HomeMy WebLinkAboutAngela Posillico/Latin Int'l
Mi"""lIIi'!'~
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R 'l Z Pl"I 2: ?ity of Miami Beach Office of the City Clerk
04 H~. J .,' p~~ f1~ention Center Drive, Miami Beach, FL 33139
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e \ '1 { l, ~' LOBBYIST REGISTRATION FORM
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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 "Lobbylsbw h.. apeclflc exclusion.. Please refer
to Ordinance 2004-3435.
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3307'
(Zip Code)
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NAME OF LOBBYIST: Last)
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BUSINESS NAME AND ADDRESS (Number and Street)
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LOBBYIST RETAINED BY: ~,
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NAME OF PRlNCIPALfa.IENT:
"5 ./..$, t(1t-:.!"4i?rttJfj,~
BUSINESS NAME AND
GflAt.
(City)
7s-Y- 227 -69 Ih
FAX NUMBER: (Optional)
/€.t,J6S fr- ~3 () 7
(State) (Zip Code)
f'(:;"Ul-TJN/l-Punfeaol. COrY!
EMAIL: (Optional)
1C:~-227 .6cr/7
TELEPHONE NUMBER:
Fill out this section if principal" a Corporation, Partnership or Trust [Section 2-482 (c))
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
thJ c, UIl ...:r. p /)~r /.-.4 c{)
IDENTiFY ALL PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH J
CORPORATiON, PARTNERSHIP OR TRUST: .
II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
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lV. DISCLOSURE OF TERMS AND AMOUNlS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLATRA"re OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
Yes
1) Pursuant to Ordinance No. 2003-3393 Amendlno Miami Beach aty COde Chaoter 2. Article VII. Division 5
Thereof Entitled ~Camoaion Finance Reform" Via The Addition Of COde SectIon 2-488 Entitled ~Pro:-iibited
Camoai9n ConbibutJons Bv Lobbyists On Procurement !~5Ues":
ent or services or on a .nt
2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City COde Chaoter 2. Artide VII Division 5
thereof Entitled "Camoaion Finance Reform", Via The Addition Of Code Section 2-490 Entitled ~Prohibited
Camoaion ConbibutJons Bv Lobbvists On Real Estate Develooment Issues":
Yes
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LlS11NG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING NOAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BE 0 EXPENDITURES OR MP!::NSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoin facts are true and correct and that I have read or am
familiar with the provo s contained in ion:482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of PrincipaVClient:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID J I CL. 1)". l: '-if P 2-l( 2. ~ 01 0 ~ 53 - Produced ID h .llr. L .ct P2-~ '2. -Ci D - D -'12..1- 0
Form of Identification q 2.. \ - 0 Form of Identification
personally known (lobbyist)
VU. SIGNATlJRE AND STAMP OF NOTARY:
!"'ersonolly known (Principal)
Signature of Publi Notary - State of Roricla
Notarization of Lobbyist's signature
OFFICIAL NarARYSEAL
LILLIAN BEAUCHAMP
NarARY PUBLIC STATE OF FLORIDA
COMMISSION NO. DD1cm89
MY COM ISSION EXP. APR. 29
State of Rorida, COunty of Miami-Dade
Sworn and SUbsai$before me
ThiS~cIaYOf_ ',1 .200L{
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Signature of Public Notary - te of Roricla
Notarization of Principal's signature
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