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Clear Channel - Martina Schmidt ~ .; City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miarnl-beach.f1.us LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) Check Box if an Amendment Price. Stanlev B. NAME OF LOBBYIST: (Last) (First) Mav 20. 2002 (M.I) DATE QUALIFIED AS LOBBYIST 200 S. Biscavne Blvd.. #2500. Miami. FL 33131 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) (305) 374-7580 TELEPHONE NUMBER: (305) 351-2204 FAX NUMBER: sprice@bilzin.com EMAIL: I. LOBBYIST RETAINED BY: Clear Channel - Martina Schmidt. Senior Vice President Business Develooment NAME OF PRINCIPAUCLIENT: 110 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)1 ? 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: Approval for Street Furniture Prolrram Issue to be lobbied (Describe in detail): III. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Relationship Design Review Board on May 21, 2002; and Historic Preservation Board on June 6, 2002; and Any Subsequent Meetings Needed 584006.1 ~ '"' IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: $425 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSA nON): $425 oer 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. t and that I have read or am familiar with the provisions ed, and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Q Produced ID X Personally Known VII. IGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK Form ofIdentification State of Florida, County of Miami-Dade Sworn to and subs bed befor me This & day of , 2002. FOR CLERKS USE ONLY Registration: kf g L~ ,-0'2- ACCEPTED [ ] REJECTED DATE: Ifrejected, state reason: Registration fee paid: \ Yes [] Cash ~ No Check MCR # ,2002 DATA ENTRY DATE: I 584006.1