Maximo Alfredo Ramos
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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 "LobbyistsW has specific exclusions. Please refer
to Ordinance 2004-3435.
RoB~INS
NAME OF LOBBYIST:
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(Last) (First) fYt 13.. (M.!)
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(Number and Street) (City) . (State) (Zip Code) . - I
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FAX NUMBER:
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BUSINESS NAME AND ADDRESS
305-~-OSOO
TELEPHONE NUMBER:
EMAIL:
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LOBBYIST RETAINED BY:
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NAME OF PRINCIPAl/CLIENT:
B~~S~MEAND~:~SS Slr~tr~nd!:~01r\ I(C~C;( I P{;;te)
3'3/31
(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 OFACER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIREcrLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE: e
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III, CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relation$ilip
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IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
1350
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A) LOBBYIST DISCLOSURE: (Required)
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
1) Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach Citv Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Procurement Issues":
2) Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach Citv 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":
Yes No:
V. SIGNATURE UNDER OATH:
Signature of Lobbyist:
VSignature of Principal/Client:
and correct and that I have read or am
Miami Beach City Code and all reporting
D Produced ID
'~NCIPAL IDENTIFICATION:
~ucedIDi/ 'Dr t.,'r ~ eS2.0-5V/- &Z-If.f"-O
Form of Identification
VI. LOBBYIST IDENTIFICATION:
Form of Identification
~rsonallY known (Lobbyist)
[] Personally known (Prindpa~)
VII. SIGNATURE AND STAMP OF NOTARY:
. State of Florida, County of Miami-Dade
Sworn and subscribed before me
This ..2.h..day. of ~1 . 20SX(
V;ignatu~~~
Notarization of Principal's signature
OFFICIAL NOTARY SEAL
LILLIAN BEAUCHAMP
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. DDl09289
'MY COMMISSION EXP. APR.29,2O(ll;
OFFICIAL NOTARY SEAL
LILLIAN BEAUCHAMP
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO, DDl092B9
MY COMMISSION EXP. APR. 9
FOR CLERK'5 USE ONLY /) I (J.
Annual Registration fee: [ ] Yes ~] No Amoun 'd ~~. 00 I MCR # .<.\()-\ q I\{ Date Paid
Lobbyist Registration Form received-and verified by:
Revised 02/10/04 F: CLER L - \[0 YIS1\LOBBYIST FORM 04
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