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Bob De La Fuente/BoyMelgreen lD Mimni B.,iId1 1lll!I) 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, 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 .LobbylstsW has specific exclusions. Please refer to Ordinance 2004-3435. de.. lib Fv.e..JJf'L {{Db NAME OF LOBBYIST: (Last) (First) (M.l) Levu..!) Ie /'Ielree~ Wt.f {'Ie-e/I lieS~,h/P5o /l1/~",. f-l- .n BUSINESS NAME AND ADDR S (Number and Street) (City) (State) (Zip Code) 3D5 :171 '7;).l{(p 305 s71-9QIi>/ jJeJ""fl/Je~f-e. e hcyt>'le.l~ree,vduTl-/of~rs. TELEPHONE NUMBER: FAX NUMBER: EMAIL:' C- ';) M I. LOBBYIST RETAINED BY: /3o~A~./ ~('ee,.J NAME OF PR CIPAljCLIE : {)eve/~eC-5 wes t ftJe AJ ~ e- L1L BUSINESS NAME AND ADDRESS 5.35 JY7/a-l'1i f] eo.ck (Number and Street) (City) FL (State) 33/3 9-630~ (Zip Code) TELEPHONE NUMBER: 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 BENEFICIARY: S j,(L.'/ r;. B~ y 1'1 e/ g ret!/O/ . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: 5 h (}... If ~ Eo y 1'1 e.-I 9 r e OJ ~ uc ~ er- Des'~,J R.~i;e."; 8ct>1' . fp'NVt>' for II. SPECIfIC LOBBY,ISSUE:.. 1/ f';" I'c. e.s' P, ilL ~c..e 'Ct/ll""tf~ e- Pr,t(\''''''' fof\ S~-rb4-c"- Q. J .. . f'_,~ ~",""J<:,,,,~ CiJlP"" vA-l r;tJ. /kill}. 'f reloca.hv'</ Issue to be lobbied (Describe in detail): . r:)o.r o;f. /tJj1l.5+M'</.' f"1' a. 7/ey rd.Cc.f,,,. III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship ('e. &f/ '1" ,.hJ .( 11 '{7 ~o O~T-26-2004 TUE 04:48 PM FAX NO. P. 03 '"" IV. DISClOSURJ; Of TeRMS AND AMOUNTS OF lOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): S~/ltry A) LOaaYlSi DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ensation or Yeli 1) Pursuant t.o ordinance No. 2003.3393 AmendlnCl Miami Bead1 City Code Chapter 2, Artide VIl, Qjvision 5 Thereof Entitled "CampaiQn Finance Reform" Via The Adgltlon Of Code Section 2-488 Entitled ~Prohibited CamoalCln Contributions By Lobbyists all Procurement Issues": Are YOU lobbvinq on a present or Dendina bid ~~r :oods. eouiDment or services, or on a present or Dendlnq award for aoods, eauiDment or service? Yes 6J 2) Pursuant to Ordinance No. 2003.3395 I\ltl~ndino Miami Bel'lr:h Clt:v COde Chaoter 2. Article VII Division 5 thereof Entltlp.r1 "C:aITlD~lcm..ElDance Reform", Via The Addition of Code Section 2-490 EntltlP.d "~r.cblbltP.d Camoaion Contributions By I ohhYIst&.Q1J Real Estate Development Issues"' V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBI!IYIST SHALL SUBMIT TO THE CITY CLERK A SIGNEO STATEMENT UNDER OATH, LISTING LOBBYING l:XPIONDITURES, AS WELL AS COMPENSATION RECEIVED, IN THi CITY OF MIAMI BEACH FOR THE PRECEDING CAl.ENOAR YIiAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAV!'! BEEN NO EXP 0 ES OR COM PEN" N DUIUNG TliE REPORTING PERIOD. )( I do Solemnly swear that all of the foregoing facts are true and correct and familiar with the provisions talne In Section 2-482 of e Miami aeach City requirements. SignabJre of I-obbyist; SIgnature of Principal/Client: VI. LOBBVIST IDENnflCATION: o Produced ID I)(,ProducedID ,\)'\\\l\'N>. L\'r~I""~ ~ Form of Identification Form of Identification .~ersonaIlY known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: ~ Personally known (Principal) State of Florida, COunty of Mlami-oade Sworn to a subsaibed befO~ me This dflY of rJt,. to (JII; 20121f FORe Annu~1 Reglrttiltlon fee: [ es [ ] NO Amount P I.obbylst Registration Form I'llcolved and verified by: Revised 02/10/04 F: C Signature of Public ry - State of Florida Notarization of Principal'lll s1gnatu€\'tl "LLi' M\LSH; New'iorl< ,.. ublic Slate 0 Notat'/ ~ 0","\6026590 '" 7 ,,0. ...' n~ COUll., 0 aualified in I',n.;:;;,. 11.. 20 ~- . . on EltP\f.S comm\S~\ *;cit # 2--7 ? K? Roaee Paid