Carter McDowell Amended(, 321 Art ~, -2Da, ~~. ~wH.i. fir, 4~
"AMENDED"
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 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.
MCDOW ELL CARTER N.
NAME OF LOBBYIST: (Last) (First) (M•I)
Bilzin Sumbero Baena Price & Axelrod LLP 200 So Biscayne Boulevard Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code)
(305)350-2355 305-351-2239 CMcDowellCcDbilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
MIAMI HABITAT INC.
NAME OF PRINCIPAL/CLIENT:
1329 ALTON ROAD MIAMI BEACH FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-673-3948 305-673-4348
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: Eric Harari
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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0
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship .b ~
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City Commission & staff no r-- r~ ,•--J
Planning Department & staff no = ~ :...,..
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $535 00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $535.00
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 pendina bid for aoods eauipment or services, or on a present or
pendina award for aoods, 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 for a Development Agreement with the City or application
for change of zoning map designation or change 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 snot-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 1gt OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATI N RECEIVED, IN THE CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL B ED EVEN IF T RE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO ~~ ~,~~
Signature of Lobbyist
I do solemnly swear that all of the foregoing
contained in Section 2-482 of the Miami B~
Signature of Lobbyist:
Signature of Principal/Client: _
VI. LOBBYIST IDENTIFICATION:
^ Produced ID 1~ ~ ~
Form of Iden
C3~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP
State of Florida, County of
Sworn to and sub,S~ribed t
This'~S day of ~~
Signature o~l"~u~lic Notary -State ofd
Notarization of Lobbyist's signature
are true and correct and that I have read or am familiar with the provisions
Co~l~ and,a}I_redorting requirements.
R.
..
'~ ~~~ry ig?`'~~~ PRINCIPAL IDENTIFICATION: Eric Har~,~piUily~~~
•*~ 0 Produced ID ~ ~ •~~~%
f~ ~ ~-~ Form of Identific$+t~'o~t•~, e~uazy~ 'I' ' ~~'
,'• r"" •.%oQ°~ ^ Personally known (Princip~ `~0 0
del%~ 3 .... oF~.`\~~~ . $ : • • ~ y
= -+ : #Op ~
~-- . ,o -.- ~ nKU
MYOOMMISSION~00`~~ State of Florida, County of Miami-[yam; •.,••~•~Q~
~,„~n„u~ t1"o""~' Thism day of ribed bef e m 2 $~iii ~fiJ~i~ ON~~\\\\~
_ Signature of Public otary - Sta of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid~_
Lobbyist Registration Form received and verified by: .tire ei /
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM 05.doc ~ Revised 12/08/04
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www miamibeachfl.gov
LOBBYIST NAME: Carter N. McDowell
I understand that no later than October 1st of each vear, 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 Offi lobbyist withdrawal in writing.
~'~~ ~_Z~-6~
~~~ Date:
nature:
MIAMI 1641072.2 7817630513
2/25/09