HomeMy WebLinkAboutGFS, Corp
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Oty of Miami Beach Office of the Oty Oerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityderk@d.miami-beach.f1.us
LOBBYIST REGISTRATION FORM . 23
04 JM~ -6 AM II:
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) .,
CITY CLERK'S OFF ICE
-
RECEIVED
1:1 Check Box if an Amendment
ROSEN HAROLD
NAME OF LOBBYIST: (Last) (First)
407 LINCOLN ROAD PENTHOUSE S.E. MIAMI BEACH,
BUSINESS ADDRESS: (Number and Street) (OM
(305) 534-4757 (305) 538-5504
(M.I)
FOORIDA
(State)
DATE QUAUFIED AS LOBBYIST
33139
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER:
EMAIL:
I, LOBBYIST RETAINED BY:
GFS, CORP.
NAME OF PRINCIPAL/CUENT:
1520 S. DIXIE HIGHWAY
CORAL GABLES, FLORIDA 33146
BUSINESS ADDRESS:
(Number and Street)
(Oty)
(State)
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section If prlndpalls a Corporation, Partnership or Trust [Section 2-482 (e)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFlCIARY;-/"C~:df 6 v t!f'I W' "fW
. UST All PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
VARIANCE REqUEST
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of IndiVidual/Title
B) Relationship
BOARD OF ADJUSTMENT
STAFF OF THE PLANNING AND ZONING DEPARTMENT
/c.,.,.....4
R?~J
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYISf DISCLOSURE:
$450.00 an hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
$450.00 an hour
1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled wCamoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled WProhibited
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 iiI No
2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled wCamoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled wProhibited
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?
OYeslQ[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, USTlNG 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 ction 2-482 of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
o Produced ID
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 _.LJ
This (..2 day of ~ >- , 20U\1.-,
~D- m~)
Signature of Public Notary - State of Florida
Print,
Public
FOR CLERK'S U
Registration: IX! ACCEPTED
If rejected, state reason:
Registration fee paid: ~es ~ No
DATA ENTRY DATE: I~..f"
2nd Revision 3/18/03
[ ] REJECTED
DATE:
l'-b~()'f
~] Ca f\rCheck MC
o .
. ENTERED BY..
R\HA Tl \Labbyists\registrationa03.doc