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HomeMy WebLinkAboutAngela Posillico/Latin Int'l Mi"""lIIi'!'~ IECEWEO 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 '-.ll="\'l\ ';) er- e \ '1 { l, ~' LOBBYIST REGISTRATION 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 "Lobbylsbw h.. apeclflc exclusion.. Please refer to Ordinance 2004-3435. fMJ 0tLrr- - ".J" (M.!) 3307' (Zip Code) .~ fos 1 L- 1-/ c.tJ NAME OF LOBBYIST: Last) {f.s, f,lIf-:Mret?rlffijOtlttl-/J.t /~/.3 7 ;tJW BUSINESS NAME AND ADDRESS (Number and Street) I. LOBBYIST RETAINED BY: ~, ~ P{)S/t..J-fcbJ !t-Af(;fur 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: Gfl.hoJJ Fb~ (lJs:.I.-IfJ,Nff 3,.ri~dAAtlA1/r-t.. plf(j61t/r ~Vt6:Nr 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 tf AJ 'I lV. DISCLOSURE OF TERMS AND AMOUNlS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLATRA"re OR OTHER): A) LOBBYIST DISCLOSURE: (Required) kskrN& . ~ r.3CTtJ -0 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{ ~AJl/a~ Signature of Public Notary - te of Roricla Notarization of Principal's signature L,!I,'jkJ 7Jutuc4cUVlf> ~./~ D~ . ? t , I II ~ 0'.-". t f -.:.I I ! ~l I" h I ! ;1 ~~ Ji ~ t ~ .1 "II! I ~ c I ~ I ;~ ;~ ;a i ti f i ~ I ~! ~ilI I W '" ~ . ~ i . CD E: ( i n I ~.I