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HomeMy WebLinkAboutBeach Towing, Inc. ~ City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: dtyclerk@d.miami-beach.ft.us LOBBYIST REGISTRATION FORM - (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) D Check Box if an Amendment ROSEN NAME OF LOBBYIST: HAROLD (Last) (First) (M.!) DATE QUAUFIED AS LOBBYIST 407 LINCOLN ROAD. PENTHOnSF. BUSINESS ADDRESS: (Number and Street) (305) 534-4757 ~ R MTAMT RRArH FT.n'RTnn ~1.11.Q (City) (State) (Zip Code) (305) 538-5504 TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: BEACH TOWING, INC./MARK FESTA NAME OF PRINCPAl/CUENT: 1349 DADE BLVD., MIAMI BEACH, FLORIDA 33139 BUSINESS ADDRESS: (Number and Street) (305) 534-2128 (City) (State) (305) 534-6328 (Zip Code) 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 OFFICER, PARTNER, OR BENEFICIARY: . UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECFIC LOBBY ISSUE: TOWING FEES and REGULATIONS Issue to be lobbied (Describe in detail): m. CITY AG~NCES/INDMDUALS TP BE.LOBBIED: A) Full Name of Individual/Title B) Itelationshlp ALL N. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DI50.0SURE: $450.00 hour B) PRlNOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $450.00 hour 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Crt.v Code Chaoter 2. Article VII. Division 5 Thereof Entitled ~Camoaion Finance Reform- Via The Addition Of Code Section 2-488 Entitled ~Prohlbited Camoaion Contributions Bv Lobbvists On Procurement Issues-: Are YOU lobbyino on a Dresent or Dendino bid for ooods. eGuiDment or services. or on a Dresent or DendinG award for Goods. eGuiDment or service? DYes xvNo 2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach Citv 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 DeveloDment Issues-: Are YOU lobbyinG on a DendinG aDDllcation for a DeyeloDment Aareement with the City or aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD? DYes ~ No 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: Signature of Prindpal/Oient: VI. LOBBYIST IDENl1FICA ./ ~IY Known tJ Produced 10 Form of Identification VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: i)o.VanI~'" ~ ,..; IotfCl:ll...Jwl,)"DOtI:ItI7 .",.. ~ 1IIrllII12, 2lX11 State of Florida, County of Miami-Dade Swoml"~Ubsa1F~; _J. This ~day 0 200.:r ,; FOR CLERK'S USE ONLY Registration: [~ACCEPTED [ ] REJECTED DATE: /'15-04 If rejected, state reason: .Reglstration fee paid: [t:pfes [ ] No [ ] Cash. [ ~eck MeR l .p t'd L> n 15 ""TA ENTRY ""T<, .~..... """"" B" ~ 2nd Revision 3/18/03 F:~ \HATL\Lobbylsts\registrationa03,doc