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Frank Demandt/Seth Gadinsky (2)m 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 principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or dedsion 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 aty personnel during the time period of the entire decision-making process on such action, derision or re~mmendation 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. Demandt Frank NAME OF LOBBYIST: (Last) (First) (M.I) Demandt Architecture, P.A. 6710 SW 80"' Street, Suite 103 Miami Florida 33134 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 655-5250 (305) 655-5251 frankCaldemandtarchitecture com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: Seth Gadinsky NAME OF PRINCIPAL/CLIENT: 1680 Michigan AvenueR Suite 1001 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 276-2387 (305) 675-7759 SethCaGadinskyrealestate.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: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Conditional Use Approval for Walgreens Store at 1011-15 Alton Road Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of IndividualJT'itle B) Any Financial, Familial or Professional Relationship Jorge Gomez None Mercy Lamazares None Richard Lorber None IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER] A) LOBBYIST DISCLOSURE: (Required) $ 150 00 Der hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 150.00 Der hour 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 X No• Are you lobbying on a rresent or rending bid for goods eguirment or services or on a rresent or Rgr~,lna 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": ^Yes X No: Are you lobbying on a rending application for a Development Agreement with the City or application for change of zoning mar designation or change to the Citv's Future Land Use Mar? 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.. o Yes X No: Are you representing a not-for-rrofit wrporation or entity without srecial comcensation 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 EXPENDITU S OR COMPENSATION DURING THE REPORTING PERIOD. J Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions con in in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification `~ Personal) wn o yist) '""~~~-" CHRISTINA MAY DUFFY ,'~l~Y.PUBG`' j~ VII. SIGNAT :~® iRE~C~diJf'~' i ,;~~~, State of Florida, Cdanty of Miami-Darte~° "'-°"~°`°"` Sworn and subscribed efore me This ~~day o ~ 0~~ Signature of Public Notary State o o a Notarization of Lobbyists signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ^ Personally known (Principal) 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 FOR CLERK'S USE ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER NOURLY, FLATRATEOROTHERr ~nA~ ~M^AI~~ A) LOBBYIST DISCLOSURE: (Required) $ 150.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ 150.00 per hour The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitted "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes X No: Are you lobbying on a present or cending bid for goods, equipment or services, or on a present or cending award for goods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Devebpment Issues": ^Yes X No: Are you lobbvina on a cending application for a Development Agreement with the City or application for chance of zoning map designation or chance to the C.rtv's Future Land Use MaD? 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 X No' Are you rearesentina snot-for-profit corvoration or entity without scecial compensation or reimbursement. Y. 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 EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and 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: YI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification ^ Personalty known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of , 20_ Signature of Public Notary -State of Forida Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification id Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This day f 20 ~ i~arc m NN Commissbn DD301094 Signature of Public Notary - State o da Pues arch 29, 2008 Notarization ~ Principal's signature FOR CLERK'S USE~NLY Annual Registration fee: [ ]Yes [ ] No Amount Paid ~,s~ MCR # Date Paid