HomeMy WebLinkAbout1771 N. View Drive
~
City of Miami Beach Office of the City Cieri<
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityderl<@cLmiami-beach.f1.u5
LOBBYIST REGISTRATION FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
o Check Box if an Amendment
Velazquez, Gloria
NAME OF LOBBYIST: (Last)
1221 Brickell Avenue,
BUSINESS ADDRESS: (Number and Street)
(305) 579-0736
(First)
22nd FL, Miami,
(City)
(305) 961-5736
(M.I) DATE QUAUFIED /IS LOBBYIST
Florida 33131
(State) (Zip Code)
velazquezg@gtlaw.com
EMAIL:
TELEPHONE NUMBER:
FAX NUMBER:
I. LOBBYIST RETAINED BY:
Enrique Iglesias c/o Henry koye.
NAME OF PRINClPAL/CUENT:
1771 N. View Drive, Miamf Beach, Florida
, \'
(Number and Street)
(CitY)
(State)
(Zip Code)
BUSINESS ADDRESS:
(786) 486-8316
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section I' prlndpal is a Corporation, Partnership or Trust [Section 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
D. SPEaFIe LOBBY ISSUE:
Conditional Use Permit for Dock
Issue to be lobbied (DescrIbe In detail):
III. arv AGENOES/INDMDUALS TO BE LOBBIED:
A) Full Name of Indlvldual/ntle B) Relationship
None - quasi-judicial
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOUR! Y,
FLAT RATE OR OTHER).
A) LOBBYIST DISCLOSURE:
$265.00/hour
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE 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 contained in Section 2-482 of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
1:1 Produced ID
Form of Identification
~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 g (LcJ.. day of l>E': C . 2002.
Print, stamp or
FOR CLERK'S USE ONLY
~~ ) D?--
Registration:
~PTED
[ ] REJECTED DATE:
If rejected, state reason:
Registration fee paid: ~ ~ ~~h[ []~CR # f) t:) '7 , V
~..~ 8- b
DATA ENTRY DATE: Dol. -v' /'i '\. 2002 ENTERED BY: I
1 .' -,
1 First Revision - 05/17/02