Guy Nagahama~ I ~ ~
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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 speclfle exclusions. Please
refer to Ordinance 2004-3435.
Nagahama Guy
NAME OF LOBBYIST: (Last) (First) (M.I)
One Post Office Square, Ste. 3400 Boston MA 02109
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
617-342-7870 617-342-7956 GNagahama@Jefferies.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Jefferies & COmoanV Inc
NAME OF PRINCIPAUCLIENT:
520 Madison Ave, 8th Floor New York NY 10022
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
212-336-7270 LKimmel(c~Jefferies.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
FIII out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: RlChard HOlder
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
u.SPECIFIC LOBBY ISSUE:
Issuance of Municipal Bonds
Issue to be lobbied (Describe in detail):
ul. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(g) include
a statement of the extent of any business, financial, familial, professional or other relationship, giving rise 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 said City
personnels' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
or
Patricia Walker, Chief Financial Officer ~ none
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
In-house employee sa arled
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). In-hOUSe emplOYee salaried
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 pending bid for goods, equipment or services. or on a
present or pending award for goods 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 lobbying on a pending 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 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 snot-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
Signature of Lobbyist: L/ ~~.; ""'
c Signature of Principal/Client: ~
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~ ~ VI. ~ LOBBYIST IDENTIFICATION:
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Form of Identification
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~ VII. SIGNATURE AND STAMP OF NOTARY:
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Sworn to and subscrib ~f re me
This day of , 20
Signature of blic Notary -State of lorida
Notarizatio of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
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Notarization of Principal's signature "~
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TO BE COMPLETED BY CITY GLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid S MCR # Date Paid
Lobbyist Registration Form received and verified by:
F;\CLER~SALL~0FC1RN15\LOBBYIST FOr2h1S`Labbyist Registratian Form 21109.doc Revised 02/11/2009
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 2y4'8g of the Miami Beach City Code and ail reporting requirements.
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City of Miarni Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.7411 ,Fax: 305.673.7254
CityClerk@miamibeochfl.gov
LOBBYIST NAME: Gu Na ahama
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.
LI,.Q, r,.~.._ ~ 2
Signature: Date:
F,tCl.>RtLOBgYiSTtLabbyist Registration Form 32708.doc