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Deas, AlexandraCity 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. DEAS ALEXANDRA 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 7241 305-351-2176 Adeas(a~bilzin.com TELEPHONE NUMBER: FAX NUMBER: EMAIL. LOBBYIST RETAINED BY: Di Lido Beach Resort Ltd. and Di Lido Beach Commercial Ltd. NAME OF PRINCIPAL/CLIENT: c/o Bruce E. Lazar 605 Lincoln Road 5~h Floor Miami Beach FI 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-535-8118 305-673-8865 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: Bruce E. Lazar IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: C"3 r --t C II. SPECIFIC LOBBY ISSUE: ~ '~ All land use/zoning issues and Mitigation of special master liens r~ ; ~ •`~ ' '' Issue to be lobbied (Describe in detail): ~ -~-- III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: ~' ....r. ~ .. ,~ A) Full Name of Individual/Title B) Any Financial, Familial ar Professional Relatio ~ ip Ow `'` Code Compliance Division and staff no City Manager and staff no City Commission and staff no 5' ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) MIAMI 3/6/09 A) LOBBYIST DISCLOSURE: (Required) $320 00 - B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $320.00 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 lobbvinq on a present or pendina bid for aoods equipment 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 lobbvinq on a pendina application for a Development Agreement witn the ~lw or~ppu~cecivn for change of zoning map designation or chanae to the Citv's Future Land Use Map? ~ ; ~- _ ` t 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition ~~'lob~st" aS"'¢et forth in Section 2-481 above) who only appears as a representative of anot-for-profit corporatiorr~r entity witFrgut special compensation or reimbursement for the appearance, whether direct, or indirect, to expre;~s support or opposition to any item, shall register with the clerk as required by this section but, shall not be rec~.rlred--~t~$$ pay'~hy registration fees.. -~ '~ ~ w ^ Yes /No• Are you representing a not-for-profit corporation or entity without special cormAen'~tion 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 MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. /~ O~(_~V Signature of Lobb st 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 Miami BeaclyfLity Code and all reporting regyjrements. Signature of Lobbyist: ~i'~-mot. Signature of Principal/Client: ~ VI. LOBBYIST IDENTIFICATION Produced ID Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Mi ~ (~,, ~~ Swom to and subscribed befo N :•'t ArIVCOMIdISSIONiDD529254 This day of ARC. r,,,,~ 1~,,,,8',~~, R ~~ Signature of Public Notary -State o~Florida Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me tp0.V.P„B~ ~JaTy L MA71`NA Th's ~ d a of , 200 •'' ~'• ° * MY COMMISSION # DD 610330 ovember 25, 201b g ature of Public Notary -State of > e g~~g~tNouryservice arization of Principal's signature °rF` FOR CLERK'S USE ONLY !~ t~ y Annual Registration fee: [ Yes [ ] No Amount Paid MCR #~ ! ~ b G3 Date Paid ~/ U y LFo\\bbLLyisRRt~R,eAgis~tlrvlataioRn Form received and verified by: 1 F62~Z~1"7U0~~60I391A-M\Lobbyist\LOBBYIST FORM 05.doc ~ ~ Revised 12/08/04 ~11AMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl Gov LOBBYIST NAME: Alexandra Deas 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. ~) 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. w Signature: Q ate: C7 N O --'~ O ~}ry 1~ ~ ail r-` ~ :~ f,; ~ ~ W V i ~ ~!' n ~ -°r, ~' '~ r"} ~ ~.-~ O MIAMI 17~~ 538.1 7000060139 3/12/09