Murano Three, Ltd.
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City of Miami Beach Office of the aty Oerk
1700 Convention Center Drive, Miami Beach, FL 331,39
Email:,,dtyderk@q.miall)i-beilQ1.fl.us'.;'" ;. ~:.
LOBBYIST A.EGISTRATION,FORM
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(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
i:l Check Box if an Amendment
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NAME OF LOBBYIST: (Last) (First)
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BUSINESS ADDRESS: . (Number and Street) (aty)
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(State)
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DATE QUAUFIED AS LOBBYIST
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(Zip Code)
306 '21 ~ - ~'1 0"2-
TELEPHONE NUMBER:
'306 .zl~ ~B'
FAX NUMBER:
EMAIL:
I. LOBBYIST RETAINED BY:
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NAME OF PRlNOPALjCUE :
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TELEPHONE NUMBER:
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BUSINESS ADDRESS: (Number and Street) (City) (State)
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FAX NUMBER: (Optional)
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(Zip Code)
EMAIL: (Optional)
Fill out this section if prlnclpalls a Corporation, Partnership or Trust [Sectlon 2-482 (c)]
. NAME OF CHIEF OFfiCER, PARTNER, OR BENEACIARY:
. UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY IS5UE:'. ,._~i', ": "
p.,.~V\.nb~; ~"Q.t,_. hCM~~> ec.ac.~ '" (2c.,,~o.u
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III. CITY AGENCESJINDMDUALS TO BE LOBBIED:
A) Full Name of Indlvidual/ntle
B) Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
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V, SIGNATURE UNDER OATH:
ON ~~Eiisr OF EACH YEt~ iACH a.OsSYiST'~H1LL'SUBMITtOTHFdrv cLiRK A SIGNED i
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.' t .
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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 contai in Section 2-4 the Miami Beach City Code as amended, and all
reporting requirements.
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Signature of LObbyist:
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Signatureb(PrincipaI/Cllent: .' . 'n1:'~} ~ '&A...;/~~tt::
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VI. LOBBYIST IDENTIFICATION: V' . " i" ~,' " '., ' !' ' " '. , '.,
Cl Produced ID
Form of Idenoficatlon
cr"Personally Known
VII.
State of Florida, County of Miami-Dade
Sworn to and SUbscri?- m,e
This / Y day of 2002.
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FOR CLERK'S USE ONLY
Registration:
~CEPTED
[ ] REJECTED
DATE:
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DATA ENTRY DATE:
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If rejected, state reason: ~
Registration fee paid: {-1"Yes No
5 [ ] Check
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2002
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I First Revision - OS/17/02
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