Amy E. Huber /The Tides Hotel_. _ ~'/~~ ~ V~~~DU
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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.
Huber Amy E.
NAME OF LOBBYIST: (Last) (First) (M.I)
Shubin & Bass, P.A. 46 S.W. 1st Street, Third F1, Miami Fl 33130
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-381-6060 305-381-9457 ahuber@shubinbass.com
TELEPHONE NUMBER: fAX'NUMBER: EMAIL:
LOBBYIST RETAINED BY:
The' Tides Hotel /Tides Hotel Property, LLC
NAME OF PRINCIPAL/CLIENT:,.
1220 Ocean Drive Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(3051 604-5070-
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:
nSPECIf=IC LOBBY-ISSUE'
. •
The Palace Food Bar, Sidewalk Cafe, Entertainment Establishments
Issue to be lobbied (Describe in detail):
i
ul. CITY AGENCIES/INDIVIDUALS TO. BE .LOBBIED:: Pursuant to City Code Section 2-482(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 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) Any Finaricial, Familial or Professional Relationship
N/A •
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1V. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
' RATE OR OTHER): l /
. 1-
• _ A) LOE36YIST DISCLOSURE: (Required) HOUT'ly rat0
_ 2,~
`, B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION
(Required).. ) HOUT'),y P1t0 ~t% IJ
The following information..must be zinswered: • , .
1) Pursuant to .Miami Beach City Code Section 2-488 Entitled"Pi-ohibited Campaign Contributions By Lobbyists
" " On ProcurementlssueS": ,
.. ^ Yes ~No: Are~4ou 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 o~n a pending application for a Development Agreement with the City or
application for change of zoning map designation or change to the City's Future Land Use
. ~ .Map? ` • - .
3) Pursuant to Miami Beach Gity Code 2-484 (h) Any. person (except those exernpt 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 compehsation or reimbursement for the. appearance, whether direct,. o'r
. - ~ 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. .
- , ~ V. " $IGNATl1RE UNDER OATH: •,-
' ON _ OCTOBER 1sT OF EACH YEAR. EACH• LOBBYIST SHALL SUBMIT TO THE -CITY CLERK A SIGNED
STATEMENT UNDER OATH. LISTING LOBBl"~~~- ---------- ---
RECEfVED. !N THE CITY OE MIAMLBEACH FOR T
• BE FILED'EVEN°IF THERE HAVE BIEEN NO`EXPE
PERIOD.
' I do solemnly swear that all of th fo' g facts ar
provisions.contained in Secti 2 e iami Be
,~ ~
Signature of Lobbyist;
Si atlare of Lbbliyist
true acid correct and that I have read or am familiar with the
;h City Code and all reporting requirements.
1
..
Signature of Principal/Client:.- .: _ ~~~~`//
` ~ C~
' VI LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
. ~~.'Produced IDProduced ID f-L~L~# I~5~5-(c,~a0-~~-~ ~~~~
' Form of Identification Forme of Identification
~ry Public State of Florida J ~ ~~
.. ~ Personally.k a`'~by~~, (]uintavaui Personally known (PrincrpA~t~~~""YP~~ r ISJ1BElSATCHEU. '
~, , ~ My Commission DD880881 ~ ~= MY COMMISSION N DD 679ti91 '
+•.d ~ ,~ EXPIRES: Apri113, 2013
` VII. ~ SIGNATUR ~ M~>~d9`~@1fa ~;;j;;F;?"' t?ondedThNNotaryPublicUndenvriters
.: ... _.
. s•
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade ,
worn to a ssrib d`befo er mew Sworn and subscribed bef a me
' ~ day r( 20~ This a7 day of `l~} t 2009 '
Sig ature of Pub r - tate of Florida • ~Sigrtat re of Public otary =State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
' - TO BE COMPLETED BY CITYCLERK'S STAFF ONLY '
Annual Registration fee: [ "] Yes [ ] tJo Amount Paid $~ ~) ~., tiJC~ ~ _MCF2 # D Date Paid ~ ~ -
` Lobbyist Registration Form received and verified by: ' - ,
' F:}~i.~~''~~~Ll~at t3dZ~ixj~C~f+~1'T~l ?"c;F~P3~ _r..3izy~~~ &d~~}i~t~~1..:;. r,:~ i,s `. z . r . ,:__, O ReY15ed 02/11/2009
~~ ~~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.741'1 ,Fax: 305.673.7254
LOBBYIST NAME: Amy E. Huber, Esq.
I understand that no later than. October 1st of each year, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form.
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for-code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
April 27, 2010
Date:
F:iGLERiLOBBY1STiLobbyist Registration Form 3274$.doc