Andrea D. O'Naghter/Friends of the Bass Museum,~
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m MIAMIBEACH
S ~~-S ~QYl.SiJ~~~n 8~~ rrvl.D t~( ~o~'Z C?~UOIeS
BUSINESS NAME AND ADDRESS (Number and re t) (City) (State) (Zip Code)
313~-
T EPHONE NUMBER: FAX NUMBER: EMAIL: ~ Dye
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1700 Convention Center Drive, Miami Beach, I*L 3313~'/I•r. ~ ~ P1~~2.
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LOBBYIST REGISTRATION FORM ~ ~'i~~ 5.
Lobb ist means all ersons em to ed or retained, whether aid or not, b a rinci a! who seeks to encoure the U ~ ` C
y p p y p y p p ge passage, defeat or modification ~f ~
any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendatio~~ryry' 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 tens
speGfically includes the principal as well as any employee engaged in lobbying activities. The term "Lob yists" has specific exclusions. Please
refer to Orc~ina a 2004-3435. n
o~ I~.~-e rL t~d~'e z~
E OF LOBBYIS ~ ast) (First) M I
City of Miami Beach Office of the City CIS
I. LOBBYIST RETAINED BY:
t'Y~ C K
NAME OF PRI
.~NT:
21 Z t pa.~~-
(Number and
FIII
a
z
` ,
(State)
or Trust [Section
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR
SUCH CORPORATION, PARTNERSHIP OR TRUST:
L_ 3335
Code)
OWNERSHIP INTEREST IN
f~CiFIC LOBBY ISSUE:
sue to be lobbied (D a in detail):
/_
iii. CITY;AGENCIES/INDIVIDUALS TO BE LOBBIED.: Pursuant toy City Code Section 2 2(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 Clty 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 if the subject
contractual relation.
A Full Name of Individu
l Title B) An Financial, Familial o r Professional Relationship.
a
~[
! IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION
RATE OR OTHER):
,P) LOBBYIST DISCLOSURE: (Required) ~%
B) PRINCIPAL'S D-SCLOSURE (OF~QBBYIST COMPENSATION)
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited
On Procurement Issues":
C' present or pendinsl award for ~IOOds. equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign
Real Estate Development Issues":
WHETHER HOURLY, FLAT
Contributions By Lobbyists
By Lobbyists On
3) Pursuant to Miami "Beach City Code 2-484 {h) Any person (except those exempt from the definition of
"IobbyisY' 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.
~ reimbursement. .
V. SIGNATURE UNDER OATH:
ALI Af~TAO CS AsT AC CwAU vi
PERIOD.
I do solemnly swear that all e f egoin
provisions contained in ion 2-4 of the
Signature of Lc
true and correct and
'.~ CipriCo~e and all r
VI. LOBBYIST IDENTIFICATION:
~duced ID ~ `
Form of Identifi 1
Signature of Lobbyist:
Signature of Principal/Client:
^ Personally known (Lobbyist)
VII, SIGNATURE AND STAMP OF
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~_~y of ~Q„g~_, 2009
ite of F
nature
~~
I have read or am familiar with the
Ing requirements.
~ ~
PRINCIPAL IDENTIFICATION:
^ Produced ID ~ ~,
Io~ ~ ~ Form of Identification
I Q N = ~ ~
f
° ,~
o ~ z ersonally kn
owri (Principal)
~ ~ ELISA ~,
~. ®NSO
~
o
•e
~ MhIISSION # DD674336
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F.7~IRgg,Juiy 14 20
W ~ 11
Y
~~A°°°°`c°
State of Florida, County of Miami-Dade `
~ m Sworn an subscribe, before me
ik_•yd, This day of , 2009
~~.
,~,;~r:~ nature o Public No -State of Florida
Notarization of Prin' pal's signature
I
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Reglstration~feeYes,[ '- ] No Amount Paid'$ '-_ =MCR # i i- Date-Paid •:-'- dl
Lobbyist,Registration F m received and verified by: Lo,((
`F-\CLER\$ALL\aFORD1S\LOBBYISTfORMS\LobbyistRegistration Form Z1i0~ 9.doc ReViSed"02/11/.2009
~'
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,
CITY CLERK Office Cityl
Tel: 305.673.7411 ,Fax: 305.673.7254
~~
LOBBYIST NAME: --Pa _.
I understand that no later than October 1st of each ye
forms, pursuant to Section 2-485 of the Miami Beach City
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
Miami-Dade County Commission on Ethics and for code vio
In addition, once an issue I have registered to lobby on has
to immediately notify the City Clerk's Office of lobbyist withd
~ ~^j~ / ("
Signature:
F:\CLERILOBBYtSTILobbyist Registration Form 32708.doc
i
I
N.miamibeachfl.gov
@miamibeachfl.gov
dr I must file the following
Code, with the City Clerk's
t
ame being transmitted to the
lion evaluation.
r
>een resolved, I am required
awal in writing.
~ 2~d ~
~. ,
Date: