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Richard Gurevitz m - City of Miami Beach OffIce ofttle City Cerk 1700 ConventIa1 Center CriYe, Miami Beach, R. 33139 EmaII: cIlydertt@d.mIaml-beach.f1.us LOBBYIST REGISTRATION FORM ('I <a "1l (City of MIami Beach, City Code Olapter 2, D\vIsIon 3, Secticn 2-41) ~ A'\ ./-. <A p' C] a...uox Ihn A_ A. ?: ": ~ '&~f,t~rr1- I (Laot) j: I'], I ~ft2[) S <it!) "',. <lUMJASlAS ~ tJ'~ ~ ~~~ ~!.t~~ I '1/L ~f~V:- (W0xIe) ~ ~ 0 ~;.J..?L//1170 ~~31'f'111~ A..inq2Se!~r1.tJI1' L~"~~I;-rtrW~Il. :r'....lISl-\ Cf.JfRR. of t11A/.'11,~L. rMOF~ENT: ().. +J oj ... p~ rf ~CX P , ~~!J!:&1-ftt!2a~LfS ~t/ 51 )12~~f1b nt~)1/;;JI13Z. 3D5.... 314 -/110 ~ ~l ,1111/ ()&-r!:Ltf&~aJo"()L TB.EPHONE f'f.MI:R: FAX' ( J ~: ~ {J t"J FlI out.. secIion Ifprtnclplll.. COll'poratlon,.............porTru8t (SectIon 2-482 (e)] . NAME OF OilEF OFFICER, PNm'ER, OR BEN:RCIARY: (1 U ~ t\.~9\.J .sG,4({A~fCS j"e.....>'~ '" C4""J-(.R,.e t>f rt ,1f.l-' '.~ 'L., . usr ALl ~ HOlDING, DIRECTlY OR IM:lIRECTl Y, A 5% OR MORE Q\MIIERSHIP II'lTERESf IN SUOi CX>RPORAlIqN, PAJme&IIP OR lRUST: k) O,J e.. . D. ~ u.Y ISSUE: &~~.:!et/'f.t::,1< ~O J1IQJtr~\U5 & PIPIt,'f' - 40 I h - l{tfJJd' detaII). R Ot.-r fA L- P Pi ~rt r;rVe 14/ ~, 661llA1 m CITY AGENClES/IMDVIDUALS 10 BE LOBBIED: A) FIll Name f1I JncIwIduaI/11IIe B) 1WIIIIoI....1p D/)u~ 1) Pursuant to Ordinance No. 2ID03-3393 Amend/no Miami Beach atv Code Cl"Iaoter 2. Artide VII. D1v1s1m 5 1llereof Entitfed "Camoalm Anance Reform" Via The AddItim Of Code section 2-438 Entitled "Prohibited CamoaiCll ContrIbutJons BY Lobbvists On Procurement Issues": :e.=.=:. o::~e:.=rJkl~:ror"""" oron. Dr.lnt 2) Pursuant to OrdInance No. 2003-3395 Amendlno MIami Beach atv ("triP 0laDb!r 2~ Artide VII DIvlsIon 5 thereof EntItled "Camoaian Anance Reform". Via The Addition Of Code Sectlal 2-490 Entitled "Protlblted C8moaim CCln~butlons BY L.obbvIs1s On Real Estate DeveJooment 1sJes": Are YOU IobbvIna on . aendlna ......1adIon for. DewIoDmfnt Aan!lIIment with the CItv or ~ for dI8nae of zanIna m8D.....anIdton or dI8nae to the ~. Fub.- land .... MIlD? V. "'11IRI1MDIR~1H: ON OCTOBER lIlT OF EACH YEAR,. EAOt LOIS8YIST SHALL SUIIMITTO nlE aTY a.ERK A SIGNED Sl'ATEMENT UNDER 0A1H, LJS11NG 1DISIJYING EXPENDI1URES IN 1ME aTY OF MIAMI lEACH 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. Signature of lobbyist: Signature of Pl1nclpaVCI VI. LDBBYIST IDENTIFJ ~ Produced to j)t,V' ~ \ c... Form of IcEntification o Personalty Known State rJ ROrida, County of Miam~Oade Sworn tnaDd SUbscri~~ ~ me This ~ Pay rJ ~ 2003. VB. SlGNATURlIIfD sr". OF NOTMY OR DEPUTY a.ERK: Print, stamp or type name d Notary Public l/ Registration : FORCURK'S .. ONLY ) / [ ] REECJB) DATE: E 5' 03 I I If rejecbld, st:ale reason: Registration fee paid: [ ] YT [ DATA ENTRY DATE: q' I cS .2003 ENTERED BY: I 0+ 2nd Revision 3/18103