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Aletha H. Player FPL , ( P1 - e,v ea M IAMIBEACH RECEIVED City of Miami Beach Office of the City Clerk 2010 DEC - 9 Phi 12:13 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM CITY CLERK'S OFF HC E Lobbyist means at 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 1 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 lobby activities. The term "Lobbyists" has specific xclusions. Please refer inance 2004 -3 LAY lei A NA OF LOB r t) `/ BT: f LO `� elax c w . v (Fi a l M.I � �/ f 317 BUSINESS NAME AND ADDRES (Number and Street) (Cit 5 5541- y) (St a)e 4 ip k ij1 ) ' Cod ) �5 �a as 30 A? A eY-Ailiwt c as T ELEPHONE NUMBER: FAX NUMBER: EMAIL Please notify this office if your contact information changes: address, phone, or e-mail address. I. LOBBYIS ETAINED BY: i IA- uier e L 86 E 3 NCC7 ` & ' N; A-m � I � / 531 B1V NA DD Numb r�{i et) 54 �/ (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out th" section if principal is a Corporation or Trust [Section 2-482 (c)] • N �� • D AM OF CHIEF OF I I � ��� 4EFICIA t TIFY ALL PER ON HOL NG, DIRECTLY OR NDIRECT Y, A 5% O MORE OWNERSHIP INTERE9� IN 4 41.yi . jilt H RPAR AT R HIP OR el 1 r I U Ii.SP CIFIC LOBBY ISSUE: ran Con it-e. Issue to be lobbied (Describe in detail): III. 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) Any Financial, Familial or Professional Relationship Ilil e ,/1 tfl4M,SIo a do 1616 111024 a Ai 0 i) e 1 /it-W red N o ftki / 1 f IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOB: 1ST i S •SUR Required) / / / r �l / . _ I . 41., ' Ii / B) PRINCIPA ' ! DIS ) r OF LO: ' :� • r • ∎ r ` • / 4,,,,W (Required . ' L� I. �� � / 1., A .,,, The following information must be answe ed: 1 6; -<-0 r .9 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyrs s ,' , On Procurement Issues ": T, ?• ` � . C1 •/ ti El Yes XNo: Are you lobbying on a present or pending bid for goods, equipment or services, or on a i in present or pending award for goods, equipment or service? C 2) Pursuant to Miami Beach City Code 2 -490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues ": ❑ Yes X No: Are you lobbying on 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 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 a not - 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 a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WEL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEA' A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITU - - • R COMPE • ION • 4 RING THE REPORTING PERIOD. / 1 1 / • Sig :ture of Lobby t I do solemnly swear that all of t - .o egoing acts are trul -nd 6 and that I have rea• - am familiar with the provisions contained in Sectio- - 8. of ,- , 'iami Bo. ► p ity !• / - :nd all reporting requirements. Signature of Lobbyist: ■ / � � . i r Signature of Principal /Client: C" Al - ,` L e _,, -La -)/(.--- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification R/Personally known (Lobbyist) 'ersonally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of • ida, County of Miami -Dade State of Florida, County • , , . -mi -Dade Sw• , to and subscribed - �. fire me . -"o .nd subscribe..•efore m- T �' day of ..3� , 010 This - ; `.i 1 1:1: of o C • 10 ' — r - ,' - • vi• -. - . ate ' •lorida Signatu TP:f Public ',1 ry – State cii lorida 0 a i lit • ob• is 's nat - Notariza on of Princip.I's s - - : oo r ro otary Public - a 4 ,. . 4 %'► % ~ ' • -t A H ins J Note : :V £t f Florida V • • . • ; • TO BE COMPLETED BY CITY C - - - ' STAFF ONLY - :. J 2(,, ,py , c 'p oi r Ar 'k¢a n fee: [ T ] -s [ ] No Amount Paid $ -F' 0 MCR # ` L` , S / , - . :.., 0 „ ©D9 30 • • w i ' e • i r . • - -• - «•. ived and verified by: ' n* . • v ' . F: \CLER \$ALL \aFORMS \LOBBYIST FORMS \Lobbyist Registration Form 2010.doc - - - ► + ,s 7 p, al 1\A I M 1 EACH 4 42 's PA. City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov /( . CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: kiyEe 1 I understand that no later than February 28th of each year, I must file the following form, 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 and Compensation 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. / i , J.A ' — f , A_i I /2/1/2u, Signat re: / Date: