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John Rodstrom 03/05/03 m City of Miami Beach OffIce of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miami-beach.f1.us LOBBYIST REGISTRATION FORM - (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) Check Box if an Amendment Rodstrom John NAME OF LOBBYIST: (Last) (Rrst) 110 East Broward Boulevard Suite 1850 Fort Lauderdale BUSINESS ADDRESS: (Number and Street) (City) (954) 462-9666 (954) 462-6263 (M.!) Florida (State) 03/05/03 DATE QUAUFlED AS LOBBYIST 33301 TELEPHONE NUMBER: FAX NUMBER: (Zip Code) john.e.rodstrom@citigroup.c EMAIL: I. LOBBYIST RETAINED BY: Salomon Smith Barney Inc. NAME OF PRINCIPAL/CUENT: 388 Greenwich Street New York New York 10013 (Number and Street) (City) (State) (Zip Code) BUSINESS ADDRESS: (212) 816-6000 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAlL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l . NAME OF CHIEF OFFICER, PARTNER, OR BENEFlOARY: Howard Ward Marsh, Managing Director and Head of Municipal Securities Division UST ALL PERSONS HOLDING, DlRECTl. Y OR INDIRECTl. Y, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR 1RUST: Citigroup II. SPECIFIC LOBBY ISSUE: RFP -- Underwriting Services Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Relationship Purchasing Department IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: Fixed salary plus discretionary bonus B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): Fixed salary plus discretionary bonus 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, 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 requiremen . ~ ? Signature of Lobbyist: VI. Produced ID ~~:~~') Form of Identification VII, SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: ~ro~cL State of Florida, County of ~ elmi sv.:om~ 91Jld SUbSC~~fOa~r This 'f1.- day 0 'A , 2003. JACQUELINE KOBIALKO NOTAAY PUBUC - STATE OF FLORlo.o COMMISSION' CC"381~ EXPIRES ,1I/21/2Ol13 BONOEO THRU ASA HI88-NOTARY1 Lz of Public Notary - State of Florida Print, stamp or type name of Notary Public Registration: [~PTED FOR CLERK'S USE ONLY":Z.. ( ~ ('f'\ ~ [ ] REJECTED DATE: ~ If rejected, state reason: /' Registration fee paid: L\o1Yes [ ] No DATA ENTRY DA~~ (,/03> 2nd Revision 1/27/03 [ ] Cash [ ] Check M~A _ .J .2003 ENTERED BY: tI--f:!!5- F: \CLER\HAn \Lobbylsts\reglstration03.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: Fixed salary plus discretionary bonus B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): Fixed salary plus discretionary bonus 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, 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. SiQ""'"' of lobby"" ~ Signature of Principal/Oient: . . , VI. LOBBYIST IDENTlFICA ON: .---.-...'" , I Produced ID '" ~E!rsonaIIY KnOwn') Form of Identification VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: -::;; 1'1'; 6. i) jO- '" (.10'> "J '~k, lL. t-lG. G Il j,,-: Stett: af Florida, COloJRty of ~~laFfli DaEle cr- Sworn to and subscribed before me This J.I day of l)), fir (.. rl , 2003. ANN GAMBALE Notary Public. State of New York No.01GA4944727 Quallfled In Kings County , Commission Expires Nov. 28. ~ <c Q 3:\ ~ oJ..- Signature of Public Notary - State of Florida j~\I'\f) G- ~ V'b Ak.... Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY Registration: [] ACCEPTED REJECTED DATE: If rejected, state reason: Registration fee paid: [ ] Yes [ ] No ] Cash [ ] Check MCR # DATA ENTRY DATE: .2003 ENTERED BY: 2nd Revision 1/27/03 F: \CLER\HA TL \Lobbyists\registration03,doc