Mara E. Gonzalez/C&D Miami Real Estate, LLC~,.
?~ MIAMIBEACH
• 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 mod cation of any ordinance, resolution, action or derision 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 spec~cally includes the principal as well as any employee engaged in
lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 20043435.
Gonzalez, Mara E•
NAME OF LOBBYIST: (Last) 7~ (First) (M•9
Proper Composition Inc. - 2747 SW 8th Street Miami, F1 33135__
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Z~p Code)
(305) 644-9121 105) 64~-051 maragn,,,a~P~lanrovercomnosition.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) (Ctty) (State) (Zip Code)
(786) 208-5709 italgic@bellsouth.net
TELEPHONE NUMBER: FAX NUMBER: (Optional EMAIL: (Optional)
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 OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
Speak in front of the Board of Adjustment for 3 rear set back issues.
Issue to be lobbied (Describe in detail:
u. SPECIFIC LOBBY ISSUE: ~~~~ ~ 3~S W~~~q ~~~Y~~ 9
Ill. CITY AGENCIESANDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Tdle ~ B) Any Financial, Familial or Professional Relationship
i /
D
5~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
` RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required
none payment for Lobbyist9'LaCctivityT N1
B) PRINCIP,Anonspa m0ent~~fo~B~,obby SPtENact~~ity
~""~ (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 ~ No Are you lobbying on a present or pendintf bid for stoods equipment or services or on a present
or pending award for goods, equipment or service?
2) Pur~ant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate 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 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 a not for-profit corporation or entity without special compensation or
reimbursement .
V. SIGNATURE UNDER OATH:
ON OCTOBER 15T 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 EXPEN~UR~ OR COMPENSATIO DURING~HE REPORTING
PERIOD. , /'
of
I do solemnly swear that all egoing facts are true and correct and that I have read or am familiar with the
provisions contained in S on 2 of the Miami B~ City and all re orting requirements.
Signature of Lobbyist X (/~
Signature of Principal/Client ~~ ~~
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
U Produced ID U Produced ID
Form of Identification Form of Identification
$I Personally known (Lobbyist) ~J Personally known (Principal)
VII. SIGNATURE AND STA QtA$Y_ .
~~~ ANASTAGIA 1. DELEON
State of Florida, County of Miami- NOlory pubic • S6~111 ibiidari ,County of Miami-Dade
Swom to an subscri before ~ Exp~'dlriep 0 scribe before me
T ' day of i~ ' I'•r Cornmbsion M da of ! , 2 DS
~~•~' 8onde0 8y Nation ary Aa ~~~
Signathre of Public Notary -State of Florida ignature of Public Notary -State of Florida
Notarization of Lobbyists signature Notarization of Principal's signature
TO E COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ (~~ '~
MCR # ~~~ 9G ~ Date Paid ~. 3 ~ 4?
Lobbyist Registration Form received and verified by:
Revised 02/04/2008
m fJ~,IAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME:
Mara E. Gonzalez
CilyClerk@miamibeachfl.gov
I understand that no later than October 1st of each Rear, I must file the following
forms, pursuant to Section 2-4.85 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
l~ 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.
C.
Sign re. - Date:
Revised 02/04/2008