Alexander P. Heckler - Ray Gonzalez 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.
NAME OF LOBBYIST: (Last) (First) (M.1)Tlp-q rd _t4j 11 UbrMIL W4 PA Du U rl� J �._ki I
BUSINESS NAME AND ADDRES (Number and Street) ( ity) (State) (Zip Code) x
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TELEPHONE UMBER: FAX NUMBER: EMAIL: r
Please notify this office if your contact information changes:address,phone; or e-mail address.
I. LOBBYIST RETAINED BY:
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NAME P R I N P L L I MlaMr'SL ` -4-7
-�11 A0 NW (0;� 8f BUSINESS NA E AND ADDR (Number and Street) (City) (State) (Zip Code)
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TEL ONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Jc_ ,AJ
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)]
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NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: �M-4Qic-L
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCI-WORRgATIONS
PARTNERSHIP OR TRUST: C
ii.SPECIFIC LOBBY ISSUE:
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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 persqp be lobbied
41A N/A
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Pursuant to City Code ition 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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