: 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. t ~ ~a rYU~s~ ~1r' (nrst) a-a5 N E M iz.-r~e..r nber and Street) (City) S~~)~7a~yL ~ I. LOBBYIST RETAINED BY: NAME OF PRINCIPAL/CLIENT: BUSINESS NAME AND ADDRESS (Number and Street) TELEPHONE NUMBER: FAX NUMBER: (State) (Zp C de) 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: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE ~, ^ CORPORATION, PARTNERSHIP OR TRUST: -t-~ (C)/7~1 INTE/REST IN SUCH Y'- ~7 ( ~~ II. SPECIFIC LOBBY ISSUE: m(,I,ni~~~~ ~ ~on~ '~he~~C~ ~~Q/1C.(~~ ~~~~~5 Issue to be lobbi d (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship ~. er,~ _1j2._C~ • ac t~~ /vorL~. (M,I) ud~ ~cc( l~at~n ~L331~:3L (State) (Zi Code) ,~ ~~r~ rrI ~ ~ ~~ . I ~ u.~ EMAIL: r ~_ (City) IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION PLAT RATE OR OTHER] A) LOBBYIST DISCLOSURE: (Required) d ~ ~~ r/. ~ JC rE~~ or~1 ~ Crl ~'11~ B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). The following information must be answered: ~~'~;~~~~~ 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited C On Procurement Issues": present or pending award for goods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Estate Development Issues": Map? :LOSE WHETHER HOURLY, Gil Contributions By Lobbyists By Lobbyists On Real 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.. C Yes ~ No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TI STATEMENT UNDER OATH, LISTING LOBBYING EXPEND ORES, A RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE P EDING C~ SHALL BE FILED EVEN IF THERE HAVE BEEN NO E DITURES~R REPORTING PERIOD. ,,~~ I do solemnly swear that all familiar with the provision requirements. Signature of Lobbyi Signature of Princi VI. LOBBYIST IDENTIFICATION: Produced ID )THE CITY CLERK A SIGNED ~S WELL AS COMPENSATION .ENDAR YEAR. A STATEMENT COMPENSAT DU ING THE - Signature of Lobbyist `I ~regoing acts are true an correct and that I have read or am in Sec1~482~t~eri ni Beach City Code and all reporting Form of Identification PRINCIPAL d Produced ID ~~'~`~''~3' ~ ~ Form of Identification ^/personally known (Lobbyist) Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn to ar~~ subscribe~d,,b~f~ore~~me Sworn and subscribed before me This _~.~day of=z~' 2007 This 2.%~ day of ~~~,~`f~ Z~r- ~,.-20''' _ NOTPiRY PAJ$LiC•Sf~`.1'E ®F FL®RII)~ _ ,I`~,..~.f',~ ~/`j'.ce-~.~t Signature of bli Notary - f Florid~EShllii It1I1g Signature of Public Notary -State of Florida Notarizati of obbyist~~~6~axissior. #DB378244 Notarization of Principal's signature r ~ondedThruAtiar!.~B~Hi6~~K~4pI~S~QNLY ~_M Annual Registration fee: [ ~1 Yes [ ] No Amount Paid ~.._f,~U V MCR rl(/~ ~ ate Paid Lobbyist Registration Form received and verified by: I ~ " F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised ] 0 CN W ~~VN m w ~ C~ ~~ w ~^>-„ "-`ntiz ~- w~?pcW O_ a c J~O~O =a.z,F a ~ ~ Z ~o V