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Steven J. Beko - Wade Pattersond~~~ Pa~ m MIAMI BEACH ~",v` 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 foreseeabty 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 speeifle exclusions. Please refer to Ordinance 2004-3435. BEKO STEVEN J NAME OF LOBBYIST: (Last) (First) (M.I) CARE RESOURCE, 3510 BISCAYNE BOULEVARD #300, MIAMI, FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-576-1234 305-571-2020 SBEKO@CARERESOURCE.ORG TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this ofFce if your contact information changes: address, phone, ore-mail address. LOBBYIST RETAINED BY: WADE PATTERSON NAME OF PRINCIPAUCLIENT: CARE RESOURCE, 3510 BISCAYNE BOULEVARD #300, MIAMI, FL 33137 NAMt ANU ADDRESS (Number (State) (Zip Code) FIII 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: II.SPECIFIC LOBBY ISSUE: VISITOR AND CONVENTION AUTHORITY GRANT FOR MUSCLE BEACH /WHITE PARTY WEEK Issue to be lobbied (Describe in detail): ill. 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 Clty 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 personnel' 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 Finandal, Familial or Professional Relationship MIAMI BEACH VISITOR AND CONVENTION AUTHORITY ~L Sul wv a;c ~lir uiut. ~~~~~~~~~~M~~ ~ .~rk.o r.~.uver, roe. www.FomttWorkllow com ws ~~. a g .t nuw- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) SAI ARY PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): SALARY ~aulredl_ 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": 2) Pursuant to Miami Beach City Code 2-490 Real Estate Development Issues": Campaign Contributions By Lobbyists On Man? 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-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. do solemnly swear that all of the fore act; provisions contained in Section 2-482 0 Signature of Lobbyist: , Signature of PrincipallClient: ~ A ~~ VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification VII. SIGNA State of Florida, Swom to r~ su Thic I -1 ii awn (Lobbyist) AND STAMP OF NOTARY: ~ec~nd that I have read or am familiar with the and a reporting requirements. PRINCIPAL IDENTIFICATION: 0 Produced ID 1 VI111 VI IVGI I1111VQlIVl1 Personally known (Principal) _~~•7- ~, ~. i .~ m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.741 1 ,Fax: 305.673.7254 CityClerk@miamibeachfl.gov wledgement of fines/suspension from lobbying for failure to comply with City of Miami .Beach lobbying Laws LOBBYIST NAME: sTEVEN J BEKO I understand tl registration re listing all lobk calendar year to lobby. A compensation expenditure k communicatiol WILL RES TO FILE AUTOMA either file the County Comn IN ADDI' BEEN RE CLERK'S t no later than October 1st of each year, lobbyists subject to lobbyist ~irements shall submit to the city clerk a signed statement under oath ing expenditures, as well as compensation received, for the preceding iith regard to the specific issue on which the lobbyist has been engaged statement shall be filed even if there have been no expenditures or luring the reporting period. The statement shall list, in detail, each category, including food and beverage, entertainment, research, media advertising, publications, travel, lodging and special events. .Y ITURE AND FEE DISCLOSURE REPORT iR DAY. ANY LOBBYIST WHO FAILS E REPORT BY DECEMBER 1, SHALL M LOBBYING UNTIL ALL FINES ARE 'FACED TO THE MIAMI-DADS COUNTY C TRUST. In the event a lobbyist fails to fines, the Clerk shall notify the Miami-Dade ~O LOBBY ON HAS ' NOTIFY THE CITY Signature: Date: Americas LegdNe4loc. www.Fom~sW odcFlow. com