Bruce Fero/Michael Food ByHall
_ B.....
l!I!!
'I"'-CEIVED
.!l1KI'
04 M^R lOAM II: 09 City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
cln CLERi'\,S OFfICE
LOBBYIST REGISTRA nON FORM
lD
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any
manner in this section, during the time period of the entire decision-making process on such action, decision or recommendation
that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the
principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435.
NAME OF LOBBYIST:
~o (Last)
!Q2oce:
(First)
I;;
(M.I)
~#~'~f'Y)
TELEPHONE NUMBER:
~'~bO
FAX NUMBER:
I. LOBBYIST RETAINED BY:
1'x Ud.t L L.. C.
NAME OF PRINCIPAL/CLIENT:
~oo 'PXr2aJ ~1 ~1atrS
40, er~
BUSINESS NAME AND ADDRESS
~. ~. 45ZJ3.
TELEPHONE NUMBER:
Mw.,,~ ~~
(Number and Street) (City)
tL
~4f
(State) (Zip Code)
3015 '~.4b~
FAX NUMBER: (Optional)
NaJe.
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
~ Oru-~
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A SOlo OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~ ~SO.L - lCD-/.:.
II. SPECIFIC LOBBY ISSUE:
~ ~oJ--ft) b'n1'nJ~1
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOB8IED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
?~~eJ ~
N~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (ReqUlred).$
r;;?&&
Yes
1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2, Article VII. Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaign Contributions Bv Lobbyists On Procurement Issues":
lVices or on a nt
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 BY Lobbvists On Real Estate Develooment Issues":
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LlSllNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
p~ S~bbYist
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 and all reporting
requirements.
5l,oo,",e of lOOby,,,, ~~
Signature of Principal/Client: .~ .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID
Produced ID
Form of Identification
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribe before me IL
This \\')'*' d y 20.Q.,.
State of Florida, County of Miami-Dade
Sworn and subscrib before me ^.
This ....I.O:&.day of (.,lt1 200.,.
MARTA M. HERRERA
MY COMMISSION # CC 982158
EXPIRES: November 16, 2004
Bonded Thru NotIry Public Underwrllere
MARTA M. HERRERA
MY COMMISSION # CC 982158
EXPIRES: November 16, 2004
Bonded Thru Nolary Pubflc Underwrltel1
FOR CLERK'S USE ONLY 1..1- b fjJ
Annual Registration fee: LX] Yes [ ] No Amount p. 15'0,- MCR # l? Q 1- Date Paid
Lobbyist Registration Form received and verified by: /
Revised 02/10/04 F: CLER\A L\ A - L B IST\LOBBYIST FORM 04
J ,-w,-Of