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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 -Lobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435.
Dougherty Lucia A,
NAME OF LOBBYIST: (Last) (First) (M,I)
1221 Brickell Avenue Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-579-0603 305-961-5603 doughertyl@gtlaw,com
TELEPHONE NUMBER: FAX NUMBER: EMAlL:
I. LOBBYIST RETAINED BY:
LG 94, LLC,
NAME OF PRINCIPAl./CUENT:
LG 94, LLC,
BUSINESS NAME AND ADDRESS
94 LAGORCE CIRCLE,
(Number and Street)
MIAMI
(City)
FLORIDA
(State)
33140
(Zip Code)
786-208-2113
TELEPHONE NUMBER:
305-538-4302
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c))
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
TOOD GLASER
IDENTIFY ALL PERSONS HOLDING, DIREffiY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
TOOD GLASER AND ALAN L1EBERMAH
II. SPECIFIC LOBBY ISSUE:
BUILDING & ZONING ISSUES
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
BOARD OF ADJUSTMENT
PLANNING I ZONING DEPARTMENT
FIRE DEPARTMENT
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $ 4 6 5 . 00 Rou r 1 y
B) PRlNOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), $ 4 6 5 . 00 Hour 1 y
. h
1)
~rs:nt to ~rdi~n,: No. 200~-3~9~ Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5
e f Enti led " m Ian Finan e efi rm" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoai9n Contributions Bv Lobbvists On Procurement Issues":
nt
2)
::~~n~ t~ ~inan: No, 2003-3395 Amendina Miami Beach aty Code Chaoter 2. Article VII Division 5
e f n it! "Cam ion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions BY 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, USTlNG 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 PENSATION DURING THE
REPORTING PERIOD.
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:
Signature of Principal/CUe
VI. LOBBYIST IDENT
o Produced ID
Form of Identification
PRINCIPAL IDENTIFICAnON:
""\.. "Cc", \..;,,~
*rodUced ID <Q ~""t..\. -~ -\::,'\ -<:::> '\ '\ - '0
furm of Identification
~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
o Personally known (Principal)
State of Aorida, County of Miami-Dade
Sworn to and subscribed before me
This 2~ '\
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This G\. day of 20 0"\
1
...., I
FOR cLERK'ltUSE ONLY '/ '
Annual Registration fee: [ y-l'es [ ] No Amount Paid d ~. - ()() MCR #:?f 7 c~ JDate Paid
Lobbyist Reglstratlon Form received and verified by: (t.! .
Revised 02/10/04 F: CLER\ALL\MARIA-M\LOBBYISnLOBBYIST FORM 04
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