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Anthony Alvarez/C&D Miami Real Estate, LLCm MIAMIBEACH City of Miami Beach OfFce 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 rat, by a principal who seeks to encourage the passage, defeat or mod cation 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-malting 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 bbbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 20043435. Alvarez, Anthony NAME OF LOBBYIST: (Last) (First) (M.I) Anthony Alvarez Esq -2742 SW 8th Street, Miami, Fl 33135 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 1305) 644 9121 (309) 643-0510 anthonvalvarezll(~vahoo.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: C & D Miami Real Estate L.L.C. NAME OF PRINCIPAUCLIENT: 5767 NW 151 Street Miami Lakes, F1 33014 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 208-5709 talgic@bellsouth.net TELEPHONE NUMBER: FAX NUMBER: (Optwnal) EMAIL. (Ophona~ Fill out this section if principal is a Corporation, Partnership or Trust [Section 2.482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OVIMERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC L013BY ISSUE: s~f 3 SS wa s~-~-~-r ~e . Speak in front of the Board of Adjustments for 3 rear set back issues. Issue to be bbbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of IndividuaUTitle I B) Any Financial, Familial or Professional Relationship ~jDf~ 5~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Re wired) none a ent for Loqbb iststaCCtivit Nt B) PRINCIPAL on spa ment~~fo~B~,obbyisPtENa~Tt~Vity (Required). 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 lobbying on a present or pending bid for goods equipment or services, or on a present or pending award for goods equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ~~ - _ ..• n::n~~inn }nr a rlavaleement Agreement With the City or ^~es ~:vv aDp~lc~atiOn ~ change of zoning map designation or chance 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 registier with the clerk as required by this section but, shall not be required to pay any registration fees. ^ Yes ~ No' Are You representing coot-for-profit corporation or entity without special compensation or 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 MU-MI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR CAM SENSATION DURING THE REPORTING PERIOD. ~~ /1 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 Mia Be City Code and all reporting requiremerrts. Signature of Lobbyist $ Signature of Principal/Client /r '`~~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: U Produced ID U Produced Ip Form of Identification Fonn of Identification ~ N,,,,y~, ,,.,~i.,,,,~ BI Personally known (Lobbyist) ~ j(I Personally known (Principal) :,;~'~ ~~ ~~ VII. SIGNATURE AND STAMP ~'•.~. State of Florida, County of Miami-Dad ~ State of Florida, County of Miami-Dade ~~gooo 3' Swom to nd subscribed before me ~ Swo n subscri fore me ~ c ~ j ' day of of ~ 0 ao ~ .~ ~ D .~~ ~~ ~(7 abure of Public Notary -State of iiw' _ ~gnature of Public Notary - Stiate of Flo ' as ~ N ~ Notarization of Lobbyist's signatu g ~ ~ Notarization of Principal's signature °o }~~ ~ ~ TO B ~~ Y CITY CLERK'S STAFF ONLY ~ ~ ~ ~Q ,e f ~o Annual Registration fee: [ ) [ o Amount Paid J 4 ~ ~ MCR # Z Date Paid jZ O o Lobbyist Registr do Form received and verified by: Revised 02/04/2008 m ~ti~IAMiBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwv,,.miamibeachfl.gov CITY CLERK Office Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: Anthony Alvarez CityClerk@miamibeachfl.gov I understand that no later than October 1st of each year, 1 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 J 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. 11/29/08 Signature: Date: Revised 02/04/2008 ~^