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Wayne Pathman/Alan Lieberman 2370 Flamingo Dr.MIAMIBEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 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 induces the princlpal as well as any employee engaged In lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2Q04-3435. Pathman Wayne M NAME OF LOBBYIST: (Last) (First) (M.I.) Pathman Lewis, LLP, 2 South Biscayne Boulevard. Suite 2400. Miami, FL 33131 _ BUSINESS NAME AND ADDRESS (Number of Street) (City) (State) {Zip Code) 305- - 425 305-379-2420 woathmanlewista7~pathmanlewis com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Alan Lieberman NAME OF PRINCIPAUCLIENT: ~~ Alan Lieberman Properties 1680 Meridian Avenue Suite 102 Miami Beach FL 33139 _ BUSINESS NAME AND ADDRESS (Number and Street) (City) (Statc) (Zip Code) 786-271-3458 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fiil out this section if principal is a Corporation, Partnership or Trust ]Section 2-482 (c) ] • NAME OF CHIEF OFFICER, PARTNERS, OR BENEFICIARY: Alan Lieberman • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Alan Lieberman II. SPECIFY LOBBY ISSUE: Midttation of Code Violations/Liens/Fines at: 2370 Flamingo Drive Issue to be lobbied (Describe in detail): 1[I. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A Fuil Name of IndividuaUTitle B An Financial, Familial or Profession Relationshi Assistant Cit Mana er, Robert Middau h No Buildin De t/Code Com liance Re resentative No City Finance Dept and any other appropriate City De tslOffices No [V. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly Rate - $400 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly Rate - $400 The fallowing information must be answered: Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited campaign Contributions By Lobbyists on Procurement Issues": Yes ~NO: Are you lobbvine on a present or nendin¢ bid for eoods. equipment or services, or on a present or pendine award for Goods. eauiument or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited campaign Contributions By Lobbyists on Real Estate Development Issues. Yes y~-'1 N0: Are you lobbvina on a tlendinE apoli atiop for a Develoomeat AEreement wi(~i the City Of ttpolication for chance of zoning mau desi¢nation or chance to the Cltv's Future Land Use Mau? 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, shalt register with the clerk as required by this section but, shall not be required to pay any registration fees. Yes ~ No: Are you representine anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER IST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, A5 WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECE NDAR YEAR. A STA ENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR C ENS TI NC TH REPORTING PERIOD. gnature 'sI I do solemnl swear that alt of the fore oin facts are true and ircb ect and that I have read or am Y 8 $ familiar with the provisions contained in Section 2-482 of ~fe 'anti Beach Code and all reporting requirements. Signature of Lobbyist: Signature of PrincipaUClient: VI. IFICATION?~~` PRINCIPAL IDENTIFICATION: `~~~~ottnun~uq~~~~'' pIY C~~~~,~et°28ed ^ Produced ID ~,~~~_ by °'°°~ e EXPIRES'. Nov P~r~uw~~are rrrt of Identification Potm of Identifizat3on'~o~ ~,~"` `~~ • `yo . g~yeAlhru Notary ~ ,•~ o , , ~^ G : LL ~c~ • ~4' ~• v C sonaily known obbyist) rsonally (Principals ~ ;S o ~ ~~; 1' ~ ': ~ O .~ :' ti ~, VII; SIGN UREA D.~T ~OF T Y: ~ . eonded~;`OJ~ ~~ ;\~`- State of~drid" ~ o ~iamt- a State of Florida, Count of Mia i-Dade '/°'~'~~*• •NOTAR~~,\~ ~~~~\ y y Eutnntw Swo to a df~u scrib~~yefoFeJ~e ~ ~ Swo subscrib b ~e "This ay of, 20 This day oY~~~, 20 V`-~ GG~ __~~ FOR CLERK'S USE ONLY Annual registration fee: [ ]Yes [ J No Amount Paid MCR # Date Paid Lobbyist Registration Form received and verified by: F:~CLER\SALLIMARIA-M~I.obbvistU..OBBYIST Form oS.doc Revised 12/08/04