Ricardo J. Dopico/ Estefan Tele
Mmmi 9t!~h
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to
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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 or~ance 20~-343S. 'I _
c!)oj)/c C), /.L, C &71J-e:k 'Ii'
NAME OF L9BBYIST: (Last)
~2-o ;j'~
BUSINESS NAME AND ADDRESS
0/3
(Number and Street)
(First)
fh- fl,'a~, J~L .l-L "J3/3j
( tate) _ (Zip Cod?
r L ~' t.. ~ c{2 e dt. ftv->. (On?
/;
FAX NUMBER:
EMAIL:
I.
LOBBYIST ETAINED BY: "\
EZTE 17 IF1C'Y'.hoor> I',
NAME OF PRINCIPAljCUENT:
;)t 3J/3?
(Zip Code)
'i )...0 V c -r:-f2S: C'J.r-) ft-rn u t:F
BUSINESS NAME AND A D ESS (Number and Street)
SO$" 695" 7~H
TELEPHONE NUMBER: FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (cll
NAr;)' OF CHIEF OFFICER, PARTNER, OR BENEF~IARY:
-.d /C0;J J::.. IJ.rn A 0 -e=o I' r /fJE~, Oe- v;-
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~. /' SPECIFIC LOBBY ISSUE: A /?
. YI-S/Tl9P :/ (!orJve.,..,.j;n '-0..e.?y 6p-~,..,j-
Issue to be 10bbiecf(Describe in detail):
II;Pf/P c<>-j"J
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
et1Jl'J ltoJ flu
33\ :UO S,;{dTlJ UI:J
Cl :21 Wd 1- flOM'10
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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). 0
ensation or
1) Pursuant to Ordinance No. 2003-3393 Amendinq 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
Campaign Contributions By Lobbvists On Procurement Issues":
Yes
2) Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaiqn Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaiqn Contributions By Lobbyists On Real Estate Develooment Issues":
Yes
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
~~ --eA ----- .q,-..'-- '"' }C
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
VI.
LOBBYIST IDENTIFI
>a
Signature of Lobbyist:
Signature of Principal/Clien
fkrA-orl
~ f'S, f.)~ ,Jr;-
. RINCIPAL IDENTIFICATION:
Produced ID
Produced ID
Form of Identification
~ Personally kno~bbYist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identification
C~ersonallY k~prin<:ipal)
..../
e of ublic N ry - State of Ronda
rization of Principal's signature
,,\~~~.~4;I.... Lori ~'. Sundermier
~:~.;=;,\:~;: Com~lsslon #DD 166525
"-.,;. '1l:~= ExpIres: Dee 23, 2006
....."~~oH~~':. Bonded Thru
"1/1111\' .o\IIIlflIIQ Ilgndin@Co..lne
FOR CLE.
Annual Registration fee: [ ] Yes [ ] No Amount P Id
Lobbyist Registration Form received and verified by:
Revised 02{10{04 F.
NLY
MCR # ,;2 7;;) ~("'Date Paid