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4360 Collins, LLCSent by: GREENBERG TRAURIG 3O5 579 0717j City of Miami Beach Office ~ ~ Ci~ Clerk 1700 Canvention Center Drive, Miami Beach, FL 3313g Email: cib, clen%Od ,m~n~ -beach, fl ,us I.OBBY~ST REGZSTRATZON FORM Miami Beach, City Code Chapter 2~ Division 3, Section 2-4B1) [] Check Box If an Amendment Reshe .f. sky ,,, Gary NAME O~ LOBBY[ST: (~) 1221 Brickell Avenue BUSINESS ADDRESS: (Number and Sa'eeL) 305-579-0737 TELEPHONE NUMBER: 06/10/03 5:12PM;]e;Fax #737;Page 2/5 (First) (city) ' (state) DATE C~RJAL.~RED A~ LOBBYIST 33131 (Zip Code) Z. LOBBYT. ST Ri=TAT, NED BY: 4360 Collins, .LLC NAME OP PRZNC~PAI~CL/ENT: 1717 N. Bayshore Drive Miami, FI 33133 eUSINESS ADORERS: (Numbe¢ and Sb'ee~) (City) (State) 305-532-3340 TELEPHONLC'N{JMBERi '- FAX NUMI~CR: (Op~ioflal) - ' (?Jp Code) EMA~L: (Opaanal) Fill out this s~-Uon if prindpal is a C~rporaflon, Partnership or Trt~t [$ectior~ 2-482 (c)] * NAME OF CHIEF OFkqCSR, PAR'INER, OR B~EF~C~ARy: L/ST ALL PER..q)NS HOLDING, DIRECTLY OR ]NDZRr:CrLY, A 50,% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATZON, PARTNERSHIP OR ~: SPEC~FZC LOBBY Amen~men[ 'co zoning Issue to be lobbied (D~be in detail): Ordinance and Zoning Map CTI'Y AGENCZES/INDZN~OUALS TO BE LOBBZED; A) Full Name ~f Zndlvtdualj11Ue B) RelaUonshlp Sent by: GREENBERG TRAURIG :305 579 0717; 06/10/0:3 5:12PM;]etFex._#737;Page 3/5 D~:I..OSMRE OF TEII. Iq~ AND AHQUNTS OF LOBBYIST COMPEN$~N (DISCLOSE WHETHER ~fOUR/. ~ ]:t~l. T IM TE 01~ OTHER]: B) PPJNCIPAL'S OZSCLOSURE (OF LOi~BYIST ~MPENSA'r[DN): $235 l) 2) Pursuant t~ Ordinance Nh. 2n~O~.-:3a93 Amendina Miami Beach gev r_e~e__ Che~ 2. Article V~L D!~mon ~ Thereo~ EntiUed 'CamoaiQ~ Finance Reform' Via The Addition Of C_r~_e Section 2-'t88 Entitled 'Pmhibie,~ Camoaian Contributions By i nhhvists On PrOCurement IssL~s#: Are wu Iobbvina on a Dresent or Dendina bid for a__n_N~_S; euuioment or services, or on a or Dendinq award fl3r ao~_d__~_ eauioment or se~vioe? D YeS Pursuant to Ordinance No. 2003-339S Amendina Miami Beach Citv Code Cha=er 2, A~ticle VH Division S bhereof Entitled "Camoaian Financ~ Reform", Via The Addition Of f'~l~ .~ection 2-490 Entitled 'Prohibit~ Camoaiqn Contributions By Lolobvists On Real Estate Develooment Are you Iobbvinm on a Dendine anolica~ion for a Oevelonment Aareemmnt with the Ciev or aoDliCatlon far chanae Df zoni~a mad desianation or chanae to the City's Future Land Use MaD? DYes ~No V. ~GNATURE UNDER OATH: ON OCTOBER ].st Of EACH YEAR, EACH LOBBY]~' SHALL SUBMIT TO THE CTI'Y CLERK A S~GNED STATEMENT UNDER OATH, L~ST~NG LOBBYING EXPENDTrURE~ ZN 1'HE ~ OF MIL&HZ BEACH FOR THE PRECEOZNG CALENDAR YEAR. ! do .solemnly swear that all of the foreg¥i~g~[acts are true and correct ar~l that ] have read or am familiar with the provisions conta~Jned~i[~l~c~ion 2-482 of the Miami Beach City Code as amended, and ali Signature of Lobbyist: L..~J/~ ~-"~.~. Signature of Pri/IcipalJaient."--~/~,~,~-~' ~ Produced ID Form of ~dentification VLt. S~GNATURE AND ~TAMP OF NOTARY OR DEPMTV State of Florida, County of Miami-Dude Sworn to and subscribed before me This ,/(:.~ dayof ~_~L)~t~ , 2003. ,,,~,~,, Senmfer Arenc~bm ?.k:;~' .-~. "-, Commission #DD 198 i S5 ~_~i. '~. i;~ Expires: Mar 30, 200? '",':'~,~ ~ ~ ~.~'.~:~ Bonded Thru ',,.1,," Atlantic Bonding Co. Inc. Registration: ]~ If reJeCted, state reasam ~ Personally Known Sign~-tu~e of Public Notary - State of Florida Print, stamp or type name of Notary Public DATA ENTRY DATE: ~.~.._,2003 ENIP..REDBY: ~../.,~.? ~ 2n~ Revt~don 3/tSln3 F:\C~~~U~a03.d~