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Zyscovich, NWS./ Or of Miami Be. ach Office of the Qty Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Emaik cityderK@cl.m[ami- bead% fl.u s LOBBY[ST REGtSTRATZON FORM (Qty o[' Miami Beach, City Code Chapter 2, Division 3, SeCtion Check Box if an Amendment NAME OF LOBBYIST: . i (Las[) ; (First) i (M,I) DATE QUALIFIED AS LOBBYIST aUSINESS ADDRESS.' (Numar anO Street) (City~ (Sta~ ' (Zip Code) LEPHON~ NUMBER: - ~. FAX NUI~BER: EMAIL: LOBBY/ST RETAINED BY: -NAME OF PRINCIPAL/CLIENT: tJJ EMA.[L: (Optional) · _~111 ~ this section If principal is a CorperatJan, Partnemhlp or Trust [Section 2-4e2 (c)) ~ NAME OF CH[EF OFFICER, PAR'r~IER, OR BENEF[OARY: 4_--~> L[ST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SPEC~[FZC LOBBY ISSUE: Issue to be lobbied (Descr[l~e in del~il): ~: ~ AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of tndlvldual/lqtle B) Relationship £0/20'd ~S~£~9 S~£ £d30 ~B~D H38 IWWIW ~113 &S:gT ~e~-ge-gn~ £0' d ~£01 A) LOBBYIST DLSCLOSURE: B) PlaNt'[PAL'S DLSCLOSURE (OF LOBBYIST COMPENSA'I'[ON):. l) 2) Pursuant to Ordinance No. 2003~3393 Amendlna Miami Beach Cit~ Code Chm~ter 2. Article V[L Division 5 Thereof Entitled 'Camoalqn Finance Reform' Via The Addition Of Code Section 2-4BB Enbtied 'Prohibited Camoalan Contributions By Lobbyists On Procurement ~ssue$': Are you Iobbvlne off a oresent or oendln~ bid fer ooods, eeuiament or~e~vlces, or off a oresent or o~dlflq awird ~r aooda, eauil)ment or ~en~ice? n Yes~'.No Pui~uant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaoter 2LArUcle V]~ DivisiQn 5 thereof Entitled 'Camoalon Finance Reform". Via The AddRlon Of Code SectJon 2-490 Entitled "Prohibited Camoaiqn Contributions By Lobbyists On Real Estate Develooment Zssues": Are you Iobbvina on a Dendlnq anDIIcaUon for a DeveloPment Aareement with the Cit'~ or V. SIGNATURE UNDER OATH: ON OCTOBER Is'r OF EACH YEAR, EACH LOBBYZ~r SHALL SUBMTr TO THE ~ CLERK A S;~GNED t~-q'AT~MENT UNDER OATH, LZ~I"J. NG LOBBYING EXPEND~FI'URES ZN THE cTrY OF MZAMI BEACH FOR THE PRECEDING CALENDAR YEAR. ! do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am familiar with the provJ$ions~C,~tained in Sectio~].~82 of the IVllaml Beach City Code as amended, and ali reporting requlrements~.~/~,/~.,., ~//~//~'~ Signature of Lobbyist: {.~'"('/(~'~'~'__//L~./ ' Signature of Prindl~l/Oient: / .~', -~"~//(~[ VX. LOIIY~'I' ~DENI~I~CAT~ON: / / / ~ Produced ID /~/ ~1~ (~ersonaliy Known Form of Tc~er~ ~cation State of Florida, County of Miami-Dade STGNATUKE AND ~'I'A.~ P OF NOTARY OR DEPUTY CLERK: Sworn day of ~"~, ,2003. This t~l subscribe~d b_ef~o_re me Signatuje of Public Notary - State of~ Florida Print, stamp or type n[ame of Notary Public Regls~'aUon: [ ] ACCEPTED If rejected, state reason: Regis~'afl°~ fee paid: ~]r~[ ] No DATA ENTRY 2~ Revl~on 3/t8~3 FOR CLERK'S USE ONLY [ ] REJECTED DATE: [ 3 Cmsh [ I C~eck ~tCRI/) # · · 2003 ENTERED Iff: ~/'~-' - ¥ 'F:\CLEl~ATL\Lo~bylsts\regis~atlona 03.d oc Mmyur David De.mm- Commissioner Matti Herrc~a aowe~ C~s~on~ $~m~ C~ Com~s~er Saul O~ Commi~;onet ~c~ S~bcr8 J~ M. Go~r~Je~ City Ma~ Diaz-Burn.wi;. A~ia~t City M~a~r C~$~a Cue~o, ~Sb~nt Ci~ M~ag~ Roan Middau~, ~sls~t Ci~ M~ M~ ~m~, Eaecu~ve ~i~ ~ 1he C[~ M~agcr Ran~m Mgu~zo, chle'or sm~ Tim H~L Spccial ~sis~t m thc Ci~ ~u~y Dubb~, Ci~ A~omey Donald Dapy, Chief D~u~ Ci~ A~omey Eode Compli~n~ Oi~llon K~I Caren. O~ae Fire Depa~nt Flo~d J.~, Fire ~ief Planning an~ ~eing Depa~ment )orge Gome~ ~{~tor Will/~ H. Ca~, Director D~;~, ~cwation ~d Nci~bo~d Pla~g Division A~ndo Voids, Pl~ning a~d Zon~g M~ger ~uck T~ B~s April Hitch, See~ tO ~ B~ Ju~ D[~, Pl~ning Ant~i~ $~hl, Receptio~is~ gi~o Gu~, Pl~n~, Pithing & Zoning ~n P~ns, Plann~, Pla~i~g & MarUa Surer, Pl~n~, Plann~S & C~a~ph~ Dunn, PI~n~, Pl~nlna & Zoning Mark 8~n Finn~, PJ~n~, Planning & Zoning Planning M~y ~, St, Pl~n~ S~phm F~n, Sr. Planer, Planning & ~ndo Vald~, Pl~ning and Z~g M~ a~l Hirsh, gecm~ to ~ B~M o[Adjus[m~t ~o~ R. M~n~, R[CP, D~bm and ~mse~on MaMgcr ~o~ ~ M~, AICP, ~i~m ~d ~sc~ti~ M~agcr l,au~ Quenelle, Sr. Pla~m, ~ign & Neigh~ood Joyce Mey~, No~ B~ch Pl~ing Eouben Cold.Il. Plann~, Dmi~ & P~e~adnn ~lea ~uekim, Sr. Hans ~a High, P~nnet Pvbllc Wor~ Joseph $ohnean, Director Amelia gohnaon. Transpertallon Coordinator Henry $o~son~ Senior Planner, Da~ Ha~ O~qce Asa~ia~ r/ote, r and Sw~,~r Division Nathan Pope, Water m~d Sewer Utilities Sup~n~dem John ~nt~, S~, 8~=iltgh~n8 ~d ~D.A, Heidi Jahnson-~ghL ~A Iiuildlng DepnrtmeM Phil Amn, Build;nj~ Dk~tor l-[amld Dolikhani,/~tSLSi~nt Rich:mi McConazhle, Chiof Building lnspvetor Jerl 0;= C~clkin, Senior Buildin8: Inspector I"errnff Counler Evely. 1-I. Sanchez, Office Azsn=inu: IV F~le. etrleal Gary Ormga, Chief Electria*l Impe~tor Plumbing Paul l~lledge, C"hict'Plumbing ln~:mr Mohammed PIrtto¥i, Chief ~4¢ee~.~lbllL'y 0lady,: Sala$, C'lhi<r Aceessibility Mep~mr