Arturo G. Griego - Claude Chandonnet "- lK
m M I AMIBEACH
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 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.
Grm o Ar -1,;m 6
NAME OF LOBBYIST. ast) (First) (M.I)
1 c. Des iRo2 h tctrni Recicl-h L 13c'1
BUSINESS NAME A ADDRESS (Number and Street) (City) (State) (Zip Code)
30 6 3.212 i 3 3 • 4 F. 41 et tech (4) i 4ec cAcs 9 n ne
TELEPHONE NUMBER: FAX NUMBER: MAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
LOBBYIST RETAINED BY:
C )c udc C hr-tt � c) nne -
NAME OF PRINCIPAL/CLIENT
Mr^rx, i?f Gii.44 TA.--Inprta/c'cr r\-V T MC, 1--C. j 3 G i 5 lc v/ �, j ,1.1\I (co 11-
BUSINESS NAME AND ADDRESS (Number and Street) (City Ave, (State) (Zip Code)
2\2 GP3 45:7 e c rec:►1s 1 t rosn.cm
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:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
266 (enc>x Ave. M \ c i i h L 3? \ 3c1
Issue to be lobbied (Describe in detail):
m. 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
Des k91 -\ :iJ Pcxa rd
Pursuant to City Code Section 2- 482(g) 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 lobbyist registration form filed.
Sec 2- 482(g) Any Financial, Familial or Professional Relationship
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W. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). * 0
The following Information must be answered: I,
1) Pursuant to Miami Beach City Code Section 2 Entitled Prohibited Campaign Contributions By Lobbyists On Procurement
Issues": 1
Yes K Are you lobbying on a present or pendlna bid for goodsi eau lament or services. or on a present or pending
awar for goods, sauipment or s ervice?
2) Pursuant to Miami Beach City Code 2-490 Entitled °Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues': i
Yes k. Are you Iobbvina on a pending application for a Devetoomeppt Aareement with the City or application for
chance of zoning map designation or chance to the Citv's Future Land Use Map? j
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 xe required to pay any registration fees.
Yes Are you reuresentina a not-for-Profit corporation or entity without special compensation or reimbursement .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH YEA EACH LOBBYIST 8HALL SUB MIT TO'rHE_CITY CLERK A SIGNED STATEMENT UNDER
._ -la _ _ I .LtL• = B , c y�'_.,'.11_i - L . . • , , ' ' , t : : • , 1 E L • I, t• _ _ 1 . ' • - :1A :EAC 0 -
I . _ • , 1 , _ . 1 , ! 1_. - _.1_�u al. 'i _ _ L3'i! YT GLi_ .:. _ _ t ,• _.!lli.__ O:
COMPENSATION DURING THE REPORTING PERIOD, �� ' _ 1
./_&B
, • : • obbyi-- 1 ,
I do solemnly swear that all of the fo : • , fads are true and correct and that I t aye read or am familiar with the provisions contained
in Section 2-482 of the Miami Beac • de and all reporting requirements.
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Signature of Lobbyist:
�' -, ',LC By • Nerchan • National Propertie - , Inc
Signatur, of Principal/Client
.!
Claude T CRSfi onnct, Preaiaent I ,
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
l
Produced ID • _ Produced ID
Form of Identification Form of Identification
'(Lobbyist) - ersonally • (• ncipal) .
1/11. SIGNATURE AND STAMP OF NOTARY: A , 1
f GARY . r ; y, ; • ,.. , • n I -i' /:,,, 11 / i i
State o Florida, County of Miami -Dade ., : ` wa I State of Florida, County of Miami-0 = -, ,, , E of > ozu
Sworn to subscribed before me �{
ission DD920 Sworn 67 nd sub scnb ed before me i . •]• Wren 8 Wren This ._ v� day of � , 2011 Comm - rn j____
day day of 201 1: :_f
Expires: AUG. 27, 2013 : ,., Commiss #�DD920567
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of
ISO ATWNTIC BOOING aim!. ; ; • a Expiretq: AUG. 27, 2013
Signature of Public Notary — State of Florida Signature of Public Notary — State of Florida SID MU ATLAk'IIC BO1wuIg ao,nta
Notarization of Lo�y(sts signature Notarization of prindoal's signature
TO BE COMPLETED BY CITY CLERIC'S STAFF ON Y /
Annual Registration fee: [ ] Yes [ ] No Amount Paid $ CR S ' . - if Date Paid
Lobbyist Registration Form received and verified by: i I ! . 7414W; 1
F \GLER \SALL \aFORMS \LOBBYIST FORMS■l.obby,st Annual • egi on Fo •,, r . AV I . Revised 11/2011
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CA MIAMIBEACH
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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: At - KA - 0G. Gr
I understand that no later than February 28th ofi each year, I must fi le 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
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 lobbj'ist withdrawal in writing.
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Signature: ej D
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