HomeMy WebLinkAboutClear Channel - Martina ... (2)
,
\....-r
1'-
----
.A.,
. ~
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityclerk@cLmiaml-beach.fl.us
LOBBYIST REGISTRATION FORM
~
:Jt
~
)
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
Cbeck BOI If an Amendment
(Last)
(First)
200 South Biscavne Boulevard. Suite 2500. Miami. Florida 33131
BUSINESS ADDRESS: (Number and Street) (City) (State)
~-
(Zip Code)
(305) 350-2355
TELEPHONE NUMBER:
(305) 351-2239
FAX NUMBER:
cmcdoweH(a)bilzin.com
EMAIL:
I. LOBBYIST RETAINED BY:
Clear Channel - Martina Schmidt. Senior Vice President Business Develooment
NAME OF PRINCIP AUCLIENT:
110 East 420d 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(q>.clearchannel.com
EMAIL: (Optional)
FiU out tbls section If principal Is a Corporation, Partnersbip or Trust ISection 2-482 (c)l
? NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Aooroval for Street Furniture PrOlrram
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/lNDMDUALS TO BE LOBBIED:
A) Full Name of Indlviduavritie B) Relationsblp
Design Review Board on May 2 I, 2002; and
Historic Preservation Board on June 6, 2002; and
Any Subsequent Meetings Needed ,
,"
Doc.#S68S94 v.1
~fo;r
.. .
-.
--..
, ,
, .
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
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE
PRECEDING CALENDAR YEAR.
"Signature ofPrjncipaI/Client:
Signature of Lobbyist:
VI. LOBBYIST IDENTIFICATION:
~ 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
This.;lo day of /'-/ nJ 1s' ' 2002.
GISEI.1.E PACHECO
MY COMMISSION. DO 016885
EXPIRES: Aprtll0, 2006
_ThNPIchInl_nco~
Print, stamp or type name of Notary Public
Registration:
~CCEPTED
FOR CLERKS USE ONLY /
[] REJECTED DATE: s- _ 2.Dlu;;)-
I f
Ifrejected, state reason:
Registration fee paid:
/
[tY Yes
[ ] Cash
[ ] ~o C) '2.c:::o r)
[\..Y' Check MCR ~ t If
DATA ENTRY DATE:
I
.2002
ENTERED BY:
I First Revision - 05/17/02
Doc.#568594 v.l