Louis Terminello/Peter Pekofsky
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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 prindpal 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 dedsion-making process on such action, decision or recommendation
that foreseeably will be heard orreviewed by the city commission, or a dty board or committee. The term specifically includes the
principal as well as any employee engaged in lobbying activities. The term ftLobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435.
Terminello Louis J.
NAME OF LOBBYIST: (Last) (First) (M.I)
Terminello & Terminello. P.A. 2700 S.W. 37th Avenue Miami. FL 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 444-5002
TELEPHONE NUMBER:
(305) 448-5566
FAX NUMBER:
LJT@Terminello.Com
EMAIL:
I. LOBBYIST RETAINED BY:
Peter Pekofsky, President
NAME OF PRINCIPAL/CUENT:
Club Deep. Inc. 621-623 Washington Avenue
BUSINESS NAME AND ADDRESS (Number and Street) (Oty)
(305) 532-1509
TELEPHONE NUMBER:
Miami Beach, FL
(State)
33139
(Zip Code)
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, DIREcrL Y OR INDIRECfL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Conditional use approval to operate a Neighborhood Impact Establishment
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of I~dIVidual/Title
B) Any Financial, Familial or Professional Relationship
City of Miami Beach Planning Board
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$10.000.00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
$10.000.00
Y
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 2-4B8 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Procurement Issues":
No:
2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Real Estate Develooment Issues":
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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, 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.
f-
Signature of Lobbyist
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.
Signature of Lobbyist:
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LOBBYIST IDENTIFICATION:
-
Signature of Principal/Client:
VI.
o Produced ID
PRINCIPAL IDENTIFICATION:
D Produced ID _f L. \) '- 9 ~ \ a
Form of Identification
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Form of Identification
:~sonaIJY known (Lobbyist)
o Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
ry State of Florida
obbyist's signature
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~~-/ Expires December 1 O. ~llO4
/" FOR CLERK'S USE ONLY # / ~
Annual Registration fee: lL/lYes [ ] No Amo nt ~d lIb MCR # L.L" [,,()93, Date Paid 21:J 0
Lobbyist Registration Form received and verified by: /
Revised 02/10/04 F: ER \ IA-M\LOBBYIST\LOBBYIST FORM 04