Brian Adler/Joel Sussman Truste
DEC.-03.031WEDlI0:19 BILZIN SUMBERG ET,AL
P OD4
City oCMiami Beach Office ofthll City Clerk
1700 Convention Center Drive, Miami Beach, FI. 33139
Emai!: cityclerk@ci.miami-beach.n.us
1.0BDYIST REGISTRATION FORM
(Ciry of Mi;mti BClllCh, Cily Code Cbapler 2, Division 3, Section 2-481)
o Cheek JIoxlf all Amendmont
Adler. Brian S.
NA.ME OF LOBBYIST:
(LillI)
(FirSI)
12/7103
(M,l) DATE QU ^ LIFlED AS LOBBYIST
200 South Biscavne Boulevard. Suite 2500. Miami, Florida 33131
BUSYNESS ADDRESS: (Number and Slteel) (City) (Slate)
(~ip Code)
(305) 350-2351
TSLEPHONE NUMI3ER:
(305) 351-2206
FAX NUMBER:
badlcr@bilzin.com
EMAIL
L LOBBYIST RETAINED BY,
Joel Sussman. Trustee
NAME OF 'RJNCIPAUCUIlN1':
6565 Collins Avenue, Miami Beach. PI. 33141
BUSINESS ADDRESS: (Number and Street)
(City) (slate) (Zip Code)
(305) 866-2122
TGLEPHONE NUMBER:
(305\ 866-88~3
FAX NUMBER: (OplioPQl)
EMAIT. (Optional)
Fill out tlals section if principat is a CorplIratiDII, Partnership or Trust [Sedlon 2-482 (c)J
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY, N/A
· LIST ALL PERSONS HOLDING, DIllECTL Y OR lNDIRECTL Y, A 5% OR MORE OWNERSHIP
INTEllliS'r IN SUOi CORPORATION, P ARTNERSlUP OR TRUST N/A
n. SPECIFIC LOBBY ISSUE:
North Shore Historic District in Relation to 6S6S Collins Avenue. Miami Beach. Fl. & 6605
Collins Avcnue.. Miami Beach. FI.
Issuc to be lobbied (Describe In detail):
Ill. CITY AGENClJ:S/INDlVlDUAJ.S 1'0 BE LOBBIED:
A) Full Name orIndividuaJ/Titlc B) P.elatlonsbip j
Historic Preservatioll Board & Staff
Planning Board & Staff I
City Commission & stair --
I
D~C,-03'a3(WEDI 10:19 BILZiN SUMBERG ET,AL
I
P 005
IV. DISCLOSURE OF TERMS .\ND AMOUNT8 OF LOBBYIST COMPENSATION (DISCLOSE
WHETHER HOURLY, FLAT RATE OR OTHER):
A) Lobbyist Dis~losure: SJRO.OO per hOIlT_
B) Principal'. j)iscloslll'e (of Lobbyist COJq:Ienilltion): .~".,... P'U hOllr
l) I'WlUr:mt to OrdJoancu No, 2003-3393 Amcmdil1g Millmi Beach City Code Cbnplel 2. ^"i~le VII, Division
5 Thereof Entitled .Calllpaign Finance Refonn" Via The: Addition of Cod" Seclion 2-48~ Entitle
"Prohibited Campaign ConrributiollR By Lobbyisl' till Procurement IsSlIllS":
Arc you lol>byiJ'l DB II present or pending bid ror I:ullds, equipment or "rvlcel, ur on a prCllleat or
pClIIdilllllwarcl for louds, equipment 01' Icrvkes? 0 Vel X No
2) Pursuant 10 OrdinallCe 2003.3395 Amending Miami DUlch City Colle Chapte, 2, article VTI, Division 5
thereof Bntitled .CaDlpaign Fil1l111Ce Refom," Via TIle Addition afCode ScctiOll 2-490 Entitled
"Prohibited Campaisn Contributions Dy Lobbyists on Real Estate De\l~Jopnlent Issues":
Are you lobbylnlllln a pendlll( Application for. Dovelop""nt Alreement with the City or
AppUcation for chan!:e of zenlng mllp dosJllJUlt!lIn or ellanee to the City's Futuro Land Use MlIp'~
o Vell XNo
V. SIGNATURE UNDER OATH:
ON OCTOBER 111 OF EACH YEAR, I!:ACH J.oBBVrST SHALL SUBMIT 'I'O THE CITY CLERK A
SIGNED STATEMEN'r UNDER OATH, USTJNG LOBBYING EXPEN,PlTURBS IN THE CITY OF
MIAMI BEACH FOR TliE PRECEDING CALENDAR YEAR.
I do solemnly swear tblllll1 oftbe foregoing facts are tnle Md cnrrect and that T have read or 0111 familillr with the
provisiollS conlained in Se . '0 2-482 lite Miallu Bcac:h City Code alllllnendecl, and IE r"Porlin~ l'~uiIcmems,
Signature of Lobbyist;
Signature of Principlll/Cllenl:
VI.
o
P1'Oduccd 1D
Form oflcleudiieslioll
~n8jJYKnoWn
vn, SIGNATURE AND STAMP OB NOTARV OR DEPUTY CLERK:
SlIIle OfFJO~~irt)' of MillmI-Daclc
Swo~o and su S bed ~re me
Thi ::::..aax Wht A 2003.
GISEllE PACHECO
MY COMMISSION # DO 016885
EXPIRES: April 10, 2005
Bo,,"" ThN Plclhal'CllnlVraoo. Aeencv
Print, stamp Qr type mune of Notary Public
R....i'lrlltion
~cePled
FOR CI.ERK'$ llSE ONL,Y
[ J Rc.fecre<t D~I.)2/ IVJ tJ3
If rejecllXl. slllte FCll$on:
Rcginralion foe pllid [ I Yes ? No
DATA ENTR.Y I)ATE:...l:2.. (l
,
2" RevisiOn 1/27/03
[JCl1Ih['
ENTERED BY;
,2003