Alfredo GonzalezCity of Miami Beach Office of the Gity 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 prindpal who seeks to encourage the passage, defeat or modification of
arty ordinance, reaolutlon, ariton or derision of arty commissioner, any action, derision, recommendation of the City Manager w any dty 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, derision or recernmendation that foreseeabty will be heard or reviewed by the rity commission, or a dty board or committee. The tens
specifically indudes the prindpai as well as arty employee engaged In lobbying adivitiea. The term "Lobbyists" has speeifle ezelualons. Please
refer to Ordinance 2004.11435.
Gonzalez Alfredo J.
NAME OF LOBBYIST: (Last} (First) (M.i)
1221 Bridcell Avenue, Miami, Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code}
305-579-0588 305-951-5588 gonzateaaj@gtlaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Southgate Tower Apartments c% Harry Nash
NAME OF PRINCIPAL/CLIENT:
6600 West Broadstreet, Suite 100 Miami Beach, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
___ $04288-0011 804-285-4737
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
or
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Harry Nash
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
Southgate Tower Apartments request before the DRB Board
Issue to be lobbied (Describe in detail):
III. ~ . - 'x' \ ' ~ k ~ ~: ~ ~' = -' (Pursuant to City Code Section 2.482(9)
include a statement of the extent of any business, financial, familial, professional or other relationship, gluing raise to an
appearance of an impropriety, witfi any City personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4} include a statement of any cotntractual relationship (paid or unpaid} from 12 months preceding the
commencement of service of City personnel to be lobbied.)
A Full Name of Individual Title B An Financial, Familial or Professional Relationshi
Building Department /Fire Department Board of Adjustment /Design Review Board
Planning and Zoning Department, Public Works City Manager's Office
Historic Preservation Board, Planning Board Flood Plain Management Board
S~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $375.00 Hourly
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $375.00 Hourly
(Required).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 288 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yes X No: Are you lobbying on a present or oendina bid for goods. eauipmerrt or services. or on a
present or oendina award for goods. eguipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entided "Prohibfted Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes X No: Are you lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation or chance to the City's Future Land Use
Ma°?
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-profd
corporation or entity wfthout spedal compensation or reimbursement for the appearance, whetl~er direct, or
indirect, to express support of or opposition to any item, shall register with the deck as required by this
section but, shall not be required to pay any registration fees.
^ Yes X No• Are you representing a not for-Drof1t corporation or entity without special compensation or
reimbursement. .
I do solemnly swear
provisions contained
^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY;
State of Florida, County of Miami-Dade
Swom to and subscribed before me
This Z da of coo 0
Sign e o rich
No rization of Lo 1st's nature
IlT-correct and that 1 have read or am familiar with the
Code and all reporting requirements.
^ Produced ID
Form of Identfcation
~Personaily known (PNncipalj
Y~rq~h~a 4~2X~Yit~
State offloHda, County offlAiea~i"Dade
Swom an~ subscribed before me
This "day of ~gb~ 2010
Signa a of P biic Notary -State of Fli
Notarization f Principal's signature
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TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: ]Yes [ ]~No Amounf Paid $ MiyR~ Date Pali]' ~
:.Lobbyist Registration Form roceived and verified by:
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F:iGLERliof96vts[,1>~.i?t~-.h~;.onIEorn, X2708"' '... Revl~ed0$127120Q8 .:'
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V.` SIGNATURE UNDER OATH:
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK OFFice CiiyClerkC~miamibeachfl.gov
Tel: 305.673.7411 ,Fax:' 305.673.7254
LOBBYIST NAME: Alfredo J. Gonzalez
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 ail active lobbying issues.
1) Lobbyist Expenditure Form
2J 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.
.~•
Date:
F:ICLER1LQi313Y1ST1Lobbyist Registration Form 32708.doc
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Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
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Received of c/(, /~ ~ '
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(THIS INFORMATION MUST BE COMPLETED) Offl Finance Director
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Account Number:
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Preparer• Dept: EXT: