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Carter N. McDowell/Sandy Lane Residential LLC, Amended-~ ~ H n1 ~~ ~'- dJ ~~ OGC- I~-~ 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 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. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. McDowell Carter N. NAME OF LOBBYIST: (Last) (First) (M.I) Bilzin Sumberg Baena Price & Axelrod LLP 200 So. Biscayne Blvd., Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-2355 305-351-2239 cmcdowellCc~bilzi n. com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: Sandv Lane Residential LLC NAME OF PRINCIPAUCLIENT: 2399 Collins Avenue Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)604-6796 (305)747-6408 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) o Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] --1 0 -C N • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:Morton's of Chicago Florida Holding, Ir~ ~ r{~ N ~? ~~ pn "T"~1 • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5%.OR MORE OWNERSHIPU~NTF.I~ST_IDI SUCH CORPORATION, PARTNERSHIP OR TRUST: ~. ~ ,~ -rf .. SPECIFIC LOBBY ISSUE: - ~ CIt Land Use and zoning issues involving the Gansevoort South Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Nan:e cf Irdividua!/Title B) Any Financial, Familial or Professional Relationship Planning and Zoning Department none Building Department; Planning Board none Historic Preservation Board; Special Master IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) $535 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $535 aer hour ~~ The folpbwing information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes ®No: Are you lobbvina on a present or aendina bid for aoods eauipment or services, or on a present or aendina award for aoods eauipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^ Yes ®No: Are you lobbving on a pendina application for a Development Agreement with the City or application for chanae of zoning map designation or chanae to the City's Future Land Use 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 snot-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.. ^ Yes ®No: Are you representing snot-for-profit corporation or entity without special compensation or reimbursement? V. SIGNATURE UNDER OATH: ON OCTOBER 1`t OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STAT ENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF I 1 BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF HAVE BEEN NO ENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. it _ ~. ~ i Signature of Lobbyist -Carter N. McDowell I do solemnly swear that all of the fo in Section 2-482 of the Miami Beach Signature of Lobbyist: true and correct and that/I ha read or am familiar with the provisions contained N 0 rep/'i~' d~1'~ e A -=t c~ Carter N. McDowell Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ,.'Produced ID Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swo n to and subsc ibe before me Thi~ day of , 20~ - ~ ~ ~- ~ - r,., ~~I r ~ ~' n> >~ ~; rn ^+-± PRINCIPAL IDENTIFICATION: ~,~ °°ry•- ~ ~ zz ^ Produced ID ~ T Form of Identification ., ~ ~ `~ ^ Personally known (Principal) c~ N rF-; ~ State of Florida, County of Miami-Dade Sworn and subscribed before me This day of , 20 Signature of Public Notary -State of Florida Notarization of Principal's signature Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM 05.doc -, >R CLERK'S USE ONLY Date Paid Revised 12/08/04 dIAMI 1643063.1 7645223517 The following Informatlon must be answered: 1) Pursuant to Aliieml Beach City Code Section 2.488 Entitled "Prohibited Campaign Contrtbutfons By Lobbyists On Procurement Issues' ^ Yea ~ No: Are you lobbving o a present or pending bid for goods equipment or services or on a present o 2} Pursuant to Miami Beach Clty Code 2.490 Entiged "Proh>bited Campaign Contributions By Lobbyists On Real Estate Development issues`. ^ Yes ~ NO: Are you IODDL ILIA do a pending appllcatlon for a 13eveloprnerrt ;Agreement with the City or 3) Pursuant to Miami Beach City Code 2.484 (h) Any person (except those exempt from the definition of "lobbyist" asset forth in Sectioon 2-481 above) who only appears as a representative of a not for-prot7t corporation or entity without apectai compensation or reMnbun:ement for the appearonce, whether direct, or indirect, to express sappi ~~ nr~88osifion to any item, shag register with the clerk as required by this sect~n but, shall not be required to pay y reg ^ Yes ®No: - .--resentlna a not~or-profit coporatlon or entity without special comvensatio» or reimbursement? V. SIGNATURE UNDER OATH: ON OCTOBER 1„ OF EACH YEAR, EACH LOBBYIST SHALL SUBlWR 70 THE CITY CLERK A SIGNED STA ENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVE , IN THE CITY OF I BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN tF HAVE BEEN NO ENDITURES OR COMPENSATION bURiNG THE REPORTIN<y PERIOD. Signature of Lobbyist--Carter N. McDowell 1 do solemnly swear that all of the foregoing fe re true and correct and that I ha read or am familiar with the provisions contained in Section 2.482 of the Miami Beach Ci d re u c°:~ na --i c,° Signaturo of LobbYlst: a r N. Dowel ~-, rr i . r-- ..~ '~ Signature of Principal/Cq `~' tV ~~ °' ; ~"i VI. LOBBYIST IDENTIFICA710N• PRINCIPAL IDENTIFICATION: ~„ D Produced ID 0 Produced ID r-- ~' Form of Identitic~tfon / Form of Identtflcation '~ .,,,, i~'1 Personally known {Lobbyist) f~ Personalty known {Principaq `^J ~ ~,7 V!L SIONATtJRE AND STAMP OF NOTARY: ~ ~ State of Florida, County of Miami-Dade State of Florida, County of MlamWade Swo to and subs gibe before me Swom and subscribed before me Th' of ~ 20,~: This „~ day of-~`~~~ _2~0QQ~, Signa>ure Signature of Public Notary -State of Florida NotalizaGo _ _ ~, Notarization of Principal's signature Annuat Registration tee: [ ]Yes [ ] No Amount Paid MCR # Date Paid Lobbyist Ragiefration Form received and verified by: Revised t2/08l04 F:ICLERI$At.LWIARiA-M1LobbyiatlLOBBYIST FORM 05.doa `OTAR~' PLTiLIC-STATE OF FLORIDA ~~~ Eileen T. Morales Commission # DDg81031 . Expires: OCT. 12, 2009 Bonded Thnt Atlandc Bonding Co., lrc. .~cl "off guiPcoB aRUBpy null, papuoq 6002 `ZI :LSO :sarsdxg I EOI l3bQQ # uoissguluoa salexoy~ :t uaalig vQRiO'1:: dC ,g.Gy,IS°OITA~fi 1,2it~:0:\ MIAMI I643063.176452Z35I7