Collins Avenue Associates LLC
SENT BV: BERCaw & RADELL, PA;
~ ..
3053776222;
AUG-26-02 1:23PM;
PAGE 2/3
h\..
ff..W'
. _:
cty of ~rri SiI.dt cmc. ot lh<< CitV Cat
1700 CDny~ Center []ffle, Miami Boch, R.. 3J139
Emd:. cityclckOd.mlarri-beKhJl.II&
LOBBYIST REGiSTRATION FORM
,-
.~..
(City 01 Miami kad1, cty Code OIapt.r 2, ~~on J, sccr.ian ~-4':U.)
..! Check Box If an Amendment.
Hamlin Christopher
NAME OF L08eYfST: (Last) (first)
200 S. Biseayne Boulevard, 19 Floor
8USlNeSS AOOReSS; (Number and Str.eet) (otyJ
(lP~) 17S-7~79 (305) 381-7675
TEL!PHONE NUM8l!R.: fAX NlJMoeR:
(M.I) DATE QUAUAED /IS lO8BY1ST
Miami Florida 33131
lsutE) (~p Code)
f1WL:
1. l,OBBYlST RI!T.uN~ tv:
Collins Avenue Associates,
HAMI! ct' PRINCJPAI.ICJ~
c/o Bercaw & Radell, P.A.
200 s. Biscayne Boulevard,
BU ~INESS ADDRESS; (Number and street)
L.L.C.
N8S0
COty} .
Miami Florida
(Sbbl)
33131
(lip Cad!!)
t 10",1 ]7~_C;100
TEU:PHCt if NUMlIfR:
t 305l 377-~222
FAX NJM8EJl: (0ptl0MI)
ew~ (0pci0nI1)
Pill out this lMICtiors if pMcI....11s . CerpD'lItlan, "Df'1nc~11l 0' T",.. [54Ctf..., 1-4.2. (e)]
NAMe OF OilEF OFRCER,. PAATNCR. OR8ENeFlctA."'; Don Peebles
7 UST AU. p~oNS HOUltNG, DlR!CT\.Y OA. lNOlltEC1L Y, A 5% OR MORE OWNERSHIP UfIl!IlEST IN SllCH
COIU'OMTIOI'I, PAATNEltSHIP OR. TRUST:
II. SP!;CJfU::'LOBBY' ISSUe.: Variance APplication for Hi.torte: pre)Srrvation
Board requlations, section l1B-532(f) and 1'~-564(f)(11 ~enew~~7.
. AppJ.icatlon for Cert1.f1oates of'._.Appropr1ateness and Demo ~tion
I55Qe to be lobbied (Ocaille in cIdIll):
, -
IlL crrv ACI!.....:II!.5/IND:tVIDUAL!TO BE t.OBGU!Ot
A) ',,11 Nam...f lndividual/Tatle B) ~..tI--"ill
Jorge Gomezj Director None
Mercy Lamazares None
William Carey None
,.
.,
Neither the Applicant nor its representatives will lobby members of the Historic
Preservation Board prior to the public hearing since they will be acting in their quasi-
judicial capacity. .
SENT BY: BERCaw & RADELL, PA;
3053776222;
AUG-26-02 1:24PM;
PAGE 3/3
\
lV. DISCLOSURE OF T5UlIS AND AMOUN1S OF LOBBYIST c:DiIR'l!NSAlJON (DISa...OSf: ~ HOURLY,
R.A T RA Tf" OR OTHtR): .
A) LOBmsT DISQ.OSURE:
Hourly $400.00
B) PlUNCPAL'S DJSCL.OSURe (a'- LOBIISYlST CDMPENSATION): rIU;, " .i tlA . c.,G
V. Sl8NA'IVAE UNPER OA'IltI
ON OCTONR 1" OF EACH YIiAR, EACH LOBBYIST SHAll SUIMITTOTHI! c:rrT CL!R.KA SIGNED
sTAl'I!Mr!NT UNDER OAT1t; USTING LOBJlYING EXPENDnuRES IN TIlE crTY OF MIAMI BEACH fOR
THE PRECmlNG CALENIMR YEAR.
