Michele Jacangelo/Billboard Mag
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
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.
JIlL...... '( to Mu.I.#.l....
NAME OF LOBBYIST: (Last) (First)
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BUSINESS NAME AND ADDRESS I (Number and Street) (tly)
(M.!)
J OtJb':t
(State)
(Zip Code)
(.,~ 1.- I..nt, 11"2.'
TELEPHONE NUMBER:
1P'l{,-II"f\.t-!.#r.. 1'-1
FAX NUMBER:
'jtJtULl'l6~ hi(lb>tliL,."J.(.~
EMAIL:
I. LOBBYIST RETAINED BY:
NAME OF PRINOPAL/CLIENT:
'billl?o
BUSINESS NAME AND ADDRES
(Zip Code)
Ie lUll -ltru.. Ss \) \)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
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:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Iss
~s
III. CITY AGENCIES/INDIVIDUALSTOBE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
UlM.t. Ot~ Vc A ~ 5oa.at J..l(di'"'ll -~
.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
,Is t()
B) PRIN PAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
Yes
1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Procurement Issues":
No: / Are YOU lobbving on a Dresent or Dending bid for goods. egUiDment or services. or on a Dresent
or Dending award for goods. eguiDment or service?
Yes
2)
Pursuant to Ordinance No. 2003-3395 Amendina 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
Camoaion Contributions Bv Lobbvists On Real Estate Develooment Issues":
/ Are YOU lobbying on a Dending aDDlication for a DeveloDment Agreement with the City or
aDDlication for change of zoning maD designation or change to the City's Future Land Use MaD?
Yes
No:
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTlNG 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.
/2/~
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. ~
519m'"re of lOOby'''' ~ A---------
Signature of prinCiPal/Client(
VI. LOBBYIST IDENTIFICATION: PRINOPAL IDENTIFICATION:
Produced ID
Produced ID
Form of Identification
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
/J1ilIJ YflI' /lew y,~(,
State of ~, County of A4iaFlli ~!le
Sworn to and subscribe~ before me U
This J Sf" day of 1t/i.IL.. . 20~ 7
Ititvt/tJ IlAd~ '
Signature of Public Notary - State of~N,/
Notarization of Lobbyist's signature
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This _day of , 20_
Signature of Public Notary - State of Florida
Notarization of Principal'S signature
MARK 8. MILLER
Notary Public. Slale 01 N... 'fQfll
No. 31."878912 I
aualltied In New York Counly 0 Ill'
CommI..lon Explr.. No..mba, '0. ao_
FOR CLE
Annual Registration fee: [vfYes [ ] No Amount
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLE
's USE ONLY '} ~; /
MCR a'6?CPtJ'73 Date Paid 4 -5 -C/-f'
~~vnu business media
April 1, 2004
Paula Calderon
City of Miami Beach
Office of the City Clerk
1700 Convention Center Drive
Miami Beach, Florida 33139
Dear Paula,
Enclosed please find Billboard's lobbyist Registration form and a check for $150.00 to cover
the lobbyist registration fee for Michele Jacangelo.
As discussed, please fax a copy of Billboard's lobbyist registration to me at 646-654-5819 as
soon as possible, as Michele will be presenting at the VCA board meeting next Thursday,
April 7, 2004.
Please contact me at (646) 654-4675 or barieninaer@vnubusinessmedia.com with any
questions or comments you may have in connection with the form.
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CITY OF MIAMI BEACH
CITY CLERK'S OFFICE
1700 CONVENTION CENTER DRIVE
MIAMI BEACH, FL 33139
(305) 673-7000
FAX: (305) 673-7254
FAX TRANSMISSION COVER SHEET
PAGES:
2 Including Cover
FAX:
April 5,2004
BARBARA GRIENINGER
646-654-5819
DATE:
TO:
SUBJECT:
SENDER:
LOBBYIST REGISTRATION
Paula A. Calderon, Office Associate V. ext.6339 @
Below please find a copy of the receipt for payment of the Lobbyist Registration for Michele Jacanqelo.
I will also send an email to the members of the VeA advising them of your registration.
Page 1 of 1
Calderon, Paula
From: Calderon, Paula
Sent: Monday, April 05, 2004 5:12 PM
To: 'Grisette Roque'
Cc: Gibson, Elizabeth
Subject: Lobbyist Registration
Please be advised that Michele Jacanqelo with Billboard Magazine has registered as a lobbyist
with the City to lobby on subject: Grant application for Billboard R&B I Hip-Hop Awards.
Paula A. Calderon
City of Miami Beach
City Clerk's Office
1700 Convention Ctr. Dr.
Miami Beach, FL 33138
305-673-7000 ext. 6339
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4/5/2004
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*************** -CDMM. JOURNAL- ******************* DATE APR-05-213134 ***** TIME 16:133 ********
MODE = MEMORY TRANSMISSION
START-APR-05 16:132
END-RPR-05 16: 03
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a
-CITY MIAMI 8CH CLERK DEPT-
************************************ -CITY CLERK DEPT - ***** -
3135 6737254- *********
CITY OF MIAMI BEACH
CITY CLERK'S OFFICE
1700 CONVENTION CENTER DRIVE
MIAMI BEACH, FL 33139
(305) 673-7000
FAX: (305) 673-7254
FAX TRANSMISSION COVER SHEET
PAGES:
DATE:
2 Including Cover
April 5, 2004
BARBARA GRlENINGER
646-654-5819
LOBBYIST REGISTRATION
Paula A. Calderon, Office Associate V. ext.6339 8
TO:
FAX:
SUBJECT:
SENDER:
Below please find a copy oCthe .eceipt for pllyment of the Lobbyist Registration for Michele Jacanqelo.
I will also send an "mail to the members of the YCA advising them of your regis!rlltion.
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Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
No. 266 07 3
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(THIS INFORMATION MUST BE COMPLETED)
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