Brian S. Adler/PLC Investments
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, Fl. 33139
Email: cityc1erk@cLmiami-beach.f1.us
LOBBYIST REGISTRATION FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
D Check Box if an Amendment
Adler, Brian S.
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: (Nurnber and Street) (City) (State)
(Zip Code)
(305) 350-2351
TELEPHONE NUMBER:
(305) 351-2206
FAX NUMBER:
badlerralbilzin,com
EMAIL
L 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)l
. 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/INDIVIDUALS TO BE LOBBIED:
B Relationshi
\76040\21542\ # 688506 vI
8/24/044,13 PM
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE
WHETHER HOURLY, FLA l' RATE OR OTHER):
A) Lobbyist Disclosure: $325.00 Der hour
B) Principal's Disclosure (of Lobbyist Compensation): $325.00 per hour
1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2, Article VII, Division
5 Thereof Entitled "Campaign Finance Reform" Via The Addition of Code Section 2-488 Entitle
"Prohibited Campaign Contributions By Lobbyists on Procurernent Issues":
Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or
pending award for goods, equipment or services? 0 Yes X No
2) Pursuant to Ordinance 2003-3395 Amending Miami Beach City Code Chapter 2, article VII, Division 5
thereof Entitled "Campaign Finance Reform" Via The Addition of Code Section 2-490 Entitled
"Prohibited Campaign Contributions By Lobbyists on Real Estate Development Issues":
Are you lobbying on a pending application for a Development Agreernent with the City or
Application for change of zoning map designation or change to the City's Future Land Use Map?
DYesXNo
V. SIGNATURE UNDER OATH:
ON OCTOBER 1st OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF
MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear thaI all of the foregoing facts are true and correcl and that I have read or am familiar with the
provisions contained in Sec. -482 fthe Miami Beach City Code as amended, and all reporting requirernenls.
Signature of Lobbyist:
Signature ofPrincipallClienl:
VI. LOBBYIST IDENTIFICATION:
Form ofIdenlificalion
&ersonallY Known
o
Produced ID
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
Statc of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 5'h gay of Aug ., OMA
/$*i', C1tRISTlNEA. BOWER
!"!,,J,,'\:, MY COMMISSION # 00 344021
~i.~"i!i EXPIRES: February 20, 2006
'IJ.FIf..f:\"'- BoodedThr\iPicl1ardlnsuraooeA/jltnr::y
rLN\4.~
of Publi1f.OjS,y - State of Florida
n,l\ M. . tl rJIJ-
Print, slamp or type name of Notary Public
Registration Accepted
If rejected, state rcason: /'
Registration fee paidUYcs [ ] No
~ /3 ()
I
[ ] Rejected
FOR CLERK'S USE ONLY
Date: f., hi:> { bLf
/1 ~
[ ] Cash f...J'C'heck MCR# ~ 2'-('"
,-zou:r ENTERED BY: ~/
V
F:\CLER IRA TL \Lobbyislslregislralion03 .doc
DATA ENTRY DATE:
2nd Revision 1/27/03
FILE NQ.667 08/17 '04 18:07
ID:BILZIN,SUMBERG
FAX:30527475!)3
PAGE 3/ 4
IV, Dl~CLOSURE Q}' TER:'VIS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE
WHETHER HOURLY, FLAT RATE OR OTHER):
A) Lobbyis! Disclosure, $325.00 per hour
B) Principal'; Disclosure (or LobbyLS! COlllpemation): $325.00 oer hour
I) PUlsuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2, Article VII DiviSIon
5 Thereof Entilled "Campaign Finance Reform" Via The Addition of Code Section 2-488 EnMe
"Prohibircd Campaign Contributions By Lobbyists on Procurement Issues":
Arc you lobbying on a present or pending bid for goods, equipment or service., or on a present or
pending award for goods, equipment or services? Cl Yes X No
2) Pursuant to Ordinance 2003-3395 Amending Miami Beach City Code Chapter 2, altlele 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"
Arc you lobbying on a pending application for a Developrnent Agreement with the City I>r
Application for change of zoning map designation or change to the Citfs Future Land l st: .\1ap'!
::'YesX '\0
V. SIGNATURE Ul'OOER OATH,
ON OCTOIIER 1st OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURE'S IN THI: CITY OF
MIAMI BE.\CH FOR TIlE PRECEDING CALENDAR YEAR.
J do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the
provisions ccntained in See. -482 fthe Miami Beach City Code as amended, and all reporting rcqllircmeIlts.
Signature ur Lobbyist:
Signature of Principal/Client:
VI.
LOBBYIST IDEXfIFICATION: Ra. D(U.4S L..~;'
/'ProducedlD N(j.G-~j.o' 1.<1). r(~. <')0<<"/
Form ofIdentification
Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: .
State ofFlonda, County of Miami-Dade
Sworn to and subscribed before me
TlilS 5'" gay or AllOust 2004.
"JI''II!k:.. CHRISTINE A. BOWER
/1/,/:;:\;, P.! COMMISSION # DD 344021
~'~.~.f EXPIRES: February 20, 2006
"'''i.Fif.~"f..., BoodedTllruPichaldlnsuranceAlJ8nC1
. ;~tate JfFlorida
~---- ---Z'- -. FOR CLERK'S USE ONL V
Registration Accepted r ] Rejected Datc:#':P.___
Ifrejected, slate reason: ~_ / __~__~__
ReglStrallon tee paid l~-!,} ~~~ [ ] Cash [y-Clieck MCR# n_____
DATA ENTRY DATE:.--!df-2!2--.J{iJJif ENTERED B _____'_
2r.d Revision 1/27/03 F:\CLER\HA TL\Lobbyisu.\registrationOJ.doc