HomeMy WebLinkAboutCraig Smith / National Gay and
Ftli;wni 9~
bad
ifjP
.:iIU3
-
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRA nON 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, dedsion, 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.
NAME OF LOBBYIST:
5oufCe- f:.v~\-s
BUSINESS NAME AND ADDRESS
[~dO\J7tJro- q4Z-~
TELEPHONE NUMBER:
G"lN\.l )-k eN:>. \~
(Last) (First) -,
t<Q5 Nt. 2><61--~ Sf- 0 ?or~l fL 331~
(Number and Street) (City) (State) (Zip Code)
tJra ;~ ~~00tee 0>etA.rs I QOY'l\
(M.!)
FAX NUMBER:
I. LOBBYIST RETAINED BY:
;VcJ10Y1a-l ~-I and Lt!sb1'~V{ ~<fikForc..€
NAME OF PRINCIPAL/CLIENT: /
13Z-!) n1C<~~Ci-chv;eJrt? five- t1rs,oo tJ~t/vtCJf-crv1 Pt (D0f)S
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
C 1D'l.) Co? CJ c.. ~03 CJ!'{)bbl ~5'P--,J.kft.-.,k.td:ce\()f'9
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) I
Fill out this section if principal is a Corporation. Partnership or Trust [Section 2-482 (c)]
.
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: , _ _ I I
~.rles lCobbJlttS VJrc.ckr ot- ])evelOP~1
IDENTIFY ALL PERSONS HOLDING, DIRECfL Y bR INDIRECfL Y, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II.
SPECIFIC LOBBY ISSUE:
0- c:wJ-- II
III.
CIlY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B)
1)
Y- ~
2)
Y- ~
V.
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaign Contributions Bv Lobbyists On Procurement Issues":
Are YOU 10bbvinG on a Dresent or !lendinG bid for Goods. eGuiDment or services. or on a Dresent
or !lendinG award for Goods. eGUiDment or service?
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5
ttlereoJ_Entitled "Camoaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaign Contributions Bv Lobbvists On Real Estate Develooment Issues":
Are YOU 10bbvinG on a !lendinG aDDlication for a DeveloDment AGreement with the City or
aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD?
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CI1Y CLERK A SIGNED
STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITURES, AS WELL COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR EAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEN RES OR COMP SATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the for
familiar with the provisions contain .
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI.
oing facts are tru and correct and that I have read or am
ion 2-482 of e Miami Beach City Code and all reporting
LOBBYIST IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Lobbyist)
Annual Registration fee: ~ ] No A
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER
PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Principal)
r~'~."L''''I''~~''i
~ __WZ007 :
i ~.... BandId lI1nlugh l
: (1OO-4~2S41 FlalIdIt NalIIy Alan.. Inc. :
.....................................................
NLY SEi:"i ~ /--(..,_ 1_
MCR G . Date Paid ~
\MARIA-M\LOBBYIST\LOBBYIST FORM 04