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Carter McDowell/PLC Investment City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miami-beach.flus LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) D Check Box if an Amendment McDowell, Carter N. NAME OF LOBBYIST: (Last) (First) 8/5/04 (M.I) DATE QUALIFIED AS LOBBYIST 200 South Biscavne Boulevard. Suite 2500. Miami. Florida 33131 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) (305) 350-2355 TELEPHONE NUMBER: (305) 351-2239 FAX NUMBER: cmcdowell@bilzin.com EMAIL I. LOBBYIST RETAINED BY: PLC Investments. Inc. NAME OF PRINCIPAL/CLIENT: 420 Lincoln Road. Penthouse, Miami Beach, Florida 33139 BUSINESS ADDRESS: (Number and Street) (City) (state) (Zip Code) (305) 531-5220 TELEPHONE NUMBER: (305) 531-5280 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: . . LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST II. SPECIFIC LOBBY ISSUE: Parking and zoning issues related to 420 Lincoln Road Issue to be lobbied (Describe In detail): III. CITY AGENCIES/INDlVIDUALS TO BE LOBBIED: B Relationshi \76040\21542\ # 689325 vI 8/24/044:12 PM IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RATE OR OTHER): A) Lobbyist Disclosure: $400.00 Der hour B) Principal's Disclosure (of Lobbyist Compensation): $400.00 Der hour I) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2, Article VII, Division 5 Thereof Entitled "Campaign Finance Reform" Via The Addition of Code Section 2-488 Entitle "Prohibited Campaign Contributions By Lobbyists on Procurement Issues": Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods, equipment or services? D Yes X No 2) Pursuant to Ordinance 2003-3395 Amending Miami Beach City Code Chapter 2, article VII, Division 5 thereof Entitled "Campaign Finance Reform" Via The Addition of Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists on Real Estate Development Issues": Are you lobbying on a pending application for a Development Agreement with the City or Application for change of zoning map designation or change to the City's Future Land Use Map? DYes XNo V. SIGNATURE UNDER OATH: ON OCTOBER 1st OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT U]'(DER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. Signature of Lobbyist: effect and that I have read or am familiar with the ode as amended, and all reporting requirements. I do solenmly swear that all of the fore provisions contained in Section 2-48 f t Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: [I Produced ID Form ofIdentification ~OnallY Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Sworn to and subscribed before me This It" gay of August, 2004. l~'~~ ""~.., '~' ...' . .: ;'.,;#. . CHRISTINE A. BOWER MY COMMISSION # DD 344021 EXPIRES: February 20, 2006 BonciIl:lThruPlchlrtllf\lUlBrlll9Agl11't;y Registration ~ed FOR CLERK'S USE ONLY [ ] Rejected Date: g /30 I ntj I / If rejected, state reason: Registration fee paid DATA ENTRY DATE: [ ] Cash [ "2())<{ ,-- eck M CR# ENTERED BY: 2nd Revision 1/27103 F:ICLER IHA TL ILobbyistslregistration03.doc FILE No.667 08/17 '04 18:0? . . ID:BILZIN,SUMBERG FAX:3053747W3 PAGE 4/ 4 IV. D1~CLOSURE OF TERMS A-'ID AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURIS, FLAT RATE OR OTHER): A) Lobbyist Disclosure: $400.00 per hour.. B) Principal'> Disclosure (of Lobbyist Compensation): $400.00 ""r hour 1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapler 2, Article VII, Division 5 Thereof Entitled '.Campaign Finance Reform" Via The Addition of Code Section 2-488 Entitle "Prohibited Campaign Contributions By Lobbyists on Procurement Issues": Arc you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods, equipment or services? [] Yes X No 2) Pursuant to Ordinance 2003.3395 Amending Miami Boach City Code Chaplt'r 2, arbcle VII, Division 5 thereof Enbtled "Campaign Fmance Reform" Via The Addition of Code Section 2..490 Entitled .'Prohibited Campaign Contributions By Lobhyists on Real Estate Development IsslJ~s" An' you lobbying on a pending application for a Development Agreement with the City or Application for change of zoning map designation or change to the City's Fulure Land be Map.! IJ Yes X No V. SIGNATURE UNDER OATH; ON OCTOllER 1s1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE crT\: CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBY1:'11G EXPENDITURES IN TIlt: CITY OF MIAMI BE.\CH FOR THE PRECEDING CALENDAR YEAR. Signature of lobbyist: . orrect and that I have read or am familiar with the ode as amended, and all reporting requirements. I do solenmly swear that all of the fore . provisions contained in Section 2-48'1 f t Signature of Ptincipal/Client:._ VI. LOBBYIST IDENTIFICAT-WN:....... I . ~ NO.. ufll/trH./cu_ cr . Produced \[) C,"'O.'~ 1.. I(~. fDo'f Form of Identification }'crsonally KJ10Wn ....~~'w' Ii<~'."j'..~'" ~'\-' ~,~:! ~ ..;..;ii.. .Rf"f;\" tary - ~tate .)f Florid" Registration r ~kd Ifrejecled, state rea.son: /' Registration fee paid U"\'es [ 1 No DATA ENTRY DATEnSf3.) :2"d Re,.ision 1/27/03 FOR CtERK'S USE ONt Y [ ] Rejected Date~ /30j0y- / ' [ ] Cash [Y-Check MCR# ~D!.f ENTERED BY: F: \CLER\H A 'I'L \J..obbyist~ \rcgisr,atitm03 .do<-'