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Todd Glickman/Todd GlickmanCity 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. Th6 term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. ~~~ (NESS NAME AND . /~ 3~~ =PHONE NUMBER: (First) (M.p umber and Street) (City) (State) (Zip Code) ~: 1_ r\ O~ LOBBYIST RETAINED BY C~ ~ Glt'~ NAME OF PRINCIPAUCLIENT: ~~ol ~>~~t ~~~~ 5~~~~ BUSINESS NAME AND ADDRESS (Number and Street) (City) ~ ~s /3~9/ 9s~-~ FAX NUMBER: FAX NUMBER: fOotionall ~~ (A. Q~ ~/Gt / (State) (Zip EMAIL: Code) ~~~~ Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: ~-to~l s~rl~ • IDENTIFY ALL PERSONS HOL ING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: n. SAECIFIC'LOBBY ISSUE: Issue to be lobbied (Describe in detail): ul. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of IndividualfTltle B) Any Financial, Familial or Professional Relationship C (~ ~ C~J~ ~fl ~` Pal©~1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) ~~ j~ ~`~~ ~~~ /~ !/,~ „i B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION~~ /Grh~ /~1f,,9 ~ Y ~~ (Required). l 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": 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues': Map? 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. reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1sT 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 Be/ac"h~City Code and all reporting requirements. Signature of Lobbyist: ! 6~ ~` l/r~ Signature of PrincipaUClient: VI. LOBBYIST IDENTIFICATION: (~ ~) PRINCIPAL IDENTIFICATION: ~7, .~/ Produced ID ~~~ ~~ 7 ~/" ~~ ~ ~roduced ID ~_L~jv~~`/ Form of Identification Form of Identification ^ Personally known (Lobbyist) ^ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribe efo me This )(~ day of _ 4~, 20b State of Florida, County of Miami-Dade Sworn and subscribed before me This ~~day of , 20_ yra a /I .~i 4 1//_ ' /l /l Signature of Public Notary - State of~l'orida Notarization of Lobbyist's signature Signature of Public Notary -State of Florida Notarization of Principal's signature T BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # Date Paid Lobbyist Registration Form received and verified by: Revised 02/04/2008 City of Miatni Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, v,~ww.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 ~. I/ LOBBYIST NAME: ~ ~/d, 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. ~~ f . ~ ~ ~~ ignature: D e: Revised 02104/2008 f' ,i:< ~. Global Spectrum, LP Partnership Disclosure Statement Global Spectrum, LP is a limited partnership and its partners are as follows: 1. Global Spectrum, Inc. (General Partner), 3601 South Broad Street, Philadelphia, PA 19148 2. Comcast-Spectacor Ventures, LLC, 3601 South Broad Street, Philadelphia, PA 19148 3. Globe Facility Services, Inc., 111 Second Avenue NE, Suite 517, St. Petersburg, FL 33716