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Clifford Schulmanr c . 1 ,, ~~s 3 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 2004-3436. Schulman Clifford A. NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig, P.A. 1221 Brickell Avenue Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0613 305-961-5613 schulmanc@gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: TM Real Estate Group, LLC ~ AS (~~~(t. Fad. ZEOEK ~ace~s NAME OF PRINCIPAUCLIENT: 2150 Coral Way, Suite 6-B Miami FL 33145 Bl)SINFRS NAMF ANn Anf)RFSS lNumhPr and RtrPatl lCitvl lRtatel l7in (:octal 305-854-2552 305-854-2595 _ TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)j • 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: u.SPECIFIC LOBBY ISSUE:. 315-321 Ocean Drive, Building Issues 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, flnanclal, 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. A Full Name of Individual Title B An Financial, Familial or Professional Relationshi Historic Preservation Board, Planning Board Board of Adjustment Building Department, Fire Department City Manager's Office Planning and Zoning Department ,Public Works ~JI:j~Q ±~„~{.:~-t~ :t E :? { I ~Z ~d ~- g3.~ QIGZ ~ ~ ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT ' RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) 645.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): 645.00 Hourly (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": ^ Yes V^INo• Are you lobbvina on a present or aendinn bid for goods. eauiument or services, or on a present or pending award for goods eauiument or servlce4 2) Pursuant to Miami Beach City Gode 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^ Yes x No• Are you lobbvina on a pending application for a Development Agreement with the City or application for change of zoning map designation or chance to the Citv'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. ^ Y_es ~(No• Are you representing snot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: Signature of Lobbyist: '~ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ Produced ID ^ Produced ID Form of Identification Form of Identification a personally known (Lobbyist) ~.. Personally known (Principal) 8 ~ r° ~ II. SIGNATURE AND STAMP OF NOTARY: 8 tate of Florida, County of Miami-Dade State of Florida, County of Miami-Dade worn to and subscribed before me Sworn and subscribed before me NOTARY PUBLIC•STATE OF FLORIDA his ,~O da ~,2 09 This day of Mai ~0~1., 2009: Liliana Nunez ( ~ .Commission # DD67~217 '••;~?.•~ Expires: MAY 07, 2011 ~; ~ ign a of P lic Florida Signatur -State of UATLANTICBONDINGCO.,nvC. o riza ono vist's ignature Notarization of Principal's signature TO BE COMPLETED B C L RK'S STAFF. nual Reglstratlon fee: ]Yes [ ] No Amount Pa $ _MC # Date Pald obbyist Registration Form received and verified by: ~ :tCLERtSALL1aFORMS\LOBBYIST FORMS1LobbYLSt Reg o r 1 Revised 02/11/2009 I do solemnly swear that all of the foregoi acts tru nd correct and that I have read or am familiar with the provisions contained in Section 2-482 of th iami e3Ch i Code and all reporting requirements. m MIAMIBEACH City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, veww.miamibeachH.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 Clifford A. Schulman LOBBYIST NAME: I understand that no later than October 1st of each dear, 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. \Z -~O - o~ Signature: Date: F:tCLER1LOBBYIST1Lobbyist Registration Form 32T08.doc