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Monte Carlo, LLC / City of Miami Beach Office of the City Clerk 1700 Convention Center DriVe, Miami Beach, FL 33139 Email: dtyderk@Ci.miami-beach.f1.uS LOBBYIST REGISTRATION FORM RECE\VEO 03 Sf? I 6 PM 3: \ 0 .~I;'\, "L' ERK'S OFFICE '>..' I I ' \1 lD - (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) o Check Box if an Amendment ROSEN HAROLD NAME OF LOBBYIST: (Last) (First) (M.!) DATE QUAUFIED AS LOBBYIST 407 LINCOLN ROAD, PENTHOUSE S .E.. MIAMI BEACH, FLORIDA 33139 BUSINESS ADDRESS: (305) 534-4757 TELEPHONE NUMBER: (Number and Street) (City) (305) 538-5504 FAX NUMBER: (State) (Zip Code) EMAIL: I. LOBBYIST RETAINED BY: MONTE CARLO, LLC NAME OF PRINCIPAL/CLIENT: 407 LINCOLN ROAD, SUlTE 502, .. , MIAMI BEACH, FLORIDA 33139 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (e)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: ANGEL TORRES . UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECT\. Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: u. SPEaRC LOBBY ISSUE: DEMOLITION AND REHABILITION OF THE MONTE CARLO HOTEL Issue to be lobbied (Describe In detail): DI. aTY AGENaES/INDMDUALS TO BE LOBBIED: A) Full Name of Indlvidual/T1tIe B) Relationship MEMBERS OF THE PLANNING AND ZONING DEPARTMENT PLANNING BOARD . , . 'r;" HISTORIC PRESERVA1;IO'N BOARD " . lV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RATE OR OTHER~ $350 an hour A) LOBBYIST DISCLOSURE: B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $350.00 an hour 1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach Otv Code ChaDter 2. Article VII, Division 5 Thereof Entitled "CamDaian Finance ReformM Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issues": Are YOU lobbyinG on a DreseRt or DeRdinG bid for Goods. eauiDment or services. or on a Dresent or oendinG award for Goods. eGUiOmeRt or service? 0 YesXEi No 2) Pursuant to Ordinance No, 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Articie VII Division 5 thereof Entitled "CamDaion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaion Contributions Bv Lobbvists On Real Estate Develooment Issues": Are YOU lobbyina on a oendinG aDDlication for II Deyelooment Aoreement with the City or ..ooliation for chanGe of zonin~ maD desiGnation or chanGe to the City's Future Land Use MaD? DYes no V. SIGNATURE UNDER OATH: ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, UsnNG 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. ~~/ Signature of Lobbyist:'/. . .. , /' 22..L./L Signature of PrincipaVClient: ~ df' ~ VI. LOBBYIST IDENTIFICATION: a Produced 10 o Personally Known Form of Identification VII. SIGNATURE AND STAMP Of NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Sworn to and subscribed before me This \ \(l day of 5 ~~ . 2003. of Florida Print, fOR CLERK'S USE ONLY RegistratiOn: ~ ACCEPTED If rejected, state reason: Registration fee paid: ~e;~o DATA ENTRY DATE: f/~ 2nd Revision 3/18/03 ) REJEC1l:D DATE: . q --l ~ '-03 [ ] Cash ().QCheck MCR II -;tJ '1la '3 ~ 3"2- .2003 ENTERED BY:~ F: \CILR\HA TL \Lobbyists\registraliana03,doc