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Alfredo Gonzalez/Double Parkm ~;',^~1BEACH 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. Gonzalez Alfredo .1• NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig, P.A. 1221 Brickell Avenue, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (Crty) (State) (Zrp Code) 305-579-0855 305-961-5855 gonzalezaj@gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: Double Park NAME OF PRINCIPAUCLIENT: 1717 N. Bayshore Drive, Suite 201, Miami Florida 33132 BUSINESS NAME AND ADDRESS (Number and Street) (Cfty) (State) (Zip Code) 305-932-8600 ext. 205 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optronal) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Mitchell Liss and Gino Falsetto • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: u.SPECIFIC LOBBY ISSUE: Revocation or Suspension of Business License and Certicate of Use of Parking Valet Use Issue to be lobbied (Describe in detail): ul. CITY AGENCIES/INDIVIDUALS TO BE COBBLED: (Pursuant to city code section 2-482(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 72 months preceding the commencement of service of City personnel to be lobbied.) ilia) or Professional Relati Special Master, City of Miami Beach ~ s :~ ~ s ~ ~nr boot 4,,J a.l ~ . ! w.a ...~ .~ + a IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $ 375.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 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": 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. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR. EACH LI STATEMENT UNDER OATH. LISTING LOBBYINf IN THE CITY OF MIAMI BEACH FOR THE PREC EVEN IF THERE HAVE BEEN NO EXPENDITURE I do solemnly swear thatof the foregoing facts provisions contained in S on 2-48~-of the Miami Signature of Lob isfi "- ~ ~ S ~ Signature of PrincipaUClien ~ S ~ ,~ VI. LOBBYIST IDENTIFICATION: Produced ID ~; Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swom to and subscribed before me This day of `~ 200 9 Signatur of u is ary - tate of Florida Notarizat n of Lob fist's signature $ 375.00 Hourly and correct ~d that I have read or am familiar with the 4~e and I reporting requirements. ---~- v:.~..~L~11 PRINCIPAL IDENTIFICATION: Produced ID ~ L . ac . ~ C Form of Identification L2.vo •-SSt~--s5 -3by-"O ;Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This ~S day of ' , 200 9 Cigna llre o i ota -State of Florida Notarization of Pr cipal's signature ~s ~ 4f M ~. ~~; ~~~~ TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid; MCR # Date Pald Lobbyist Registration Form received and verified by: P:ACLER~LOtXBYiS"1'~LabByist RegistraGan Farm 32708.dac ROVIr~d 03/27/200$. 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contnbutions tsy Loooyisis vn Real Estate Development Issues":