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Donald J. Washburn Ryder Properties, Inc.y3gS '~oll~~r m MIAMIBEACH City o'~ Miami Beach Office of the City Clerk 1704 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a prinripal who seeks to encourage the passage, defeat or modiflption of any ordinance, resolution, action or derision of any commissioner; any action, decision, recamrnendatian of the City Manager or any dty board or committee; or any action,- decision or .recommendation of any dty personnel during the time period of the entire decision-making process on such action, derision or recommendation that foreseeably will be heard or reviewed by the dty commission, or a city board or committee. The term spedfically includes the" principal as weir as any employee engaged In lobbying activities. The term "Lobbyists" has specific exduslons. Please refer to Ordinance 2~4-3435. Washburn Donald J. NAME OF LOBBYIST: (Last) (First} (M.I) The Audio Bug, Inc. 3600 Hilkrest Drive, #102 Hollywood Florida 33021 BUSINESS NAME AND ADDRESS (Number and Street) (City} (State) {Zip Code) (,~4) 983-2788 (4~) 983-2789 audiobuq]~~I com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBY][ST RETAINED BY: Ryder Pmpertles, LLC ~~ .. NAME OF PRINCIPAL/CLIENT: ,. , Ryder Prooerties LLC 29-35 9"'gyenue New York New Yori~ 10014 BUSINESS NAME AND ADDRESS (Number and Street) (Gty) {State} {Zip Code} (212} 627-9840 ( ) __ _ • TELEPHONE NUMBER: FAX NUMBER: (0 notfp al} EMAIL: (Optional) iii! out this section if principal is a Cflrparation, Partr~ership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Guy Williams, CFO • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Exhibit II. SPECIFIC LOBBY ISSUE: Renovation, resboration,& redevel~ opment, induding variances & candltional use permit, of Soho Beach House at 4385 Coiiins Ave Issue to be lobbied {Describe In detail): III.. CITY AGENCIES/INDMDUALS TD 8E LOBBIED: A) Full .Name of Indirnidual~tle B) Any t•inan®al, Familial of Professional Relationship Planning Department Staff, HPB, BOA, Planning Board and C;ty Commission* ' None Untess an issue is tegistat~ve in nature. HPB, BOA, Planning Board, and Gty Commisstan members are nit lob cr~$td~~~~a pu~l h a~kig ~~. ~ ~~~~ IV. DISCLOSURE QF TERMS AND AMOUNTS OF LOBBYI57 COMPENSATION (DISCLOSE WHfTttER HOURLY, FLAT RATF QR aTHERt , $6,000.00 ~ ~~~C A) toBiiY~sT oisc~osuRir: (itequrr~ri) B} PRINCIPAL'S DISCLOSURi: (OF LO$BYIST COMPENSATION): {Required). C.~ . ~. ~ l~ The following information must be answered: 1) Pursuant to Miami Beach Gty Code Section 2-488 entitled "Prohibited Campaign Contributions ey Lobbyists On Procurement Issues": r# Yes X Na• Are you lobbying on a nresent or pending bid for goods, equipment or services, ar an a present or_aending award for +~oods, equipment or service? 2} Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions sy Lobbyists On Real Estate Devdopment Issues"; Yes X o: Ar o lobb in o a ndi 1'cation fo D e ent A m nt with Ci or aonlicatian for change of zoning map designation or change to the City's Future Land Use ~~ 3} Pursuant to Miami Beach City Cie 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 representafiive of snot-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, steal! not be required to pay any registration fees.. ^ Y No: Are o re rase tin a not-f r- ro t co rat'o r nti witho s i I ensation Qr reimbursement V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LO$BYIST 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 FORT PRECEDING CALENDAR YEAR. A STATEMENT • SHALL BE FILED EVEN IF THERE MAVE BEEN N EX ENDITURES . R MPENSATION DURING THE REPORTING PERIOD. ~~ ~ S n tore of Lobbyist I do salernnly .swear that alI of fhe foregoing facts are true an' correct and that I have read or am familiar with the provisions o wined In Se ion 2-482 of the Miami B ch City Code and all reporting requirements. /` Signature of Lobbyist: ~/ Signature of Principal/Client: ~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID ~L~ Utz Z(lo ~~ L~l~_~ ~ ~{ $~ D ~oduced ID ~~.1 \~~S i....