Robert D. Hertzberg/Penrods10:~6
CITY MIAMI BCH CLERK DEPT
City o¢ Miami Beach Office ol"~e City Oerk
~ail:
(a~ ~.~.~ ~. o~ ~ ~ ~, ~i~ ~, ~ ~ECEIVED
a Ch~k Box Ir an Amendment 03 JUL 2 9 PM 2:2 ~
305 6737254 P.02
NAME OF LOlly]ST: (Last) (Fi~) (M.1) DATE ~)UAI TFZED AS LOBBY]ST
100 :S.~.. 2nd Street, Suite 3550, Miami, FT. 33131
'BUSINESS ADDRESS: (Number an0 sheet) (Ob/) ' (State) (Zip Code)
(305) 371-6060 (305) 358-5917
TELEPHONE NUMBER ' FAX NUMBER:'" EMAXL:
Penrod Brothers, Inc.
NAMEOFPR.~I~PAL/C~ENT:
1 Ocean Drive Miami Beach
FL 33139
BUS~NESS ADDRESS: (Number ~ St:~eet) (City) (State) (ZIp Code)
(305) 538-1111 (305) 534-8937
TELEPttONE NUMBER: FAX N~IMBER; Co~uonal) EMAXL: (Optional)
Fill out thll IKtlofl If pflndpal b i ~tlo~ lltIip o~ Truit [~lclIon 2-482 (c)]
· NAME OF CHXEF OFFICER, PARTNER~ OR BENEFICIARY: Jack Penrod
· L.XST ALL PERSONS HOLDING, DIRECTLY OR XNDIRECTLY, A 5% OR MORE OWNER~I-II; Xr/I'EREST 1N SUCH
CORPORAT/ON, PARTNERSHIP ORTRUST: Jack ~enroc].
SPICIIr~C: LOBBY ~.SSUE:
Issue to Ix~JolX~e0 (Describe in cletaiJ):
C/T'Y AGENC:ZES/ZNDZ~DUALS TO mE LOBBIED:
A) Full Nm of Zaliddu~l~Title B) Relationship
and city manager
JUL-24-2003 10: 26
A) LOBBYZST DLSCL~SURE:
CITY MIRMI BCH CLERK DEPT
$325.00 per hour plus
costs
305 6737254 P. 03
B) PRINC~PAL~DISCLO~JRE(OFLOBBYZSTCOIqPENSATZON): $*325.00 Der hour,
1)
2)
Pursuant to Ordinance Na. 200]-3393 Amending_ Miami Beach OL~ ~ C~amer 2. Article V]L DivisiOn 5
T'n~-~.~r Efll~ted 'CamanJan fi~ance Re,arm' Via The Addition Of Code S~c~irm 2-488 Entitled 'Prohibited
Camoalan Contributions By tobbvis~ On procurement Issues':
Am you Iobbvina on a nresent Dr nendina bid f~r (mods, eauiment or servia~ or on a Dr~ent
or .ending award for aaeds, enuiament or s~r.~n Y~.~/~N~ -
Pursuant ~o O~dinanc. No. 2CIg3-33g5 Ame~_di_na Miami Beach Cl~v Code C~anCer 2. ArUde VII Division S
~ereof EntiUc-~l ~C~mD~ian finance Reform". V~ The AddiU~fl Of r'nde Section 2-490 E,-,GLied "_ ~P~ohibited
Camaaian Conlzibu[ians By Lobbyists On Real Estate Develooment IssueS':
Are you Inbb~_ In_a on a nGndina amdigatinn f~r a Develonm~nt Aamnt wi~ th. City or
v. SZGNATURE UNDER.
ON OCTOBER IsT OF EACH YEAR, EACH LOGBYZST SHALL SUBI41T TO THE LA I ~' CLERK A SZGNED
STATEMENT UNDER OATH, L/STZNG LOBBY/Ne EXPENDI"rUILES ZN THE CI"rY OF MZAH! BEACH FOR
THE PP~C:ED.--NG 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 pro.flare-co,rained in Section 2-~_rJ~
reportJng requirement~
Signature of Lobbylsb ,, '"-...
Signature of Prindpal/Client: L
V% LOBBYZST ZDENT/FZ~TION:
Produced ID
Form of IdenfiflcaUon
S~NATURE AND STAHP OF NOTARY OR DEPUTY CLERK:
State of florida, County of MlamI-Dade
Sworn to and subscribed before me
This ~ day of_~
h O~y
Code as amended, and all
/C~Personally Known
~gnature of Pu~bl,~ NsO,,~r~.,.S~l:~'of Florida
Prin~ stamp o~:"~y~pe"~l~-'~"~[~/Public
~-aum ~ ~: .~Y.s ( ] No
DATA EN'II~Y DATE:
TOTAL P. 03
FLA 7' RATE OR OTHER):
^) LOBB¥ISTDISCLOSURE: ~C-L,~/~) ~::)T~-~ $325.00 plus costs
B) pRINCIPAL'S DISCLOSURE (OF LOBBYTS-r COMPENSATION):
1)
Pursuant to Ordinance No. 2003-3393 Amendinq Miami Beach CiW Code Chapter 2, Article VII. Division 5
Thereof Entitled "Campaiqn Finance Reform" Via The Addition Of Code Section 2-~88 Entitled "Prohibited
Campaiqn Contributions By Lobbyists On Procurement Issues":
2)
Are you Iobbyinq on a present or pendinq bid for qoods, eq~'~t or services, or on a present
or pendinq award for qoods, equipment or service? Yes L~/)
Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach City Code Chapter 2, Article VII Division 5
thereof Entitled "Campaiqn Finance Reform", Via The Addition Of Code Section 2-~90 Entitled "Prohibited
Camoaian Contributions By Lobbyists On Real Estate Develooment Issues':
Are you Iobbvincl on a oendina aoolication for a Development Aqreeme,nt with the City or
applica~O~ chanqe of zoninq map desiqnation or chanqe to the City s Future Land Use Hap?
V, SIGNATURE UNDER OATH:
ON OCTOBER IsT OF EACH YEAR~ EACH LOBBYIST SHALL SUBMZT TO THE CZTY CLERK A SIGNED
STATEMENT UNDER OATH, LI~I'iNG LOBBYING EXPENDITURES IN THE CI~Y 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.
SignatureofLobbyist: ,~].~:.\~. ~ ,-~ j ~F..-.~"~!~
Signature of Principal/Client: .__~2~_~.~..,... ~r.,..~...~.~,~ .
n Produced ID
Form of Identification
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~.4 day of Jo~' ,2003.
STGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
Signa 3~l{~{~l~e of Florida
c cc .s ExmEs
Print, ~mp or ~ name of No~w Public
Registration: ~ ACCEPTED
If rejected, state reason:
Registration fee paid: ~g,~es [ ] No
DATA ENTRY DATE:
2nd Revision 3J~8/03
FOR CLERK'S USE ONLY
C ] REJECTED DATE:
,2.003 ENTERED BY:
F:\CLER'9-1ATL\LobbyistsyegistrationaO3.doc