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Michael Festa Beach Towing Services9 ~> City of Miami Beach OfFce 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 commfttee; 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 speclflc exclusions. Please refer to Ordinance 2004-3435. Festa Michael NAME OF LOBBYIST: (Last) (First) (M.1) 1349 Dade Boulevard, Miami Beach, F1 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 534-2128 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or a-mail address... I. LOBBYIST RETAINED BY: Beach Towing Services, Inc. NAME OF PRINCIPAUCLIENT: 1349 Dade Boulevard, Miami Beach, F1 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 534-2128 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: w~E /rvvR~GvC ~ i • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: i n:SPECIFIC LOBBY ISSUE:' Towing fees and related matter Issue to be lobbied (Describe in detail): nl. 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 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 Financial, Familial or Professional Relationship Mayor and City Commissioners None City Manager/Assistant City Mana er None Parking Department /Staff None +~q{E ~ Ln^y ~`~ `~tl ~ ~ r~ '~ ~ ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A ,LO BYIST DISCLOSURE: Required) ~it~.out compensation (annual registration & issue fee paid by principal) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Without compensation annua registration & issue ee pai y principal) 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 ®No: Are you lobbvina on a present or pendina bid for aoods, eauipment or services or on a present or pendina award for aoods, 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 lobbvina on a pendina application for a Development Agreement with the City or application for chance 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 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. ^ Yes ~ No: Are you representing snot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: nu ~n~~sr~ SST ~~ .-..... ..~ PERIOD. __ ignature of Lo y' t I do solemnly swear that all of the fore ing facts are true and rrect and that I have read or am familiar with the provisions contained in Section 2-482 o e Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: roduced ID t a ~ m ~ ~ _ Form of I entification .d ~r .-, ~ ~~~~ v,~~a~ , 3 ~ ~ A ~,,, ^ Personally known (Lobbyist) ~ ~~ "' ~ ~ o VII. ~ ~ ~~ ~ SIGNATURE AND STAMP OF NOTARY: O rV Produced ID ~~ - ~'~, ~ 2~ ~~~ 0 `?`'-~~ =tZ Form of Identification :. ^ Personally known (Principal) ~ ~ ~ .~ ~ State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn qq su scrib r me Sworn a subs 'bed r e I a ~ w a This .b y f , 2010 This ~d f , 2010 :~ ~: ;P Signat is Notary -State of Florida Si nat m ~•.,,,,,,..•~ o g ~' y - tate of Florida ~ ~ Notariz io f Lobbyist's signature Notariza ' n o rincipal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r-nnuai rceglsiraUOn T@B: t ~ Yes [ ) No Amount'Paid $ "- MC ' # Date Pa Lobbyist Registration-Form received and'verified by: ) // F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc Revised OS/7t ~b~~ ~ ~Q ~: _N N 0 ~ (~ M V ~ ~~ ~ `~ ~~~~ ~ ~ ~ I• O ~ V ~~~~~. ~ ~~ ~ a:d~~~ 6 'c~. ~: h~.~UW a r ~i,~ ~:P '~n....•` xn. ~~~~~~~ I '~~ ~~ ~ . ~: a„ :~ f City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.7411 ,Fax: 305.673.7254 Acknowledgement of fines/suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: Michael Festa f"~6~~ I understand that no later. tha of each y, ear, lobbyists subject to lobbyist, registration requirements shall submit to the city clerk a signed statement under oath listing all lobbying expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which the lobbyist has been engaged to lobby. A statement shall be filed 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. FAILURE TO TIMELY FILE THE .EXPENDITURE AND FEE DISCLOSURE REPORT WILL RESULT IN A FINE OF $50.00 PER DAY. ANY LOBBYIST WHO FAILS TO FILE THE REQUIRED EXPENDITURE REPORT BY DECEMBER 1, SHALL AUTOMATICALLY BE SUSPENDED FROM LOBBYING UNTIL ALL FINES ARE PAID, UNLESS THE FINE HAS BEEN APPEALED TO THE MIAMI-DADS COUNTY COMMISSION ON ETHICS AND PUBLIC TRUST. In the event a lobbyist fails to either file the report and/or pay the assessed fines, the Clerk shall .notify the Miami-Dade County Commission on Ethics and Public Trust. CityClerk@miamibeachfl.gov IN ADDITION, ~NCE AN ISSUE 1 HAVE RE615TERED TO LOBBY ON HAS BEEN RESOLVE 1 AM REQUIRED TO IMMEDIATELY. NOTIFY THE CITY CLERK'S OFFIC~ F LOBBYIST WITHDRAWAL IN WRITING. Signature: September 16, 2010 Date: