Neisen Kasdin/Lanier Parking Solutions0
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4` l'' LOBBYIST REGISTRATION FORM
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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 p,
NAME OF LOBBYIST: (Last) (First) (M.I)
Akerman Senterfitt, P.A. One SE 3`d Ave., Suite 2500 Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374-5600 (305) 374-5095 neisen.kasdin@akerman.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Walsh Timothy
NAME OF PRINCIPAL/CLIENT• (Lastl (First) (M I)
Lanier Parking Solutions of Florida 233 Peachtree Street, NE, 2600 Harris Tower Atlanta, GA 30303
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(404) 881-6076 (404) 881-0677
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:
City of Miami Beach Parking Services RFP Bid No. 41-08/09
Issue to be lobbied (Describe in detail):
{ M2850062;1
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A• Full Name of
Individual/Title B. Any Financial, Familial or
Professional Relationship
City Commission and Mayor None
Saul Francis, Director of Parking Dept. None
Jorge Gonzalez None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION
(DISCLOSE WHETHER HOURLY, FLATRATE OR OTHER):
A. LOBBYIST DISCLOSURE: (Required) $550.00 hourly
B. PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)
Same
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 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 chance of zoning
map designation or chance 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.
{M2850062;1 } 2
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 BEj~FIILED EVEN IF THERE
HAVE BEEN NO EXPENDITURES OR COMPENSATION D/~//! NG THE REPORTING
PERIOD.
Signature of Lobbyist
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 Secti~tl` 2-482 of the Miami Beach City Code and all
reporting requirements. /~/~/~
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
ersonally known (Lobbyist)
VII. SIGNATURE AND STAMP OF
NOTARY:
State of Florida, County of Miami-Dade
Sworn t and subscribed b~me
This day of ~" _, 2009
~~v~;
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
~c~~~i. Notary Public State of Florida
Ann Condon
My Commission OD758094
~or ~d'~ Expire
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This -day of , 2009
Signature of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: ^Yes ^No Amount Paid MCR #
Lobbyist Registration Form received and verified by:_
Date Paid
Revised 12/08/04
{ M2850062;1 } 3
V. SIGIYATUREUNDEROATH:
QN t?CT(?BER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT Tp THE. CITY
CLERK A SIGNED STATEMENT UNf)ER OATH, LISTING LOBBYING EXPENI3ITURES,
AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH'FOR THE
PRECEDING CAL,ENpAR YEAR A STATEMENT SHALL BE FILED EVEN` III' THERE..
HAVE BEEN NO EXPENDITi1RE5 OR COMPENSATION. D NG THE REPORTING
PERIOD. ~ ~,,
f
l da solemnly swear that aII of the far+
familiar with the provisions contained
reporting requirements..
Signature of Lobbyist::
Signature of PrincipaVClient:
VI. LOBBYIST" IDENTIRICA7T1
Signature: of Lobbyist
facts are true and correct andt I have read or am
x~~~2-4$2 of the Miami lie ,'City Code and alt.
[] Produced ID ~
-Farm o Identification
ersanally known (Lobbyist)
VII, SIGNATURE AND STAMP OF
NOTARY:
State of Florida, County of Miami-L3ade
Sworn i and subscribe befa a me
This day of .. ~~~ , 24Q9
Signature of Public Notary -State of Florida
Nptarizafian of Lobbyis#'s signu#ure
PRINCIPAL
Produced ID
.Farm of Identification
Personally known (Principal) ~
is ib ~ ~
* 1
State ofa, County of >~s
Sworn and subscribed before me l,~,
This$~day of , ~(~ y~ ~~~
~A~~~
Si ature of Fublic Notary - State o ~Ieri~a
No#ari~atiion of Principal's signature U~
~~ Noiary p`UGtiC 518 of ~tariGa
Ann Cmc~n
+~ MY COmmissiptt DD758i7g4
y+pir EX~Nre
.FOR CLERK'S' USE Q1VLY
Annual'Regi~iratian fee: Yes ~No .Amount Paid ~~T~ MCR ~ Date Paid ~d
Lobbyist Registration Farm received and verii'aed by: T= Sal ti
Revised 121t?8/Q4
{M2l35(-462; T l
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Miscellane s Cash Receipt
CITY OF MIAMI BEACH
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No. , ~, . '~ '± 4 4
^ Cash ^ Credit Card heck # ~~~~~~~ $ ~~
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Received of ~ fj i N l ~
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For
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{THIS INFORMATION MUST BE COMPLETED) Office of Director
Account Number: ~l/ ~~~ R 3~ ~~~ ~ By
Preparer• ~'~ ~-~~~/'(~~~1~ Dept: ~G ~~2.°,~~ ~. ~o ~'r~