Alfredo J. Gonzalez/David's Cafe, Inc.
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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.
Gonzalez Alfredo J,
NAME OF LOBBYIST: (Last) (First) (M.l)
1221 Brickell Avenue Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zi P Code)
305-579-0588 305-961-5588 gonzalezaj@gtlaw,com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Dawid's Cafe, Inc,
NAME OF PRINCIPAL/CLIENT:
David's Cafe. Inc. 1058 Collins Ave. MB FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-672-8707
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:
Alfredo Gonzalez
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
Alfredo & Maria Gonzalez
II. SPECIFIC LOBBY ISSUE:
Approval of David's Cafe Project
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
Planning & Zoning Departments
-:\ ';,
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Board of Adjustment! Historic Preservation Board
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) ).}C)A.J ~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required),
/Jove..
.
Yes
nsation or
1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2, Article VII. Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaion Contributions Bv Lobbvists On Procurement Issues":
Yes
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":
Yes
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECE ING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEND RES OMPENSATlON DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are tru and orrect and that I have read or am
familiar with the provisions co tained in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobby' :
LOBBYIST IDENTIFICATI
PRINCIPAL IDENTIFICATION:
VI.
Produced ID
Produced ID
Form of Identification
Form of Identification
Personally known (Lobbyist)
Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before lJ1e
This /c:;. dayof do7voT, 20~''l''
.L V-?/~
Ignature of Public Notary - State of Florida
Notarization of Lobbyist's signature
R""" a'\ Bertha Hundevadl
. ~ . My CommisIion DOMl2llll
'\or ....1 Expires October 22. 2007
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This / (, day of4v I u.vl-, 2OQ..<1
~~~ /-?--?~
Signature of Public Notary - State of Florida
Notarization of Principal's signature
.i'j' Bertha Hundevadt
,.... j My Commission D02412811
or" Expires October 22. 2007
FOR CLERK'S US ONLY ~ / / .
Annual Registration fee: [ ] Yes [~O AmOl)!1t Paid ! MCR # 2-? J B8~ Date Paid <6 I? Jtf
Lobbyist Registration Form received and verified by/.J! . I '
Revised 02/10/04 F: CLE \ALL\MARIA-M\LOBBYIS1\LOBBYIST FORM 04