~ t. ~ ~ G E . Form of Identification Form of Identification t"' ~~ 4 i~ Personally Ecnown (Lobbyist) c'_?'l~ersonaily known (Printipal~ ~ ~ ~ ~tN~~1~~~~HH~~ii O T VII. SIGNATURE AND STAMP OF ~ iii ~, ~~ State of Florida, County of Miami-Dade `'o•~'~ 0 9~~0 .lr~ate of F~eriea, County of f~4ii~ai-bade ~ ~ t~ Swom to and subscribed fiefore me ~ . ~ ~ ~ f .~ . ~ : ~~orn and subscribed before me L N €i This ~_day of 20~~~. ~ ~ w ~ ~ : a3'I~s ~~day of _ ~PR-1 L ,, 20.~Q ~ CD . s v`~ ~~= c~ Q\I Cn ~. Si ature of Publ' Notary =State of Flo ~•.,..• S~~~a••a~~aignature of Public Notary -State of Florida Notarization of Lobbyist's signature '~ii~~/!~ +"j1111~d~~`\ Notarization of Principal's signature FOR CLERK'S SE ONLY fI Annual Registration fee: [ 3 Yes [ ] No Amount Paid M # V Date .Paid Lobbyist Registrahlan Form received and verified by: ~ ~ Entered Sy: F:ICLERI$HLLIMf1R1A-hi~Lobbyistll.oBBYIST i1~Rh1 Q5.doc S~~ D a~ fsed iZ/OS/09 i ,. '' '` .~ - ~ ~ . ~~ ~. Ci#y of.Miami .Beach, 1700 Convention Center .Drive, Miami Beach, Florida 33139, www.niiamibeachfhgov CITY CLERK Office ~ ~ CityCierk@miamibepchfl.gov Tel: 305.673.741' l ,Fax: 305.673.7254 .. . Acknowledgement.of fines/suspension #rom lobbying for failure to comply-with City of Miami Beach I®bbying Laws . ., ,~. LO;BBY15'P NAME: 1' understands that no later than .October- l t of each ~„ ear, Lobbyists subject to lobbyist .. = registration requirements shall aubmit to the 'city clerk a signed statement under ,oath listing a l lobbying expenditures,° as .well as compensation ..received, for the preceding ca'endar year with. regard to~ the specific issue on which the lobbyist has been engaged to lobby. A statement. shall befiled even if there. have been no expenditures or - compensation during the reporting . period. ~ The ..statement shall list, in detail, each expenditure by category, including food and beverage, entertainment, research, communication, media advertising, publications, -travel, lodging and special events. - -- Fature to timely file the expenditure arltd` .feedisclosure report vorill result a in a #ine of - $50.00 per day. .Any. lobbyist who fails to file .the. required ' : e~cpenditure report by .December 1, shall automatically .be~ suspended . ~ from lobbying until all fines are paid, unless the-fine has been appealed to the Miami-Dade. C®unty Commission on E#hics and Public Trust. In the . ,. event a obbyist.fails to either file: the report and/or pay the assessed fines, the Clerk shal . - . ~° - notify~the Miami-Dade County Commission on Ethics and Public Trust.. In -addition, once anissue, l have registered to lobby on has~been resolved, I am required to imrnedi;atel'y notify the City Cierk'-s Office of lobbyist withdrawal in writing. . ~ . ,~ . . .. ~ fi . _` ,~ ~ ~ Signature: ~ 1 ~ M ~ ate: . _ t v, . ~ ( ~ O ~:J . ~ O ~ . O J - O ~ -~.-~ Ow c~ 00 . N • • ,L ~` ~ _ . U: -~ W~ V u .D J ,. ~. ~ . .O M. _. . - ~ .. ~ ~ W 2 F- . . ~ . . .. J - ,~ U J :. ~~ 1 V ._ . ~ r` O 0 ... ... - W • ~ . ,~•f- Q .. .. ~ ~ ^~ • _ O cn ° i ~ . O~ ~ C1 ~ U a~ •:_ ~ ~ _ Q ~ 0 D .Z O . w ' W . _. W ~~ - . . ~ .. • L u_ ~ ~ ~ ~ 0 O . cn ... • V ~ J ~ Y J J ~ ~. . W , ~ Q ... . , ~~ _ _, O . , ~ . _ ~ , . m 0 .. ,~ . , ~. - ~ cn ~ ~- V ~ J .. . ~ _ _ .. .~ ~ ~ . . ,_ .~..~ ~ ._ .. - w _ ~. ~ . . ~ ~ w~ ~ ~ wv _ .- _ _ O~ ~ ~ ~ . ~~ \ - O. ^ O pw ~ ~ w O ~ ~ ~ ~ .Z ~ Z . N. ~ ~, ..~ W ~ • ~ :O ~ ~ ~ OJ. _ .. ~. ~ ~ ~ ~ . ' O J ._. N p Z ~ ~ J • cn w . - ti . ~ ~ :.. - O ~ . = =O . 0 =. - . .. Exhibit C __ •. - ~ ~ - , o .~ . - _ ~ ~ cn Q . ~ 1 of 2 w m