Delano Hotel c/o Robert Todak
~
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Oty of Miami Beach Oflice of the Oty Oerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityderk@d.mlami-beach.f1.us
LOBBYIST REGISTRAnON FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-4Bl)
I< Check Box If an Amendment
d.t d a f0.Q~
NAME OF LOBBYIST: (Last)
02.0 [ -A. f1. .M it , J1.u1. L&..Jdl')
BUSINESS ADDRESS: (Nuilber and Street)
J2-fo :L
(M.!) DATE QUAUFIED /lS LOBBYIST
l:jlaru.,L I Q, 3.31-31
(State) (Zip Code)
bd.(7I1')ckwlAw.~
EMAIL:
&b
(First)
d.~ ~ {JCF)I
(City)
[~<:) ~b-\\\~
TELEPHONE NUMBER:
teoSl ~-{IlG,
FAX NUMBER:
I. LOBBYIST RETAINED BY:
lJ.t1.tU\-f) 01 ~
NAME OF PRINCIPAL/O-IENT:
tJo ~fw)+ ...p~
110& S ~iJl PI ~ ~ \..11./1 I .LJl
BUSINESS ADDRESS:
~
(Number and Street) (City)
(z>06,--) 61D-{)~ vg
FAX NUMBER: (Optional)
'h1()..l'J..
(State)
R. 33L3q_
(Zip Code)
(3D S) 0'14- to 18.Q.
TELEPHONE NUMBER:
EMAIL: (Optional)
Fin out this HCtIon If principal" e CorponIIIor., PlIrtnenhlp or Trud [SectIon 2-482 (e)l
? NAME OF CHIEF OFFICER, PARTNER, OR BENEFIQARY:
~o.r. ~~
UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
i
D. SPECIFIC LOBBY ISSUE:
~--h .AIl.J'J,-. DL) arJ '-fkN'~/vl1J^'I.Q,o
Issue to be lobbied (Describe in detail): --r---o
m. aTY AGENCES/INDlVlDUALS 10 BE LOBBIED:
A) Full Nenw fIIlndlvlduel[Tllle
B) RIlIllticlMhIp
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBIIYIST COMPENSAll0N (DISa OSE WHEntER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
,
~14 J\~.-W &~$...OO
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
II c5Ml r- f.
i-
V. SlGNAlURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR,. EACH LOBBYISr SHALL SUBMIT TO TIlE CITY CLERK A SIGNED
STATEMENT UNDER OATIl, L1mNG LOBBYING EXPENDITURES IN TIlE CnY OF MIAMI BEACH FOR
TIlE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions conta' in Section 2-482 of the Miami Be City Code as amended, and all
reporting requirements.
Signature of Principal/Client:
VI. LOBBYIST IDENTIFlCA1l0N:
Signature of Lobbyist:
.or Produced ID
Form of Identification
C:-;:::RiJIIY K~
YD. SIGNATURE AND 5I'AMP OF NOTARY OR DEPUTY a.ERK:
State of Florida, County of Miami-Dade
Sworn to and SUbscri~~e m,e
This 10 day of 2002.
Si~~~~ofFlorida
~lZIbelh Bern8RIO
Print, ~.ry Public
"..';
FOR CLERK'S USE ONLY
Registration: [l ACCEPTED [l REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ 1 Yes [ 1 No
[l sh [ lCheck
{
DATA ENTRY DATE:
1
MCR#
2002
I First Revision - 05/17/02
JUL-D272DD2 D2:11P~ FROM-TEW CARDENAS REBAK
+3055361116
T-92D P.DD3/DD4 F-556
lV. DISCLOSURE OF 'nltMS AND AMOUrns OF lDBIYI5f' COMPENSAl1Off (~ on WHE1MEIl HOURL Y,
FLAT 1U11E 011 otHER);
A) ~oeeYlST DISC~OSUflE:
----"11\. 4 J\ <11-*.4. .-VJ 8lM$a.OO
$~f}.5 !b~
,
i
B) PlUNUPAL 'S DI5C~OSUp,f tOf' LOBBYIST COMPeNSATION):
1I. 51GNAlUllE UIIlDEll OATH:
ON OCfOBlltl5f OF UCH YeAR. t:ACH LOBBYIST SHALL SUIIMIT 1'0 THE CITY Q.EIQC A SIGNED
srATENENT UNPER OATH, US11NG LOBBYING EXPENDnuAES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING cAl.EftDAR nAIL
I do solemn IV swear that all of the foregoing faCts are true and correct and that I have read or am
familiar with the provisions ccnta. in Section 2-482 of the Miami B City Code as amended, and all
reporting requirements.
Signature of Prindpal/Client:
VI. LOBBY%5I'IDEN1lFICA1U)N;
Signature of Lobbyist:
41 producedID
Form of Identification
.,s Person~lIy Known
VII. SI&NAlURI! AND $TAMP OF NOTARY OR DEPU1Y CLERK:
State of Florida, COunty of Miami-Dade
Swom to and subscribed re e
This .!) day of 2002.
FOR Q.ERK'S US! ONL 'Y
Registration: [] ACCEPTED [1 RfJEClCD DATE:
If rejected, state t~n:
RegistraDon fee paid: [ ] yes [ ) No
( ] Cash [ 1 Check MCR #
DATA ENTfl.Y DATE:
1
2002
ENTERED BY:
1 Fi",~ RPVisian - 05/17/02
JUL-O~-2002 02:11PM FROM-TEW CARDENAS REBAK
+3055361116
T-920 P.004/004 F-556
.
ST ATE OF FLORIDA, COUNTY OF MtAMI-DADE
SWORN TO AND SWSCRI D EF RE ME
THIS c:;2.. DA Y OF .. , 2002.
f
'NOi'A..id :>liAL
TANIA LEE v.MSAY
NOrAllY PUBUC STATE OF FLOlUDA
COMMISSION NO, CC842248
MYCOMMlSSION EXP. 1
Print, stamp or type name of Notary Public