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Scott Mitchell/Stan Ray [t~OL ON XH/X~] 8t:91 NOW to/LZ/60 09/27/04 .O~ 15:18 FAX 3053786010 GY&S,P.A. ~002 W ~llS ~ City of Miami Beach OffICe of the City Clerk 1700 Convention Center Drive, Miami Beach, R. 33139 LOBBYIST RECISTRAnON FORM lotltJvlst meinS III pllt50nS employed or retained, wtII!ther IlIld or not. ~ I princlpil who seeks to encour.se the lNaage, det.. or modIfklbQl'l Of InY Qfd1naftCle, resolution, iICtSoo Cll' decision fA any cammiSsioner, '/IY action, clec5iCln, recommendation of the CIty Millagei' or illY city baird or committee. or in1 dlln, decision Ql' FlXlOmmet'ldallorl of any city f)4l'SOt1l'1e1 defIrwd In ."., milnner In this &ection. during the time period CII the entire decision-malclng p~ on Mh Ktiun, dadSlOl'l or recommendation that fareseeebIy wit be heItd or reviswcd by tM dty comml!llSiOn, or I clty ba'cI or commltalt. The term 5pcQfiClllI/y includes the pnndpal is Wllll as any lI~yee im!1fged in ICltlbylng KtMties. ftll f8rm .1.aIa~ INs spadfk: eKe'...n.. Pi.... rlller ..---..... (!JJ-c~e;LI Se;tt ~ NAME OF LOI8V1ST: . ( (first) (M.I) All out tlu. 1ec:tiDn if prlnciDIII is . Corpgr.doa, ,isllMrlhlp . nwt l....... 2-41i (c)J . NAME OF OIIEf' OFFIaR. PAI\TN(R, OR IEN!flctARY: . IDeNTIFY AI.I. PEAS0N5 HOLDING, DllUc:rLY OR INDIRECTLY. A 5' OA MOR! OWNERSHIP INTER!ST IN SUCH CO~TION. PARTNERSHIP OR TRUST: D. "Ea~.BJ ISSUI: I I tf~ Issue tlD be lobbied (Daaibe In deQil): IlL CITY AGEllaU/INDMDU"... TO 81 ..ceBIED: ! A) ,.,11 ....... 1II'lndl'fIclUllfnae ') Any ,....nciM, hmmel tM' ProfeAlIOMl Relati....lhip -( 7r. '.J Or.'nT nr.r.7 17 N~~ 7 J OOTC"COCO. Y'P.J ..,U I T ILl..... ~ In..,UAU [tZOL ON XM/X~] 8t:91 NOW to/LZ/60 09/27/04 ION 15:18 FAX 3053168010 CY.S.P.A. fiI 003 IV. DlSCLOS~E Of' TERMS AND AMOUNTS Of LOUVUT COMPIlfSATlOfI (DISCLOSI WHETHER HOUlfl Y, R.ATRATEOIC OmIR): ~ ') LClIIm51' _,.: 1_0) $ :l '1 0 ~ ~ f AI. 'S DISClOSURE (OF L08BYlST COMPENSATION): (...1Ntf) . 2 ~ I Pursuant to OrdInance Ito. 2aG"M1L o / IJ,,- , n 1) Pursuant tel 0nI..1KB 1iIID. ':HMd-!:193 Amending Miami .......'" CI:y Code ~ 2. Artide VIl. DilIlllan 5 Therecl !nHl'!.rl "Cam~jgn FiMl'lC8 Retorm- Via .". ~1tIcn Of COde S8ct1an 2-488 Entlded "fIrehibit8d ~ ;;':;;:'~=--"__."OD.'- 2) PUl9Jarl to DrdiMlUll No. aa~313g!!lAJ:nendln9 Miami Beach City COd. Chaotl!lr 2.. Artk:le VllDIvi&ian 5 __ ~:""'_. "",Tho _Qt~_ ,_ _ ............. .JJL{);~~~:'~~~=~;;~..~ V. SlIItA1U1lE UNDIEIt OATIl; ON OCTOIIIR s.'" OF EACH YEAR, IACH LOBIYU'f ..uLL STATlHlNT UNDER OATH, USTlNG LOIBVJNG IXII!N RBCI1VED, IN l1'II cnv OF MJ4MI IllACH FOR THE SHALL BE PILED EVIN IF THERE HAVE llEEN NO EXP RIPORTlNG "RIOD. I do solemnlv swear that all of the familiar with the provIsIons c:ontaln requirements. Signature d lobbyist: Signature r:I P!incipal/Oient: VI. LOa8YJST IDEJtI'I1lICATlON: read or am all reporting Produced to Folm fA ldenltt1cit1on ~~Y~(L~ VII. SlGNATUM AND STAMP Of NOTARY: Produced m ~rm dIQPV' ~CIlIy known (Pri';;;"" !tete of Florid., County or Miami-OlCle SworIJ.t~ ~bscrIbed me J'oU. ThIS:KLday of 2~ ~"'I'''' "Ii ..i "'~lIj.rA.IlIIII"J' " ., ....~a.._ ,.fc1(\\c- .-..-.....-- re te of Flcrlda Notarization of LoIIbyiat'. IIignMlon r-------- -, i Annuli Regt5trtt'ion fee: (~/ J No Amounr Lobbvtst I'egIl1r1tion Form rlC8ived and verified by: Revised 02/10/04 F: CL N~ a7:;)')~'1 ~..DiltO Paid 9'/2If/ D if .M\LOBBYIST\LOBBVIST FORM 04 ~O'd 80:vl VOO~ L~ daS ~L891SS8S8:xe~ ll::llIdtO NOll:::Iffl