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Pablo Acosta/Emily Loosw.: -; ~ ,.. City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REOMTRATION FORM loDbYiq means aN pamons empbyed a retained, vAielher paid or nd, M ~ VdndVd rilq seeks b sncourape die passage, ddee[ ar rnodfir~ion d any oMinence, nssaluGOn, acTion or det7sion d any cnrrarrseiurar. amr awon, dscUon, racarcnseMe9on d tM Ci1Y Manfper or any eXy fpsrd a mrrnttlss: ar any awon, deasion or raoornnrrgedan d any ar psrsonnM dureg the tiny paaod d dre arrkre d.o>ia.mdanp a«a.. on such .won, decisbn or racona~tion that toreseeady wn a hewd or rniswsd ty Un eiy oortanisaion, or , oay tberd « torraninee. The urm epetlaeaey krwrdee tM priraipel es wA Y arty anWbyes engaged in krhbyinp awwess. TM lane N.ehbybb' hd apacMC aadrrabsa pMeee HIN lD prdMrarree Z~"Ui0. ._ _ +~y ~-qo~ lat.. co,•n Flq out 1tNS seetlon M prlndpal b a Corporation, PaMenhlp or Tnut I~ction 2-~6Z (cy NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: S p, vV~ 7~ yvL i 5 k Vl O IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OYVNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: rvvo2+i/ II.SPECIFIC LOBBY ISSUE: ~ti5u,t~. ~t ~;~lc~vh~ew~' -+- ~'lalnks~'Cvy~ru-t ~~~ G~Y I,~I~ Ini(t~e~~e55 /~o~>Yk. Issue w be ied in ~ ): Ni. CITY AGENCIESANDIVIDUALS TO BE LOBBIED: (Parsuam tr, city code sawn 2~4821y) include a statwrwnt o1 the edam of any brulrrK, fMsncW, farnllial. pmteeabnal or otMr nWlorahip, phrNp rake to an appNranee of an Ynpopriety, srMh any Cily personnel sotryM b be bbbNd: furUrer, pursuant to City Code Seetlon 2- s62(aN4) InchMb • stahnNnt d any eontraCtual relaUoMhlp (geld Or unpaid) from 12 morttha pncadNp tM corsrrrencerneM of service of City personnel to be lobbied.) A ArN Nrna d IrrdividYY B M Fimnelal, FamIIW a ProMafonal WYAlorrslr `{ C r 1. LOBBYIST itETAM1E0 BY: ~wli t~ Loos NAME OF PRI IPALK:LIENT: ~~~~t 53oI 13~u~ L~doow~f 5..r~ ~~i© l/hlliYn~ . FL 33~~.10 N. DISCLOSURE OF TERY8 ANO AMOUNTS OF LOBBYIST COMPENSAT1Of1(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (RequMsd) ~ ~ ~ ~+ p ~ ~~ ~~~ ~ B) PRINCIPAL'S DISCLOSURE (OF L BYIST COMPENSATION): (wgea.d). bra-,~____M~>~tic~ to ;at~ixrynuvr~ yf' ~7DOQ w~o+7~ti -- The folbwing infomwtion must be answered: 1) Pursuant to Miami Beach City Code Section 2-48E Entitled 'Prohibted Campaign Contributlons By Lobbyists On Procurement issues": (~) Yes ~ No• M you bbbving on a or+eaent or pending bid for goods. egubmsnt or services. or on a oroeent or pending awed for goods, eguigmerrt or service? 2) Pursuant to Miami Beach CRy Code 2-490 Entitled 'Prohibited Campaign Contributlons By Lobbyists On Real Estate Development Issues": ,Yes ~ No' Are you bbbving on a pending aoogeatbn for a Deveboment Agreement with the Cfty or aoggcatbn for change of zoning mac dssiarwtbn or change to tM CIN's Future Land Use ~Z 3) Pursuant to Miami Beach City Code 284 (h) Any person (except those exempt from the definition of "IobbyisC as set forth in Section 2.481 above) who only appears as a representative of a not-for~rofit corporation or entity without spectel compensation or reimburxment for the appearance, whether direct, or indirect, to express support of or opposition to any item, ahail n9gister with the Berk as required by the section but, shall not be required to pay any registration fees. ^ Yes ~ No' Are you reoresenring snot-for-oroflt cotuoratbrt or ettt[ty without spacial comwrwtlon w relmbursemertt . SKiNATUfaz UNDER OATH: 1 do solemnly swear that ail provisions contained in Sep L~1 Produced ID ftljL l~°~,'~ 3 tD~p ©~J 26~D Fenn of Identification ^ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swum to and subsaibed bef me This day of ,, 2008 Signature of Public Notary -State dF Florida Notarization of ~o4k~YlLSignature ie and conectland that 1 have read or am femibar with the City Code and all reporting requirements. d Produced ID ~ ~ C~Lo~ o~CJob ~~~~'~ 8 Form of Identification ^ Personally known (Principaq State of Florida, County of Miami-Dade Swom and subsp' fore me This~day of ,2008 Signature; of Public Notary = StatC'of Fkxida Notarization of Princiwl's signature AnnuN Registration t'e.: [ ] Yes_(... ] No Amourd PaW i MCR i pas rrd Lnpyylst RaaleVatlon Form received and vorlRad Iry Revbed 03/27/IOOS 9 `~ I ~ ~` City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 LOBBYIST NAME: `~-~ ~ ~ L ~~ 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. !n 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. 31 Signature: Date: l~t~visad o2,oa~zoos +. __,~~.