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HomeMy WebLinkAboutClear Channel - Martina Schmidt City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miaml-beach.fl.us LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) -~.t;. /' -......, o rV co.) :~, -:'.'''' :;0 rr\ a rl1 ) Check Box if an Amendment , , i- '-:("'. ....~, ~< --I -- ,.; "'- McDowell Carter N. NAME OF LOBBYIST: (Last) (First) Ma 20 2002 (M.!) DATE QUALIFIED AS LOB rn o -1'""'\ 200 South Biscavne Boulevard. Suite 2500. Miami. Florida 33131 BUSINESS ADDRESS: (Number and Street) (City) (State) c; -- r'" (Zip Code) (305) 350-2355 TELEPHONE NUMBER: (305) 351-2239 FAX NUMBER: cmcdowell@bilzin.com EMAIL: I. LOBBYIST RETAINED BY: Clear Channel - Martina Schmidt. Senior Vice President Business Develooment NAME OF PRlNCIP ALlCLIENT: 11 0 East 42nd Street. 18th Floor. New York. NY 10017 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) (212) 972-0515 TELEPHONE NUMBER: (212) 818-0618 FAX NUMBER: (Optional) martinaschmidt<@clearchannel.com 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: ? LIST ALL PERSONS HOLDING, DIRECTLY OR lNDlRECTL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Aooroval for Street Furniture Program Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name ofIndividual/Title B) Relationship Design Review Board on May 21,2002; and Historic Preservation Board on June 6, 2002; and Any Subsequent Meetings Needed Doc.#568594 v.1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: $365.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $365.00 per hour V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED ST A TEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. Signature of Lobbyist: or am familiar with the provisions requirements. I do solemnly swear that all of the foregoing facts are true and correct and contained in Section 2-482 of the Miami Beach Cit as amended, , Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: I :::) Produced ID Form ofIdentification X Personally Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK State of Florida, County of Miami-Dade Sworn to and subscribed before me ThisckJ day of /L!~ ' 2002. GlSEU.E PACHECO MY COMMISSION 1I DO 016885 EXPIRES: April 10, 2005 Bonded ThRl Pichard Insurance Agency Print, stamp or type name of Notary Public Registration: [vy'/ACCEPTED FOR CLERKS USE ONLY / [] REJECTED DATE: 5' _ 2. 0 I U;;>--- ( , If rej ected, state reason: Registration fee paid: // [ \...y" Yes [] Cash ~V~~eck MCRd359 ~ DATA ENTRY DATE: 1 ,2002 ENTERED BY: I First Revision - 05/17/02 Doc.#568594 v.l