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Adrienne Pardo/Chabad Lubavitch Mlm1i B~ ..... mr llJU3 lD - - 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 lime period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the dty commission, or a city board or committee. The term specifically includes the prindpal as well as any employee engaged in lobbying activities. The term .Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Pardo Adrienne NAME OF LOBBYIST: (Last) (First) 1221 Brickell Avenue, Miami BUSINESS NAME AND ADDRESS (Number and Street) (City) 305-579-0683 305-961-5683 FL (State) pardoa@gt1aw.com F. (M.I) 33131 (Zip Code) TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Chabad Lubavitch of Venetian Causeway and Surrounding Islands, Inc. NAME OF PRINOPAL/CLIENT: 115 7th Terrace Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS 305-674-8400 (Number and Street) (City) 305-535-5260 (State) (Zip Code) 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 BENEFICIARY: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Planning Board Issue to be lobbied (Describe In detail): III. CITY AGENCIES/INDIVIDUALS TO BE L08BIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Planning Board Planning Department 05/~4/r4 15:0:3 GREEHBEPG TR~iURIG .,. 9305535521".[1 t.~c. If:jf., GlDS IV. 1I1SCLOSV1l:1' or Tl'IUIIS AND AMOUNlS OF LOBII'I'JU CON'ENliAnON IDJ5CLOSt WHErIll!Il HOUR l. Y, FLAT II.A 1"F OJ.: OTIIER): A) LOBBY!ST OISCL05\JR.E: (Ilequl.re~) f350.0D $3S0.DC Hourly 8) FRINCJPAl 'S DJSC~p.& ("~ WBllI'lST COHPE~SA'T101\l): (lIequlr<ed) Yes ~ A= reDl"li!IH"'iIwa . "ot-for'lImfit mrlloralfon or .ntib wil:fleut s~;1I1 c!)1~D~nsatfon Dr _--!!!tbllrsf","-"1Wo. "Uffiu~nt:o Ordinance 1Ilo. 2004-3435. HOlnly 1) 1'.I<.!1i.\lant to OrtllnJ\~ No. 2003-3393 Amendina "'~mi F1each CItv Cod@Cha:lttlr2. Artlqe VIT, 0";3;0" S Thersol' Enttled '"Camoalan Rnanc~ .Reform" V.. The Aodltlon Of Cod!'~_?:'\.!li l;n!ittrl"fOObibnd Campaion Contributions !ly 1...obL~1<t~ On Procurement ISSues": 'tll!.!l lSi) Are YOu 'l!.bbvinCl IIIl II _sent Dr Dendin.!l bid fo~a;DIIill. eaulr-~"!I.lt'1!.~t~"'':l!'I>1'l'1 or rm.A1!.~ or DirndinCl awa rei far aoods.. ecw;amenl: iir ~ervi 4) ElIDuant to Otdin:mCf! No 2003-3395 IImendlna Miami Be~ <;:, ~ ~a~~r? ~~e '{f! DI":" 5 .liJllLe(jL~tllfe(! "Cam"'~lan Flnaxe Raform", Via The Addition C 10 2 0 En" . mh,bit C!:lF}jQa!Qn CnntrlhutJon5 By l.Dbhv~sts On ~~aI E3t3M Oevelonml!nl: ]"!;I ~N. v_~ AN yell laltlwllMl an !Il)endina au"ncalfon for l!I Dev810lllllent Aareel11l!lnt with tlH! City m: _>>liCiltiarllftr -=hana@ lit 2'Gnina "!aD dasianation f)r dtafttl8 to the CIN'&: ~tItu~ laftd u:; MaD? v. SIGNATuu UNDER ~TH, ON OCTOBER I" OF EACH YEAR. eACH LOBBY!5T SltALL SUBMIT TO THE em CLERK A SIGHt{) IIUTiMENT UND'R OATH, USTlNG LOtSIlYING EXPENDITURES, AS WELL AS COMPI!NSATlON R&cUVED, IN THE CITY 01' MIA"". BUCH fOR TH& PRECEDING CALENDAR. YIAR.. .\ STATEMiNT SH....U BE FILED I!VI!N IF THERE HAVE IEEN :UONDlTURES DR COM:]PEON DURlHc; THE IUlPORTlI'IG PERIOD. 0 b1- ~'---- "2 ~ Sl\l~ at Locbr1l1t I do sclemnly S....ecr that all of me foregoinS facts lire m.e and (:afrect oM mat ! ~ave read or am filtn!Jiar wfth &.a provisions contained in 5ectJon 2.482 of Miami Beach City COOl! and all re;.JOrtlng teql.lirementi. nO. . -- SIgr,atlJra of Lobbyist;: _~ SJgnature of Pri'lclpalJdit!nt: VI. LOIB'YIST IDENTIPItAT10N: PIUNCIPAL IDEHTlFlCATIcJNI :;J Proolload 10 LJ Prodl.ited 10 ~__. -==Jnn r1f !denllncallOn c~o;(prln"pel) Form Of Iden~fl(ation C Personally known (Lobllylst) VI!. SlGNATUIl! AND STAMP OF NOTARYr State of Florida, COJnty Df Miami-Dade Sworn and sl.bscrl:Jed before me Tris~ayof 200 I / FOIl.CLE.~5USEONlY ";:/ 1/1 I Anrouallleo.<fratl." -.:, f~~;: ; ~:v ;.'''""''~. a IJ 'd iJ MCR db. q-~ -:late Paid E.LJ/jl /lobbyi5t Ileg:_,," FOI m re<:eI'lf!C' and vertlled by: _ _ -- I I R.~';~C2i~~~__._. F: C R' !UA_.M:~.~!!~~'1DI:"zsr'~';U'l04 __"._____J