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Spencer Crowley / Silvia Coltra ~, ~ ~lj__ 'iiW to - ~3 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. c"ROWLS'-I f. ~tAX.U2- NAME OF LOBBYIST: (Last) (First) (1;1.1) GU.N~TY-fi-, YOMJ...x/Y '.7. $- er5CLLt4rJL "BIllet #3"00 fYlA.anU Pl.- BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 'S 3/3 } 2QS -31ft;-&05>J.. 3'J5'J7~- l,O{O ~uuwtetj @.~~ TELEPHONE NUMBER: FAX NUMBER: EMAIL: G<J~ I. LOBBYIST RETAINED BY: SU vLi;t CoUYaru- NAME OF PRINCIPAL/CUENT: 5D;S CoU-ins BUSINESS NAME AND ADDRESS :3iJS - g(,p& -7707 TELEPHONE NUMBER: AvuLUL- t!,;( 3{Jq f}'Uinu t!:uacn. (Number and Street) (City) (State) oOS. ~(p !/Sqif PL 3~j(/o (Zip Code) 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 BENEFIOARY: . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: m. CITY AGENOES}INDMDUALS TO BE LOBBIED: A) Full Name of Individual}Title B) Any Financial, Familial or Professional Relationship r) ,JOAJt --< :0 , , m !JOAJ e- rr; (') -",-' CO rn ;..: V) :e.. <' :JC: rn r:; /"oJ 0 I"f1 W .... . IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $/-.00. /J1) cpu hOl.U' ~ )1)0. IV p.eA hruJ'v Y 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Artide VII. Division 5 Thereof Entitled "Campaign Finance Refonn" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camcaign Contributions BY Lobbyists On Procurement Issues": Yes 2) Pursuant to Ordinance No. 2003-3395 Amendioo Miami Beach atv Code Chaoter 2. Article VII Division 5 thereof Entitled "Camcaian Finance Refonn", Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaign Contributions BY Lobbyists On Real Estate Development Issues": Yes V. SIGNATURE UNDER OATH: I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the pro~ons C ntaQ' ion 2-482 of the Miami Beach City Code and all reporting requirements. I Signature of lobbyist: yo.....- Signature of Principal/Client: VL LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Fonn of Identification Fonn of Identification V Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: Personally known (Principal) JI"'"- State of Aorida, County of Miami-Dade Sworn to and SUbscribed~Ore me d ThiS~ay of = .20<:1 ~ h ~~~6'~- .-/ Signature of Public Notary - State of Florida Notarization of lobbyist's Signature State of Florida, County of Miami-Dade Swom and subscribed before me This _day of . 20_ Signature of Public Notary - State of Aorida Notarization of Principal's signature ElmIER SANTANA RJEHT1;S ~ lit COMMISSION' DO 321816 EXPIRES: Aupl7, 2008 --HoIoIy-- FORe Annual Registration fee: ] Yes [ ] No Amo nt Lobbyist Registration Form received and verified by: Revised 02/10/04 ;~1?Z?r~Paid . ~ 10/07/04 11:39 FAX 3053766010 GY"S.P,A -- ,... lilJ003 N. DISQ OSURE 01' 11!RNS AND AMOUNTS OF LOBIYISr COMPINSA11ON (DI!lCLOSE WlIET1lBl HOURLY, FlATR~n;OR OTHER): A) lOBBYIST DISQ.OSURE: (..,1.-1) $~OO." tPU" hoc.ur . B) PIUNOPAl'S DiSClOSURE (OP LOLlSYIST COMPENSATION): (Required), I> )./)0." -pv. h.rvJ-v YB ~ :.:,;u .._Mina a nM-for-anlflt mmoratlon or entity ~ -III mm-.tion or _ bu_ nt. Pursuant to OrdinilllCl8 No. 2004-3435. . Pursullnt to orcInancle No. 2003-3393 Amending MIami Beach Cll.v pxIe Chepter 2. Article vn. OMsion 5 Thoueof Entitled "CamDBlan Finance Reform- Via lhl! Addition Of l""nrio> Section 2-488 EntltIBI"Prohi!l!!m pomoaign Contributions By lDbbyislS on Proalrement Issues-' 1) YIII ~ 2) YIII 0 V. Are VQU lobbvlna on a o_t or HI'Idin, bid for ao". eoulan.nt or ....;...... or on a _nt or aendina awanl far b.....&. ttauiDment or service? Pursuant to Ordinance No. 2CI03-33tl5 Amendina Miami - at.v Cade Chaoll!r 2. ArtIcle vn OMSon 5 ~reof Entitled "OImDBiqn Rnlll"a Reform-, Via The Additicn Of CedI! c;..mon 2-490 EnlltlBl"ProhlbllEd CAmpaign CDnbibutions By lobbyists On Real E~ DoMllooml!f1t IS5llllS": . Are YOU IobIIvino on a -.dina alldllcation for. Dev8loament A_1IIIIIlt with... CitY or , . ,'. . apaliG1tian fIw dill".. at Bmina maD dl!BianatiOl1l Gr dlange tD the Cltv's Futull! Land U- MaD' " "- , I do solemnly swear that all tit the foregoing facts are true and correct and that I 'hilVl'l read or am famll,iar with the p~nlaQ on 2-482 of the Miami Beach CIty Code.and all reporting requirements. Signatun!l of lobbyist: ........ Signature tit Prindpal/Oient: SlGNAlUllE UNDER OA11t: ON OCTOBI!R 1~ OF EADf Y!AR, EADf LOUYJST StW.L SUBMIT TO THE CITY'ClERK'A SIGNeD 5I'ATEM!!NT UNDER OATH, USTING WIlBY! ND AS WELL AS ..COMPI!NSAnON REClI!1Vl!D,'IN 1M!!.QTY 01' MlAMI,II!AOf gING DAR YEAR:.;;~;srAT-EMI!NT, SHALL BE FILI!D EVEN II' 1MERE HAVE BEEN nuRl!SOR NSA11CiJN DURING''THE REPORTJNG'PERIOD. .:''1'';" VL LOllIlYIST miN1IFlCA1ION: ProduO!d ID Form rJ lden1lllcatlon V Personally Icnown (Lobbyist) VII. 5IGNA1URI! AND STAMP OF NOTARY: State r:l F1orldll, County of Milll'Tlt.-Dade Sworn to and S\bScribe<! befOre me This ~ day of ~ .2Ot?-!j ~h~~"'~I.r-7"..... ,., S"IgJ1iItUA! of Public Notary - Stilw r:l Aorida NotiIIrization of Lobbyist's signatln ____R8IIIi$ MY'1al'lnl!BlGHI 00 32lI18 ElCPtIlES: -.. 7,_ --.,.,.,- PIlJNCIPAL IDBnD'lCATION; Produced ID j Form of 1dentIflcatlon Pel'liOl1illlv known (Prlnclpal) ,'J"':'~" ...' RJR CLEIUC'S USE ONLY Annual Rl!Qisll'lltlon fH: [ ] Yes [ ] No Amount Paid MCR It Om PiIid lDllbViSl: Registlillion fann rt!Cl!ived and W!filied !IV: RevISed rIZ/I0/04 1': CL!R\All\MARlA-M\108llYIST\LOB8YIST FORM D4