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Jonathan Fryd - Ungar-Marshall Company low MIAMI BEA H City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 to 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. Fryd Jonathan NAME OF LOBBYIST: (Last) (First) (M.I) Ungar-Marshall Company 523 Michigan Avenue Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)673-2948 (305)673-2950 ]on.@fryd.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Jonathan Fryd NAME OF PRINCIPAL/CLIENT: Ungar-Marshall Company 523 Michigan Avenue Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)673-2948 (305)673-2950 lon.(5fryd.corr. TELEPHONE NUMBER: FAX NUMBER: EMAIL: 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: Development approvals—1001 Lincoln Road Issue to be lobbied(Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A)Full Name of Individual/Title B)Any Financial, Familial or Professional Relationship HPB, BOA None Planning Department staff None 3 Q S• ? A113 City administration,elected officials None , «J3 *Unless an issue is legislative in nature,HPB,BOA,Planning Board,and City Commission members are not lobbied outside of a public hearing setting. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $ 0 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $ 0 The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists curement Issues": o r1 c Ye X No: a lobbying on a resent or endin bid for goods, equipment or services or on a resent or endin award for oods a ui ment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real elopment Issues": Ye X No re you lobbyinq 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 X No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1sT 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 BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Si Lob 'st n!tur ! t I do solemnly swear that all of the foregoing facts are true and c nd that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally kni�own obbyist) `�ersonally (Principal) VII. SIGNATURE AND STAMP4 % MOy�����4� State of Florida,County of Miami-l�.l�.• � State of Florida, County of Miami-Dade �.���;v�.•••••.� ���ii Sworn to and subscribed before rI C- ?p� Sworn and subscribe before me 12 ••; VS This day of 20 °�� * This��day of , 20L2— - :* Ni9 rization ofiLo o y st's signatr`� 1��� ``�� Notar zatif n ofllPrincipal's si nature' �iz�4w** `''������nnun���``� FOR CLERK'S USE ONLY Annual Registration fee: [ ]Yes[ ] No Amount Paid MCR# Date Paid Lobbyist Registration Form received and verified by: Entered By: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,w%vw.miomibeach(l.gav CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 ,Fax:305.673.7254 LOBBYIST NAME: I understand that no later than February 28 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. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist(or principal) who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. k:A �9 Diu 7i0 Z Signature: 6 at : F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc