Randall Hilliard CWA Local
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City of Miami Beach Office of the City Oerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityclerk@cLmiami-beach.fl.us
LOBBYIST REGISTRATION FORM
RECEIVED
03 AUG 29 AM II: 0 I
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
[J Check Box If an Amendment
CITY CLERK'S OFF ICE
ou.<lG1..l
NAME OF LOBBYIS : (First)
'::ftoc) Ie. (if'eA.s..( 'J'P -':~- ?~"2--2-1 Nfl) \J
BUSINESS ADDRESS: (Number and Street) (City) (State)
(ODS) 4:(,Cl - c{o(O'1 (60S~ ~t-3..-S3S-2--
TELEPHONE NUMBER: FAX NUM :
l,.
(M .I)
~ 2- C( 2-60~
DATE QUAUAED AS OBBYIST
33/{\
(Zip Code)
(' '^~ it ~ a.u-J @
EMAIL: Clol. cOW\
I. LOBBYIST RETAINED BY:
CD)o'\M.u"ltCA-no,J~ WDI2.I.d.Gr2> OF- AI-1GetC'r\- L--CJCA-l.- 31"f-8
NAME OF PRINOPAl/CUENT: '
.q.4-~ Col.-LIAk=... MS. :#. 21Z-,' tLelAMl &~*" F'- 3.:s 14{
BUSINESS ADDRESS: (Number and stteet) (City) (S~te) (Zip Code)
t../-S'::f - r W'l c..- k.lll\ V\.oll\. e-uJa. '31"fS . Oo".f\
NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) .J
Fill out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
R l~ J.. l"\c:.. K, ~cIl(i)1I\
. UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTL V, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
'8lYDQGT Ai'lD CDI.-t.-eG.-ll'vG- 3~A-nJ./Al~ ISSc,)eS,
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Relationship
M/AMl Be~ CoLt-< Jl.\. ~S (oA.l
VAt2.l0c.)5. M6M~<S. ~-n+6-
A1:)>-1'';u l6 T#2A;--'l10N. IrS N~j)
IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: ~ 2, <;bO A RDJU. m- - -F~ ,.t
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $" 2. I ~ A- ~ nf -- J='LA-""- ~
1) Pursuant to Ordinance No, 2003-3393 Amendina Miami Beach City Code Chaoter 2, Article VII, Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions By Lobbyists On Procurement Issues":
:~O:~~i~~:~:~ of~: G=~~:~i=:~~:rb~:~~;og~e~~ent or services, or on a Dresent
2) Pursuant to Ordinance No, 2003-3395 Amending Miami Beach City Code Chaoter 2, Article VII Division 5
thereof Entitled "CamDaiQn Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaic;m Contributions By LobbYists On Real Estate Develooment Issues":
Are YOU lobbyinG on a DendinG aoolication for a Deyelooment AGreement with the City or
. .. ..... n i ' M ?
Y
~ ,App J2b \I 8.i c W ~ ~+ ~ l'fB ~ e~ec.Vr /"'6 &lJ',\..~-~ 0.;4. AtJt:-u:.r:2-.t:f l2-6o '3,
~ .p1N.~A..>'i"'HoeI~A-TIO"l -ec::.-tfe-J) Ju~'l:> 'FbL <:::reN.~.uer.u ~~p ;:>;~q
V.- . ~"5iGNATUREUNDEROATH: ~.1
ON OCTOBER 1ST 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. ~ I
Signature of Lobbyist: ~ Q ~~
Signature of PrincipaVOient: f(- - . - . ~
VI. . ;:jIIYlST IDENTIFICATION:
~Produced ID ~nallY Known
Form of Identification
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
swor~~ sUbscrib~ I~~~?r!-me
This day of ~ 2003.
OFFICIAL NOfARYSEAL
LILLIAN IEAUCHAMP
NOTARY PUBLIC Sf ATE OF FLORIDA
COMMISSION NO. D0109289
MY COMMISSION EXP, APR. 29.2006
Sig ature of Pub IC Notary - State of Florida
L// h'ArJ IteJJtJeh4 HP
Print, stamp or type name of Notary Public
Registration: ~ACCEPTED
If rejected, state reason:
...._n fee ""., !91 [ ] No
DATA ENTRY DATE: ~
t
2nd Revision 3/18/03
FOR CLERK'S USE ONLY
) REJECTED DATE:
g -itt -C{))
~ Cash [ ) Check
.2003 ENTERED BY:
\Lobbyists\registrationa03,doc