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Adler, Brian Breakstone Homes e. . .J> .J CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 cityc1erk@ci.miami-beach.fl.us AFFIDA VIT 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 ANY CITY BOARD OR COMMITIEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION, OR A CITY BOARD OR COMMITIEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT, A TIORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, A TIORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL." 1) Lobbyist Name: Adler. Brian S. Last Name First Name Middle Initial Business Phone (305) 350-2351 Message Phone (305) 350-2351 Business Name and Address: Bilzin Sumberg Dunn Baena Price & Axelrod LLP 200 South Biscayne Boulevard. Suite 2500 Miami. Florida 33131 Email Address:badler@bilzin.com 2) Principal Retained by: 1) Breakstone Homes: 2) Kevin Hernandez Investments, Inc. 3) Les Holdings. Inc.: and 4) Amicon Development Group If different from above Street (a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner, beneficiary or interests. 1) Jorge Luis Wolf. 1200 Ponce de Leon Blvd.. Coral Gables. FL. 33134: 2) Kevin Hernandez. 353 Peachtree Battle Ave.. Atlanta. GA. 30305: 3) Leo Schiegel. 3200 NW 77th Court. Miami. FL. 33122: and 4) Adam Mopsick. 3800 Ocean Drive. Hollvwood. FL. 33019 3) Subject Matter (Describe in Detail): Ordinances Modifying Regulations for Single Family Residences 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): .. ~ X The City Commission on .2001 0 City Commission Subcommittee on , 2001 X City Staff on ,2001 X City Board or Committee on ,2001 0 Personnel on ,2001 0 Identify Others on , 2001 All Meetings/Hearings held by City will be attended 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: NONE ON OCTOBER 1 ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO TIlE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code as amended, and aU reporting requiremelltSfl<:. Y-<2 ___ Signature of Lobbyist: ~ T-- X Personally known o Produced ill Identify o Did take an oath, or o Did not take an oath State of Florida, County of Miami-Dade Sworn to and subscribed before me This I/~ day of H~ . 20(2.,. ~~~~ No or Deputy c1erk GISEUf PACtECO MY COMMISSION 'DO 016885 EXPIRES: April 10, 2006 IoncltcI TIlIIII'IallIIIl_ AfI/'#t If Notary, print, stamp or type as commissioned Registration: ~ FOil CLERK'S USE ONLY t -h [ ] RFJECffiD DAh~ t=j ~ If rejected, state reason: ......-. .~~ Registration fee paid: [ ] Yes [ ] N ot-. for-~~ ~ [ ] Cas Check MCR # . O...+- DATA ENTRY DATE. ~ ENTERED BY.