Office Depot, Inc.
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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 modlflcatio(1 of any ordinance, resolution, action or decision of any cDmmissioner; 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 6uch action, decision or recommendation
that foreseeably will be heard or reviewed by the dty 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.
Gonzalez Alfredo J.
NAME OF LOBBYIST: (Last) (Fifst) (M.!)
1221 Brickell Avenue Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (Oty) (State) (Zip Code)
305-579-0588 305-961-5588 gonzalezaj@gtlaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAlL:
I. LOBBYIST RETAINED BY:
Office Depot, Inc.
NAME OF PRINOPAL/CUENT:
c/o Nick Roth 2200 Old Germantown Road
BUSINESS NAME AND ADDRESS (Number and Street)
Delray Beach
(City)
Flofida
(State)
33445
(Zlp Code)
561-438-0519
TELEPHONE NUMBER:
561-438-0498
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out this section If principal Is a Corporation, Partnership or Trust [Section 2-482 (c)]
o NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
Edward Costa
o IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
Publicly Traded
II. SPECIFIC LOBBY ISSUE:
Sign Variance
Issue to be lobbied (Describe In detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Planning and Zoning Department
City Commission
Board of Adjustment
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $250.00 HOURLY
B) PRlNaPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $250.00 HOURLY
Yes t.::) ~:~~ reDresentlna a not-for-DrofIt corooratlon or entity without soecial comoensatlon or
t:bU ___ Pursuant to Ordinance No. 2004-3435.
1)
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach otv Code ChaDter 2. Article VII. Division 5
Thereof Entitled "Camoaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
~~::~::i::t::S B::::: pr:r::::::
I a nd I . eaulDment or services. or on a Dresent
or oendlna award for aoods. eaulDment or service?
yesQ
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaian Rnance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Campaian Contributions Bv Lobbvists On Real Estate Develooment Issues":
Yes ~
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V. SIGNATURE UNDER OATH:
ON OCTOBER 1 sr OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITU S, AS WELL AS COMPENSAnON
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECED CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEN IT S 0 PENSAnON DURING THE
REPORnNG PERIOD.
LOBBYIST IDENTlFI
PRINCIPAL IDENTIFICATION:
Signature of Lobbyist:
.,I Signature of Principal/Client:
VI.
Produced ID
Produced ID
~
~dpal) ..)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn and subscribed be~e
This ~ay of f\)o-J~ (' 20...Q ~
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Signature-orPublic Notary - State of Florida ")\..\\ Ij(!\- (l-~J
Notarization of Prindpal's signature
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Annual Registration fee: [~[ ] No AmFO n C~
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER
N:~~73?O) OatePaid 11-;)9-D~
RIA-M\LOBBYIST\LOBBYIST FORM 04