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Lou Hammond , ICA RE C F I V F City of Miami Beach Office of the City Clerk 20I I JUN -2 PM 2: 5 I 1700 Convention Center Drive, Miami Beach, FL 33139 CITY CLERK'S OFF ICt 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. NAME OF LOBBYIST. (Last) (First) (M I) [DU 4timatnri tq O cia -1-6 Tct Ea5151 5fv t 1\)-/.1\N 100D BUSINE S NAME AND ADDRESS f (Num er and Street) (City) (State) (Zip Code) o� S 0 ,I -ca�C� Ouh@ Iharnmbnd, Co r1 (?19 LEPHONE NUMBER. F X NUMBER. EMAIL. Please notify this office if your contact information changes: address, phone, or e-mail address. I. LOBBYI l-rnmb(d T RETAINED BY: L t NAME OF PRINCIPAL /CLIENT: Du N�mrrLad ccQ S 3 E ast 5 r- a- lriy, NN tc cQ B E ND N (N ber St t) (City) ^ I °I Ll 1 DO f u 'hE i hi m (Zip Code) , Cj TE EPHONE 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. WLA h nl ` O\ • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: 1 '� vnmo ^ a , S ]r ' �j„ n /l(�/ ' „ +- 1 /rn(J� aI u.SPECIFIC LOBBY ISSUE: �-�j u 9 I t l T( ' • RAH I c.. 1(( cA -ham fl am P ch VVsrit mm ei C�menti flu - 111m Issue to be lobbied (Describe in detail): III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date, stating the general nature of the subject contractual relationship. Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied MOVCA 5 ' 6ri OU r 1aan,Cxe(. bfr'(4v( Client t�uhl c ✓el�fi p ►ew,nizfi ) X itrad m j re C lien t • .f i kin ref la oes i fls .') ✓�c -1vf c�tient X Pursuant to City Code ection 2- 48 Every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobb iy st re istration form filed. Sec 2- 482(g) Any Financial, Familial or Professional Relationship se a -"-N (n) Ca 11166M §c tt (flem S: E l i �;e. 9eittiN Huard JR++ 1 man � khoh (ash ACque 110112, e O l'en i i' f l c k y IZO 5k ' n lz 7 S t. 4dki X IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) O:BYIST-.I.CLOS •E: (Required). S' _ :,..I L, i ) A. I a © f o rn I S :ill I S t a sl 4, B) PRINCIPAL' DISCLOSURE OF O� ST COMPEN AT . M / (Required) T �itu '� _ Cl((Ol.(41 � LUU It a s siciatt-'j c'� uld reces .. 0m I " j� l) -vrylL The following information must be answered: reirti/u+' In eI�1't/1C S• 1) Pursuant to Miami Beach City Code Section 2 -488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues Yes ❑ No: Are you 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 rgi 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 WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL B FILED EVEN IF THERE HAVE BEEN NO ENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature df Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I • .ve read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach ity Co.e and all reporting requirements., Signature of Lobbyist. / / / Signature of Principal /Client. l'j`D VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification Personally known (Lobbyist) 4 Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: tJ�'w�ot t2�l W� e CHRISTINA JEANNETTI k■Seu'Adt■(.__ l� W `-\v�-- State of F!orido, Co u ty of�,4i ade Sworn io an. subscri •ed before me Notary Public, State of New York State of Fler t County of Miami -Dade CHRISTINA JEANNETTI i h' _ day of s 2011 No 01 JE617727 Notary Public, Swo and subscribed befre me Notdic, State of New 1 Qualified in New York Coup This s ay of � `y 2011 No 01 iE6177276 _ Commission Expires Nov. 13 2� 1 , Q i n -New York Coun Si t aiu\of .� — Commssion Expires Nov. 13, J a, Stat 'da Sign.tur' of P. . ary . - - - orida Not. ' izati n : L • • .r s si • • ature Notar • a 'o 0 • al's signature v. TO BE COMPLETED BY CITY CLERK'S STAFF 0 Annual Registration feel ] Yes [ ] No Amount Paid $ MCR # f rirei , Date Paid _47__„,20// Lobbyist Registration Fo ,, received and verified by: Revised 1/11/2011 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: LJ k Womm 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. (-)ct- Signature: Date: