Jorge Luis Lopez/Standard Parking Corp.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 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 aty 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.
Lopez, Jorge Luis
NAME OF LOBBYIST: (Last) (First) (M.I)
131 Madeira Avenue Penltwuse Coral Gables, Florida 33134
BUSINESS NAMEANDADDRESS (Number and Street) (City) (State) (Zip Code)
305444.6102
TELEPHONE NUIuBER FAX NUMBER EMAIL:
(305)534-2373
I. LOBBYIST RETAINED BY:
Standard Panting Corporation
NAME OF PRINCIPAL/CLIENT:
1674 Meridian Avenue 106 Miami Beach, Fonda 33139
BUSINESS NAMEANDADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER FAX NUMBER (Optional) EMAIL (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2at82 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Thomas Hagerman, Chief Operating Officer
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: See attached re: 5% Beneficial Ownership
II. SPECIFIC LOBBY ISSUE: RFP No: 11-07i0~Parking~ashiers, Attendants and Supervisors for the City of Miami
Beach Parking System
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of IndividuaUTitle B) Any Financial, Familial or Professional Relationship
Mayor and City Commissioners
(see attached list) None
Administration None
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) Flat Rate $30 000
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
The following information must be answered:
1) Pursuant m Miami Beach City Code Section 2-088 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
2) Pursuant to Miami Beach City Code 290 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^ Yes r~No: Are you representing a not for-pn~fit corporation or entity without special compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1gT 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 Y R. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPEN~TION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts ar nd corre an a~ha~j.®ad"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
VI. LOBBYIST IDEN'1rIFICATION: PRINC PAL IDENTIFICATION:
^ P-oduoed ID o roduoed ID~~~ '')_'Z,~ 5
Form of Identfcation Form of Identification
Per,;onagY known (Lobbyist) ~ ..~.~,~..~ H +"~~TTE 4'k3~fTel~ Ily knovun (Principal) b L~2 C~j,,q
,., C~'i .JS~ON#C~t7427323
VII. SIGNATURE AND STAMP OF AttY; t -oyes: N~t'~v 09, 2CJ~i3
I,v 1 st ~Iv~e Insi;r~n NOrfARYPUBtIGSt?iI'E OF FI~IimA
State of Florida, County of Miami-Dade _ ~-~-. °~•~°-°~---~-- , Courriy of Miami-Dade .^ . ,10C ROSS
Swom to and subscribed before me ~ Swum and subscribed before~mel.~ J ~J, _ ' Commission # DD524291
Ttus i S~ day o[ , N v~ ~ l~aY ~~ ~ ~~ nded Th~Adantic Bo dig Co ~n~
Signature of Public Notary -State of Fkxida~~~~- ~' Sgnature of Public Notary -State of Fkxida
Notarization of Lobbyist's si nature ~ - " U Notarization of Principal's signature
FOR CLE C'S USE ONLY ~ / /
Annual Registration fee: [ ]Yes [ ] No Amount Paid P ~ MCR # ~ v Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04
721752-1
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"IobbyisY' 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..
Attachment
In reference to the disclosure of 5% or more ownership interest of Standard
Parking Corporation, please find below the ownership table is as of February 14,
2008.
John V. Holten and the JVH Descendents' 2007 Trust .....................51.3
Loomis, Sayles & Co., L.P .......................................................5.57
~~ ~ ~ ..
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
C i iyC le rk@ m i a m i beach fl . gov
U1~ tn~.o Z ~rC-i't'~
LOBBYIST NAME.
I understand that no later than October 1st of each year, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
ature:
Revised 02l04r'2005
~ ~0 48
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