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Renier Diaz de la Portilla/Regal Entertainment;,:, ~ ~ jd~r ,~ ~ I~i11 AN~I ~EA ~~~=~+H ' _ . .:~ _'y : ~~.. , . - ~'` . City of Miami Beach Office of the City Clerk 1700 Convention Cenfer Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyfst means ali persons empioyed or retalned, whether paid or not, by a principal who seeks to encourage the passage, defeat or modiFlcation of any ordinance, resolutfon, action or decision of any cammissioner; any action, decision, recommendatlon of the City Manager or any city board or commlttee; or any actlon, de~ision or recommendatlon of any city personnel during the tlme period of the endre decision-making process on such action, dedsion or recommendatlon that foreseeably wlll be heard or reviewed by the dty commission, or a city board or commlttee, The tertn specifically includes the principal as well as any employee engaged /n lobbying adivities. The term "Lobbyists" has specific exclusions. Please refer to Ordinan~e 2004-3435. Diaz de la Portilla Renier NAME OF LOBBYISi'; (Last) (Ffrst) (M,I) Gray Robinson, P.A. 1221 Brickell Ave., Miami. Florida 33131 BUSINE55 NAME AND ADDRESS (Number and Street) (Ctty) (State) (Zip Code) 305.416.6890 305.416.6687 rdportilla@gray-robinson.com TELEPHONE NUMOER: FAX NUMBER: EMAIL: LOBBYIST RE?AINED BY: Regal Entertainment Group NAME OF PRINCIPALJCLIENT: 7132 Regal Lane Knoxville TN 37918 BUSINESS NAME AND ADDRESS (Number and Street) (City) (5tate) (Zp Code) 865 925 9414 865.925.3621 rob.delmoro(~a.reqalcinemas.com TELEPHONE NUMBER: FAX NUMBER: (Optlonal) EMAIL; (Optlonal) Fill out this sedion iF principal is a Corporetion, Partnership ar Trust [Sectian 2-482 (c)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY; Rob Del Moro, Chief Purchasing Officer . IdENTIFY ALL PERSONS HOLDING, DIRECfLY OR INDIRECT'LY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Publicly traded company II. SPECIFIC LOBBY ISSUE: S2@{Clll,~ t0 f1lOdlfY Clf,~,/ COdP t0 ~Prmit calP nf haar anrl ~nrina at Rcnal !`inamac ~r, ~ incoln Rd. Issue to be lobbfed (Desaibe In detall): III. CI7'Y AGENCIES/INDIVIDUALS 70 BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial ar Professfonal Relationship Miami Beach Mayor's Office Miami Beach Commission No Miami Beach Planning Board No Mi Miami Beach City Manager No IV. DISCLOSURE OP TERMS AND AMOUNT5 OF LOBBYIST COMPENSATION (DISCLOSE WHETHER NOURLY, PLAT RATE OR OTHERf A) LOBBYISTDISCL05URE; (Required),. Flat f8t@ $15 000 paid to Gra}~ Robinson, P A. B) PRINCIPAL`5 DISCLOSURE (OF LOBBYIST COMPENSATION); (Required), Flat rate $15 000 paid to Gray Robinson, P.A. 7he following information must be answered: 1) Pursuant to Mfami Beach City Code Sectlon Z-486 Entitled "Prohiblted Campalgn Contr(butions By Lobbyists On Procurement Issues": ~,Yes ~ No Are vou Iobhvinq on a aresent or pendinn bid for aoods, eauioment or services, or on a aresent or pendina award for q~oods eau~oment or serv~ce? 2) Pursuant to Mlami Beach City Code 2-490 Entitted "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues"; 3) Pursuant to Mlam( Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyfst" as set forth in 5ection Z-481 above) who only appears as a representa4ve of a not-for-profit corporation or entity wlthout specfal compensatlon or reimbursement For the appearance, whether direct, or ind(rect, to express suppo~t of or opposition to any item, shall register with the clerk as required by th(s section but, shall not be required to pay any registration Fees., ^ Yes ~ No Are vou rearesentinn a not for arofit coraoration or entitv without snecial compensation or reimbursement. . V. STGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT 70 THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING L06BYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAM~I BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIUD. /1 -~ n ~ ) ,-~ 5ignature of Lobbylst ~ ~~ ~:,,.,,,, 3g ~~ c ,~ F •~ ;~~.~~ ~~ ~~ • ~ g~~; u~a~ ~ ~~~ i do solemnly swear that all of the foregoing facts are true and correc~ and that I have read or am famlliar wlth the provisions contained fn Section 2-482 of the Mfami Beach CIty Code and all reporting requirements. ~. ~ ~ ~~ ~ Signature of Lobbylst: ~ Signature of Principal/Clfent: , VI. L06BYI57IDENTIFICA' Produced ID Form of IdentiFcation ~ Personally known (Lobbyist) SIGNA7URE AND STAMP OF NOTARY; ~ of Florlda, County of Miaml-Dade n to a subscrlbed beFore me f day oF~~ 20_ ~ of ~ubllc Notary - State of Floi tion of LobbyisYs signature PRINCIPAL IDENTIFICATION: ~,~~E w/q[ v~ _~ o Produced ID $TATE Form of Identification OF ~Personally known (Principal) TENNESSEE N~TARY PUBUC , ~h State of ~ County of ~de ~Z~~y ~ ~ Sworn d subscribed before me My Comm. Expii Th(s ~c~y of.~, ?~.1 ^(~ April 30, 2011 ~ ~ i ~~ ~ Slgnatu~'~of P061ic Notary - State oFflaH~a- Notarization of Principal's signature FOR CLERK'S~ E ONLY ~' ~ 0 nnual Reglstratlon fee: ~[ J Yes [ ] No Amount P~Id l.' MCR # ate Pald obbylst Reglstradon Form recelved and veriFfed by; ~~J~ C~ \CLER\$ALL\MARIA-M\Lobbylst\LOBBYIST fORM O5. ~ Revlsed 12/OB/04