Wayne M. Pathman - Michael Freedman, CEOiQvq'I/-,~'~7'Si,C~
M IAM I B EAC H
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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 induces the
principal as well as any employee engaged In lobbying activities. The term "Lobbyists" has specific
exclusions. Please refer to Ordinance 2004-3435.
Pathman Wayne M.
NAME OF LOBBYIST: (Last) (First) (M.IJ
Pathman Lewis. LLP, 2 South Biscayne Blvd., Suite 2400, Miami. FL 33131
BUSINESS NAME AND ADDRESS (Number of Street) (City) (State) (Zip Code)
(305) 379-2425 305-379-2420 wpathman(a~pa[hmanlewis com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Michael A. Freedman. Chief Executive Officer
NAME OF PRINCIPAL/CLIENT:
Fuel Miami, LLC. 149 FiOh Avenue, 11`h FL. New York, NY 10010
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
212-967-7333 212-967-7337 maf(a~fueloutdoor oom _
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, PARTNERS, OR BENEFICIARY: Michael A. Freedman, CEO
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Fuel Outdaar Holdings, LLC,
100%
II. SPECIFY LOBBY ISSUE:
Advertisin and Marketin -Murals
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A Full Name of Individual/'I'itle B) An Financial, Familial or Profession Relationshi
Ma or M. Bower, Vice Ma or D. Weithorn, No
Commissioners J. Libbin, E. Tobin, M. Gon ora No
J. Wolfson, J. Ex osito; Cit Mana er J. Gonzalez No
City Attorney Jose Smith No
5~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE \VHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST' DISCLOSURE: (Required) $400 hourly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $400 hourly
The following information must be answered:
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 vending bid for Goods. equipment or services, or on a
present or pendine award for eoods. equipment or service?
2) Pursuam to Miami Beach City Code 2-490 Entitled "Prohibited campaign Contributions By Lobbyists
on Rcal Estate Development Issues.
^ Yes ~No: Are you lobbying on a aendine application for a Development Aereement with the City Of
apalication for chanee of zoning mnp desienatian or chanee to the City's Future Land Use
Mnn?
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 snot-for-protit
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 trot be required to pay any registration fees.
^ Yes ~I No: Arc you representing anot-Tor-protit corporation or entity without special compensation
or reimbursement.
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 ALENDAR YEAR. TEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES O 1 URING THE
REPORTING PERIOD. ~ i ----"lam
I do solemnly swear that all of the fore~+i,~ facts are tr and corre~and that I have read or am
familiar with the provisions contained in $ c ' n 2- f the Miam each City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client: ~ ~N
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICAT N:
1 L /
Produced ~ Produced ID C' r~ cJ~£<) /~,~`~~
• rm of 1 ntificat' t ~jForm of Identification (~p
x Personal y •now ~ ;ry6yist "~ ersonally knowh (P/rincipal) ~ J
V I. SIGNATURE AND $F NOTARY; . ~•. .~t2 ,(
!!G. • ~ ac"".. _ :,cea:-; t'~uhc UntA•.r.~tetg / V N~ 1 ~
State of Florida, County ofMiami- late o(P.terida\/ Coun[y of ~ ~ ~ ~ (i
Swom to and subscribed before me Sworn t~ and`S bscribed before me
This 2ith day of January. 2010 This ~~6~y of ~ j /, ivrr'1, 2010. ~_
JEAN lti i~OD
EXPIR~ya~~
tt0ltdetl thN pMgtypyp~ ~adlM'tltBrd
LY
No Amount Paid MCR H Datc Paid
MIAMI BEACH
City of Miami Beaeh, 1700 Convention Center Drive, Miami Beach, Florida 33139, w.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: Wa e M. Pathman
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 Clerl ' ffice of lobbyist withdrawal in writing.
Signature:
January 25,2010
Date:
F:\CLER\LOBBYIST\Lobbyist Registration Form 32708.doc