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James Carse - 321 Ocean Holding LLC City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 Expenditure report for period of:1/1/2015 through 12/31/2015 -/ A statement shall be filed even if there have been no expenditures or compensation during the reporting period. This statement is to be signed,notarized and returned to the City of Miami Beach,City Clerk's Office, 1700 Convention Center Drive, Miami Beach, FL 33139 by February 28th.A fine of$50.00 per day,per issue,shall be assessed for statements filed after the due date. If you require any assistance,please contact this office at 305.673.7411 or at citvclerk@miamibeach.gov. Lobbyist James Carse Principal 321 Ocean Holding LLC Issue 321 Ocean Drive Development.Assessed fines for$3,000.00. PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: Publications: Travel: Lodging: Special Events: Ni CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE ^ DATE REPRESENTATION ENDED: 171//1 1/) OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any attachment hereto are true and correct. Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: Produced ID �� Form of Identification Signature of Public Notary— tate of•Fieridct-We.,AN "/®0, Sworn 4o and subscribed before me XPersonally known This%l day of y20 1-6 ORLANDO CONCEPCION Notary Public,State of New York No.01C06129870 Qualified in Richmond County Commission Expires July 05,20 f 7