Neisen O. Kasdin (2)K ~ P+,~.aa/d~
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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.
Kasdin Neisen O.
NAME OF LOBBYIST: (Last) (First) (M.I)
One S.E. 3rd Ave Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-374-5600 305-374-5095 neisen.kasdin@akermal
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
First Class Parkin4 Systems / Jorge Zuelaga
NAME OF PRINCIPAL/CLIENT:
12550 Bisc.Blvd. Miami FI 33181
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-531-4466
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:
II.SPECIFIC LOBBY ISSUE:
Valet Parking Concession RFP 40-07!08.
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City code section z-4s2(g)
include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the
commencement of service of City personnel to be lobbied.)
Familial or Professional
City Commission City Manager's Office ~ None
5I~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). SBrtle
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 pending bid for aoods, equipment or services. or on a
present or pending award for aoods. equipment 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 pending application for a Development Agreement with the City or
application for chanae of zoning map designation or chanae to the Citv'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 register with the clerk as required by this
section but, shall not be required to pay any registration fees.
^ Yes ®No• Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
Signature of Lobbyist: / U
-,
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
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VII.
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
0 Produced ID
OF NOTARY:
200
lorida
Form of Identification
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Notarization of Principal's signature
TO BE COMPLETED BY CITY C RK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ ~ MCR # Date Paid
Lobbyist Registration Form received and verified by:
F:\CIER\HATL\Forms\Lobbyist Registration Form.doc Revised 03/27/2008
I do solemnly swear that all of the facts are true and correct and that I have read or am familiar with the
provisions contained in Section 2-4 iami Beach City Code and all reporting requirements.
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochH.gov
CITY CLERK Office CityClerk@miami6eachN.gov
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME: Neisen O. Kasdin
I understand that no later than October 1st of each xear, 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.
Z v
Signature: Date:
F:\CLERILOBBYIST1Lobbyist Registration Form 32708.doc