HomeMy WebLinkAboutRobert Fine / Mangos Tropical
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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 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:
Fine
(Last)
1221 Brickell Avenue
(Number and Street)
Robert
(First)
Miami
Florida
(State)
S.
(M.I)
33131 .
(Zip Code)
BUSINESS NAME AND ADDRESS
(City)
305-579-0826
TELEPHONE NUMBER:
305-961-5826
FAX NUMBER:
finer@gtlaw.com
EMAIL:
I. LOBBYIST RETAINED BY:
Mango's Tropical Cafe, Inc.
NAME OF PRINCIPAL/CUENT:
900 Ocean Drive
BUSINESS NAME AND ADDRESS
305-673-4422
TELEPHONE NUMBER:
Miami Beach
(Number and Street) (City)
Florida
(State)
33139
(Zip Code)
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
David Wallack
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
Same as above
U. SPECIFIC LOBBY ISSUE:
Conditional Use and Violation
Issue to be lobbied (Desaibe in detail):
DI. CTY AGENaES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Planning Department, Fire Department
Zoning Department, Planning Dept.
Mayor/City Commission/City Manager, Special Master
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL)j
FLAT RA TE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required)
$420.00 Hourly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 4 2 0 . 00 Hour ly
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
o Yes ~No: Are YOU lobbyina on a Dresent or Dendina bid for aoods, eauiDment or services, or on a
Dresent or oendina award for aoods, eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes:tfflo: Are YOU lobbyina on a oendina aDDlication for a DeveloDment Aareement with the City or
aDDlication for chanae of zonina maD desianation or chanae to the City's Future Land Use
Mu1
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be requirecl to pay any registration fees..
DYes 6rNo: Are you reDresentina a not-for-Drofit corDOration or entity without sDecial comoensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING 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.
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Signature of Lobbyist
VI. LOBBYIST IDEN11F1CATlON:
o Produced ID
o Produced ID
Form of Identification
Form of Identification
~rsonallY ~F1e..A (PriRaipill)J.Uiil ',IWlIl.J '*<l-' , '._.:~~
J' NAT:^ I IE COR4,i::U'"',':' /, \: ~
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, NO'TPJi",/ PUBLIC" STATE, 0" F, f,;'L,l,)RIDA ,1
C ....." .. .1" C'I ....... .. --..... 1"\2 4:3 ~ ' ~
State of Flori a, pS;ountY '~bi1i~mi:~d~. " ,. "',.l~^: j('~~ 2001:: '
Sworn and s " ""', ....t. re.....me ',", -' lV.r\'t';.,' ;)
T is =1--day of 2
]\personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This S~ da 20~
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FOR CLERK'~SE ONLY ~. g ~
Annual Registration fee: [ ] ~ ] No Amount Paid -Z ,01> MCR ~10 Date Paid /- ,
Lobbyist Registration Form ~ved -and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04