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Leslie & Natalie Zigel lD City of Miami Beach Office of the City Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: dtyclerk@Ci.miami-beach.f1.us LOBBYIST REGISTRATION FORM (J Check Box if an Amendment RECEIVED 03 DEe -5 AM 8: 1+5 CITY CLERK'S OFFICE (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) NAME OF LOBBYIST: Fine (Last) Robert (First) S. (M.!) DATE QUAUFIED AS LOBBYIST (305) 579-0826 TELEPHO~~ NYf:1B~~:, Greenberg Traurig P.A., 1221 Brickell Avenue, BUSINESS ADDRESS: (Number and Street) (City) (305) 961-5826 FAX NUMBER: Miami, FL (State) 33131 (Zip Code) finer@gtlaw.oom EMAIL: I. LOBBYIST RETAINED BY: f Leslie & Natalie Zl ~_l ~~e NAME OF PRINCIPAl/CUENT: 4335 North Bay Road Miami Beach FL 33140 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) (305) 579-0500 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section If prindpalls a Corporation, Partnership or Trust [Section 2-482 (e)] . NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY: . UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Variance for pool setback. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Relationship See Attached. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RA TE OR OTHER): A) LOBBYIST DISClOSURE: -0- B) PRlNCIPAL'S DISClOSURE (OF LOBBYIST COMPENSATION): -0- 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Artide VII. Division 5 Thereof Entitled ~Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled ~Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issues": Are YOU lobbyinG on a Dresent or DendinG bid for Goods. eGUiDment or services. or on a Dresent or Dendino award for Goods. eauiDment or service? D Yes ~ No 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled ~Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled ~Prohibited Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues": Are YOU lobbyinG on a DendinG aDDlication for a DeyeloDment AGreement with the City or aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD? DYes IlfNo V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING 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: Robert S. Fine ~o/tP Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Leslie Zi.Jgel Form of Identification ~ersonally Known CJ Produced ID VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade sworn.to~nd subscribed before me This ~:..s day oflk-retnbrr. 2003. OFFlClAL NOTARY sF.AL MEUNDA J SILK NOTARYPUBUC srATE OF FLORIDA COMMISSION NO. cC939121 MYCOMM1?SIQN E.XP. MAY22~ Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY Registration: 1\f ACCEPTED If rejected, state re~ Registration fee paid:<"'[\J.. Yes [ ] No DATA ENTRY DATE: ] REJECTED DATE: 1'2.-- ~ -0) [ ] Cash ~eck MCR # 'l~5"3lf~ .2003 ENTERED BY: 2nd Revision 3/18/03 F: \ClER\HA Tl \Lobbyists\registrationa03.doc IV:, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RA TE OR OTHER): A) LOBBYIST DISCLOSURE: -0- B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): -0- 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 Bv Lobbvists On Procurement Issues": Are YOU lobbYinG on a Dresent or oendinG bid for Goods. eGuiDment or services. or on a Dresent or DendinG award for Goods. eGuiDment or service? 0 Yes l!i No 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues": Are YOU lobbyinG on a DendinG aDDliation for a Develooment Aoreement with the City or aDoliation for chanGe of zonina maD desiGnation or chanGe to the City's Future Land Use MaD? DYes ilJ No V. SIGNATURE UNDER OATH: 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. (jJ1 0 ,~ ~ Signature of Lobbyist: I ~ '==-- _ _ Robert S. Fine Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Leslie Ziegel [J Produced ID o Personally Known Form of Identification VU. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: ~1\ ~ M.l.u:M . ~j lltf~DD:101132 \;.~ ~ s.plenlb" :M, 200li State of Florida, County of Miami-Dade Sworn t9~fbd SUbSCribe~ore me This Ii day of ..2003. Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY [ ] Cash .2003 1'1. -f7 ~O? Qh 134- 2 Registration: ~ ACCEPTED If rejected, state reaso~r.7. Registration fee paid: ~ Yes [ ] No DATAE~YDA~: J~I:) ] REJECTED DA~: 2nd Revision 3/18/03