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Wayne M. P athman/David Mancini-Ric-Man InternationalMIAMIBEACH City of Miami Beach Office of the City Clerk 17Q0 Convention Center Drive, Miami Beach, FL 33139 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 bo heard or reviewed by the city commission, or a city board or committee. The term specifically induces the principal as well as any employee engaged In lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance X004-3435. Pathmnn, Wayne M. NAME OF LOBBYIST: (Last) (First) (M.I.) Pathman_ ewis. LLP 2 South Bisc~~e Blvd Miami FL 33131 BUSINESS NAME AND ADDRESS (Number of Street) (City) (State) (Zip Cade) _305 379-2425 305-379-2420 tvo~tlunan rr nalhmanlewis.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINTD BY: _David Mancini President NAME OF PRMCIPAWCLIENT: Ric-Man huentational hte 1210 Wash'ttlgton A enue Suite 250 Miami Beach. FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 535-1742 305-535-1745 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optio»a!) Fill out this section if prittcipaf is a Corporation, Partnership or Trust ]Section 2-482 (c) ] • NAME OF CHIEF OFFICER, PARTNERS, OR BENEFICIARY: David Mancini, Lisa 3ankowski • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST [N SUCH CORPORATION, PARTNERSHIP OR TRUST: David Mancini. Lisa Jankowski II. SPECIFY LOBBY ISSUE: South Pointe fI lnfrnstructure conh•acts cmrcernine bids Issue to be lobbied (Describe In detail): III. CITY AGENCIES/1NDIVIDUAI.S TO BE LOBBIEb: A Full Name of IndividuaUTitle B An Financial, Familial or Profession ltelationshi Cit Commission .1~ .!. `~ ! ~~ ~d ~ ! 330 8002 s~ ~ IV. DISCLOSURE OF TERi~4S AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE VI'IiETi[ER t-IOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) X450 hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Regttit•c[I), $450. The following information must be answered: Pursuant to Miami Bcach City Code Section 2-488 entitled "Prohibited catpaign Contributions By Lobbyists on Procurement Issues": ~• Yes ~ No• Are you lobbyin og n a present or nentlin~ bid for goods. cnuinment or services, or on a present or nendina awat•d for eoods. enuipment or service? Ptn'suant to Miauu 13each Cily Code 2-490 Entitled "Prohibited campaign ConU•ibutions 13y Lobbyists on Rcal Estate Development Issues. 'Yes C~No' Are you [obbvine on a nendine application for a Develountent Aerectnent with the City Of -~ anpligafion for change of zoninta map designation or change to the City's Future Land Use M?L'_ PWSUant t0 MIARii I3eaCh Clty Code 2-484 {h} Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-48 t above) who only appears as a represwttalive of anot-for-profit corporation or entity without special compensation ot• 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 azly registration fees. ^ 'Yes ~No' Are van representing a trot-for-profit cornortition or entity without special compensation or reitnbttrscment. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERIC A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATIOI~I RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING GALE YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDI'fURE~ OR COMPEN TiON DURING THE REPORTING PERIOD. ~ " mature of Lobbyist I do solemnly sweat• that all oft a foregoing facts are true and correct and that I have read or am familiar with the provisions cot wined.-'rit-SestiQn 2-482 of the Miami Beach City Code and all repotting requirements. Signature of Lobbyist: ~ _ Signature of PrincipaUClient: ~ ~ I Vi. LOBBY[S'C IDENTIFICATION: ^ Produced (D Form of identification ~et known (Lodi tst) ~•~ _ L~~ Vti. SICNA Stnte of Florida, County of Mianli-[ Sworn to and subscribed eforc m This ~O~`day of~~ " - ~ -- JEAN C. MG11:OD MY COMMISSION 8 Dp ll: EXPIRES: November 11 Bon~dlnm NolhryPubga Uhl PRINCIPAL IDENTIFICATION: Produced ID Form of Identification Personally know~~'~r ` ,,iys r nzo :~•.,F,~COMMISSION#nDntt~t E;'~e,; DtPIRES: SEP 24, 201 t %•;ooew;:° yyydyvAARONNOTAiiY.cam tts Florida, Cou~uy of Miami-Dade tsn o and subscribed before me day of . 20 FOR CL--1 '' " SE ONLY (~ L (~ 0 Annual registration fee: I I Yes [ ] No Amount Paid / MCR 1l `~ me Pa• Lobbyist Registration Pomi received and verified by: F:ICLER\$ALL\MARIA-M1Lobb isr\LODRYIST Form OS.doc Revised 12/08/04 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, w.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: 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. -~ !a ~ ~ D te: F:\CLER\LOBBYIST\Lobbyist Registration Form 32708.doc