Bob De la Fuente/Loews HotelCity of Miami Beach Office of the Oty Clerk
1700 Convention Center Ddve, Miami Beach, FL 33139
Email: dtyderk@d.miami-beach.fl.us
LOBBYZST REGI'STRATTON FORf4
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
El Check Box if an Amendment
NAME OF LOBBYIST: (Last) (First)
BUSINESS ADDRESS: (Number and Street) (City)
TELEPHONE NUMBER: FAX NUMBER:
(M.I) DATE QUALIFIED AS LOBBYIST
(State) ' (Zip Code) ~ -~,~1~
EMA[L:--
I. LOBBY[ST RETAINED BY:
NAME OF PRINCIPAL/CLIENR-: '
BUSINESS ADDRESS: (Number and Street)' (City) (State)
TELEPHONE NUMBER: FAX NUMBER: (Optional)
(Zip C6de)
EMAIL: (OpUonal)
Fill out this section if principal is a Corporation~ Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFICER, P~RTNER, OR BENEFICIARY:
· LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBB~ ISSUE:
Issue ti) be lobbied (Descn~e in detail):
~ AGENC[ES/INDIV~DUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Relat]or~hip
(J ,
I]LA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
2)
Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach CiW Code Chaoter 2, Article VZI. Division 5
Thereof Entitled "CamDaiQn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
C, aml~aion Contributions By Lobbyists On Procurement Issues":
Are you Iobbvina on a present or Dendina bid for ao-_d_-: eauiDment or services, or on a present
Qr pendina award for Doods, eauiDment or service? Yes No
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chapter 2. Article V~! Division 5
thereof Entitled "Camoaian Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
CamDaian Contributions By Lobbyists On Real Estate Development Issues":
Are you Iobbvino on a nendinD application for a DeveloDment Aereement with the Cit~ or
application for chanae of zonina mad desianation or chanae to the City's Future Land Use NaD?
Yes No
V. SZGNATURE UNDER OATH:
ON OCTOBER Is'r OF EACH YEAR~ EACH LOBBYZST SHALL SUBt-tTT TO THE C~ I'Y CLERK A SZGNED
STATEF4ENT UNDER OATH,, L/STTNG LOBBy'rNG EXPENDZ'I'URES IN THE CI'TY OF F4ZAt4! BEACH FOR
THE PRECEDI'NG CALENDAR YEAR.
! do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am
familiar with the provisions contax~d i,O Sectio~2-48,~C)f-tl~e Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
V/. LOBBYZST ZDENTZFZCATZON:
o Produced ID Personally Known
Form of Identification
SZGNATURE AND STAHP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of ,2003.
Signature of Public Notary - State of Florida
Print, stamp or type name of Notary Public
Registration: [ ] ACCEPTED
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No
DATA ENTRY DATE:
2nd Revision 3/18/03
FOR CLERK'S USE ONLY
[ ] REJECTED DATE:
[ ] Cash [ ] Check MCR #
,2003 ENTERED BY:
F :\CLER\HATL\Lobbyists\registrationa03.doc
F-9S4
B) PR[NCIpAL~ DL~CLOSURE ,(OF LOBBYL-cr COMPENSATION}:
pqfsuant to C~,clba~ce No, ~nnA-3393 Amendino Miami P~ch ~ Code Chanter 2. A~cle ~I. ~vL~ion 5
~er~f E.~tl~'~moaian Finan~ Re~" Via ~e Addition Of ~e ~inn 2~88 En~l~ "~hibi~d
~m~l~n ~n~b~ons Bv I~hbvi~ ~ procurement Zssu~
~re ~u ;Obbvifla on a om.ne or oendinQ bid ~r ~- eauieme~ or ~- or on a ant
pr oendina =~::~ for eeoC_ eoui~ent or ~wi~? Y. ~
pU~ua~t tn Ordinance No, 2003-~; Amendin. Miami Beach ~i~ ~e ~a~ter ~. A~de ~ DivisORS
;~ereof En~ed "~mnaion Finance Rern~". ~a ~e Addition ~ ~e ~on 2~ ~i6~ 'Pmbib~
~R~l~n ~n~b~ons ~v I~hbvi~ On Real E~ ~eloo~nt ~su~':
A~ you ~q~n= on a oendin, ae~ll~Hon for a D~elooment ~mement with ~e CIW or
Y~ ~
V. S:[GNATUP~ UNDER OATH:
ON OCTOBER 1~ OF EACH yEAR, EACH LOBBYIST SHALL SUBMIT TO THE ~v? CLERK A SSGNED
STATEMENT UNDER OATH, LIbl~NG LOBBYING EXPEND/TURES TN THE CLfI' OF MZAMZ BEACH FOR
THE PRECEDING CALENDAR, YEAR,
I do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am
familiar with the provisions contend i,p Sectio~2-'tS,~l'--~e Miami Beach City Code as amended, and all
reporting requirements. ////~/~//'
/
$ignat. re of Lobbyist: 'L"~,,~',,~_,,, ~ ~../, ~ ,
Signature of Principal/Client: ~_~ ~{"'~ ~--t~-~ -~~ ''~'L~-~'~'~ - '
C3 Produced [D penally Form of Identification
State of Flodda, County of Miami-Dado
Sworn to and subscribed before me
This. I~/~ day of_ ~*~ ~ ,2003.
OFfiCIAL NOTARY SEAL
IL(~ ~ ~-.~. ~'~'¥ PG'~9' LtSSETH LTRLUILLO
~' cc~.~es I
uY CC~U~N ~ /
I e'OF I:~.0 JAN. 2~2004 /
S~GNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
,L,'s.x,Y/-, z.
Print, stamp or two nan'fe of Nota~ Public
FOR CLERK'S USE ONLY
~ RF_IF.L-iT:D / DATE;
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
SWORN TO AND SUB. ~.CRIBED BEFORE ME
THIS /5t DAY OF,rd~ ' 2003.
Signature of Public Nbtary-State of Florida
?rint, stamp or typO'name of Notary Public