I do solemnly swear that all of the foregolng facts are true. and conect and that I have read or am
familiar with the provisions conbti In SEictioo -482 of the Miani Beach CIty Code as amencled, and all
reporting reql..llrernents.
Signature of LobbvIst:
VI. t.OBBYIIT 1DIN'1VICA11ON:
~ Produced 10
For:m of Identification
., Personally Known ".,-;;"~:'r""'" Sylvia M. 8ermeln
f~COMMISSiON# CC9451ao EXPIRES
. vn. SJGf'A1URf AND STAMP OF "DTARY Oft ~ _. August 11, 200.
'.,jj:f'" ..~~ ecNDED THRU TROY FAIN IIISURANCE,IIIC.
State d Florida, County of Mlami-oade ' ',lIf"fl\"
Sworn to and subsa1~reA.im.e
This ~ G:, day of ... 2002.
Slgnatu of Public Notary .... State of Florida
S ~ ~ " \J.. ~'" M"'- ~
Print, mp or type name of ~ry Public,
. fOR CLIRIC'9 USE ONLY
RegIstration: M AU:~~I t:IJ [] REJECTED
If reje(1ed, st8t1!llUSl:ln:
Reglstrallon fee paid: WI5 [ ) NO 1\ ~t
p-TAEHrRYOOC ~xmOQ' ~t")
DATE:
--3 -3.. 01
I Flnt ReMIIOIl - 05111102
SENT BV: BERCOW & RADELL, PA;
3053778222;
AUG-28-02 11 :40AM;
PAGE 8/10
IV. D1'!ICLOSURE OF TERMS AND AMDUNTS OF LDlNlYIST CDMPI9WSATION (DISQ.DSE WHmta HOUR.l. Y..
FLA T M TE OR. D7HERJ: .
A) LOB8Y!ST DJSC1.05UAI.:
Hourly $400.00
B) PIUNCPAL'S DJSC1OSURI! (Of LQBB'I'JST CCM'ENSATlON):
!to":rnQ}.~
Y. SIGNA"''' UNDIR GAntt
ON OCTOBER 1'" O' EACH YEAII,. IACM LOBBnST SHAU SUBMIT TO TH! c:rrT a.EIlKA SJGRED
STATEMENT UNDER OATH, USTIlla LOBIYING EXPIlNDITURES 1ft THE an or MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAIL
I do solemnly swear that all of the foregoing facts In: true an:! c:orTI!d and tIud: I have I'eiId or ram
familiar with the provisions contained In Section 2--482 of the Miami Beach City' Code as amended, and aU
reporting requirements. .
Slgnatun: of Lobbvlst:
5910....'" ""ndplVO"'~~
YL LO"YJS'I' IDeN11fICAUOII:
..s Produced ID
Form. of Identification
X Personally Known
YlL SIGMA1VRI AND STAMP OP NOT~ OR DEPUTY CI.ERK:
state of Florida, (Duntv of Mi8mi-Dede
Sworn to and subscribed before me,
This a1A'.\l day of ~.o~ ( , 2002.
L. JUDITH GASKELL
Notify Publtc. State of Florldl
My comm. expo Jan. 23. 2004
Comm. No. CC904314
~~~~.~
. atu lie Notary - State of.Florlda
L. 0uO\(~ G~~~e:~L.....
Print, stamp or type name of Notary Public,
.---........ . .. ...-.....--.-.-
RegistratiOn: ~ ACCEPTED
POll CLERK"S USI ONLY
DATE: ~~ '.3 ,-01...
[ ) REJECTED
\ If rejec:tl!Id, statl!! rellSOl"l:
Reglstr1ltlon fee paid:
[
DATA EIilT'RY OATE:
1
Me... 2-~ I -;I 'f) t-...
2002 ENTERED ~ \i-'
I Plrllt 1UMiI10I'I - 05/17 }OZ