William W. Riley, Jr./Sandy Lane Residential, LLCCity 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.
RILEY WILLIAM _ W.. JR.
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)
305-375-6139 305-351-2285 WrileyCcilbilzin.com~ ~_
TELEPHONE NUMBER: FAX NUMBER: EMAIL: ~ ~ ;,T}
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I. LOBBYIST RETAINED BY: ~ ; ~ >`
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Sandy Lane Residential LLC ~`~ e
NAME OF PRINCIPAUCLIENT: ~ ~ ,i_°_
2399 Collins Avenue Miami Beach Florida 33139 v-~ ~ '~
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip=~,odefi;:
-~"-
305 604-6796 305 747-6408 ~' ~
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAI :`(Optional)
Fill out this section if principal is a Corporation, Partnership or Trust (Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:Morton's of Chicago Florida Holding, Inc.
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
ISSUE:
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 Name of Individual/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) $325 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $325 aer hour
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":
^ Yes ®No• Are you lobbvina on a present or pending bid for Goods equipment or services or on a present or
pendina award for Goods, 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 lobbvina on a pendina application fora Development Aareement with the Citv 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 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..
^ 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 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.
~®
Signat a of Lobbyist - liam W. Riley, Jr.
C-i -~V `~
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the p~~uisiogs'~ccontaTir ed
in Section 2-482 of the Miami Beach Cit Codee a~ all r rti g requirements. c Q'` ~
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Signature of Lobbyist: ~' -ti •~
illiam W. Riley, ~ ..-
`_.
Signature of Principal/Client: _ '"
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VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subsc ibed before me
Thi~~~ day cf ~, 20~~
Signature olf'Pylblic Notary -State
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
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
i
] No Amount Paid~~_ MCR
and verified by:
LOBBYIST FORM 05.doc '
FOR CI
~~/ Date
Revised 12/08/04
dIAMI 1642401.1 7645223517
The followlnQ information must be answar+ed:
1) Pursuant to Miami Beads Cffy Code Section 2.488 Entitled "Prohbited Campaign Contributions By Lobbyists On Procurement
Issues": '
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real F~tate
Development Issues": .
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in
Seotion 2181 above) who only appears as a representative of a nat for-profit corporation or entity without spedal
item, sttallbregtsterwIththe clerk as required byy ihissedlon but, shall~not bedrequired to ~y any registrat on fees~..sftion to any
V. SIGNATURE UNDER OATr•:
ON OCTOBER 1a OF EACH YEAR, EACH LOBBYIST 8HALL SUBMIT TO THE CITY CL1:RK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECENED, 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. ~ 1 /
v ^'
Siena of Lobbyist- ism W. Rriey, Jr. -; r°~
I do solemnly swear that ali of the foregolog facts are tare en correct and that I have read or am familiar with the provisions Main
in Section 2•-082 of the Mianu Beach C Cod1e a~ aD rti 9 requirements. ~" "~3
nature Of Lobbyist " ~ i~ N ~
~ flpam W. s
Signature of PrincipaUClieM: -n
~~ ..
VI. LOBBYIS7IDENTIFICATION:
^ Produced ID
Form of Identiftcation
Personally known (Lobbyist) .
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to and subsc bed before me
Thia~3 ~aY of 20..Q~
PRINCIPAL IDENTIFICA7[ON: ~ tV
;- ~
^ Produced ID
/ Form of identification
GV Petaonally known (PrinclQal)
State of Florida, County of Miami-Dade
Swom d subscribed b fore me
This day of 20 ~ 15!
Siprtature of Public Notary - State of Florida
Notarization of principal's signature
F - S+ Mi ~IVI~P'~wY.Hn ~ w war ~.
u ~ ~ No Amount Pald MCR # Date Paid
ed and verifted lry: Revised 12JD6/04
. _~ cn r r R 1LohbvistlLOBBYISTEORM 05.doc
:w"tAltl' Pt'BLIC-STi1?'E GF :,Ca.
Eileen T. Morales
_ ~~Commission # DD481031
T Expires: OG`I: 12, 200a
Bonded Thsu Atiandc Bonding Cc. '
Q1AMI 1642401.17645223517
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.~
LOBBYIST NAME: William W. Riley. Jr.
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.
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Signa re:
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Date:
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