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HomeMy WebLinkAboutCarter McDowell / 900 Collins J. Check Box if an Amendment (') C> -~ .::- :xl " 0 ~) rTl rn r r> () f-r"l m 71}; .r:- """" .......... <: 0') :Dl" ::I: 0 ~ rn '1 0 ...,., c.-, W f11 City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miarnl-beach.f1.us LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) McDowell NAME OF LOBBYIST: (Last) Carter (First) N. 12/04 (M.I) DATE QUALIFIED AS LOBBYIST 200 South Biscavne Boulevard. Suite 2500. Miami. Florida 33131 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) (305) 350-2355 TELEPHONE NUMBER: (305) 351-2239 FAX NUMBER: cmcdowell@bilzin.com EMAIL: I. LOBBYIST RETAINED BY: 900 COLLINS AVENUE. LLC NAME OF PRINCIPAL/CLIENT: 1434 Collins Avenue. Suite 200 Miami Beach. BUSINESS ADDRESS: (Number and Street) (City) FI (State) 33139 (Zip Code) (305)534-5664 TELEPHONE NUMBER: 305-534-5556 FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l ? NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Michael A. Stem, Rita Starr, and Ivor Hano Rose ? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Michael A. Stem, Rita Starr, and Ivor Hano Rose II. SPECIFIC LOBBY ISSUE: ~"R~ Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of IndividuallTitle B) Relationship MIAMI 841732.1 7319010200 12/13/043:28 PM . . . IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: $400.00 nib B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $400.00 nib 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 IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. at I have read or am familiar with the provisions tl all reporting requirements. Signature of Lobbyist: Signature ofPrincipal/Clie t: VI. LOBBYIST IDENTIFICATION: ~J~' Form of Identification ~ Produced ID X Personally Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK State of Florida, County of Miami-Dade Sworn to and subscribed before me This ~ day of~~ ,2004. FOR CLERKS USE ONLY rc- J 1-- 0 c/- Registration: [~TED REJECTED DATE: ri' -----/ ~Yes [] Cash DATA ENTRY DATE: I L.-rr:..U <.i 1 , Ifrejected, state reason: Registration fee paid: [] No [] Check , 200.i MCR~ /~td- S- ENTERED BY~ 1 First Revision - 05/17/02 MIAMI 841732.1 7319010200 12/13/043:30 PM JAN. -19' OSfTUE) 10:22 BILZIN SlJMBERG ET. AL P.002 (V. DISCLOSURE OF TERMS AND AMOUNTS Of LOBBYTST COMFENSATION (DISCLOSE WHETHER I10URLY, PLAT RA.TR OROTn~R); A) LOBRVlST DTSCLOSURE: (Requln::u) 8) PRlNCrPAL1S DISCLOSURE (Of LOBBYIST COM?ENSA TION): (Uequlred). Yes No: l' An: YOU rcnr~entin(! 11. nu('.for-lJrofit comm'atio" 01' enli~' without sl,eci:t' cnrnocl1sation or "timhurs~""ent. PursuanllCl Onlinancc No. 2004-3435, 1) PlIriiLlZlnt to Ordin.lnce No. 1003-3393 Amendin~ Milll11i 8~ch CitY Code Ch:rotel'1. Arricle VII. D1Vj~lon 5 ThcTCOr llil.led. IIC:~1)'loaiE'Tl r;"ancc Reform" Via The Addition OrCode Section ~-4B8 El1tltlc-d "Prohihited C;~~ f,onrrlbuliMS Bv r.C'\bbv\gl~ 01'1 Procurement lsslll::~I/: Yc~ Nu: x Are YOU lohbvint! em n Dfc!'cnt or Ilendin~ bid fill" f!ood.<i< cQuinment or !iervice!\, or or, :l.llr~ent or Dendine. award for good~. eauiDment or scrvicc'~ 2) Pursuant !i.) Ordin:lIIce NIl. 2003-3~9S AmendinE Mtami Bco.ch CilV Cod~ Chaoter 1. Article VII l1ivision 5 thereof ~ntltl~i.1 '"C:lmD~I~n Pin.",ce RcrMln". Via. The A(ldltion Of Code Sectiol1.2-490 flltitlcd "Prohibited Camo.ill.ml ~lribu[iQns f3v Lobbvis:ts On Reol Esl:J.[e Dc.:'JcloomC:!)f ls~uc!i~:: Yes No; x AI'e ,,"olllnbbvinf! nn a Dllndlne ;lPfllic11.ticm for:t OeveloDrn~nt Al!recment with,lhe City or ~Pl)ljcation frrr cl1ane,C! of ZOOiD/! nl:lp tlcsll!.\lation or ch4m~e to the Citv's Future Land U"e Man;! v. SIGNATlIRE UNDER OATH: ON OCTOB15R 1ST OF EACH YEAR, I3ACH L0138VIST SHALL SL'BMlT TO THE CITY CLERK SIGNED STATEMENT UNDER. OA.TH, LISTING LOBBYING liXPENDlTURTIS, AS W~LL AS';; P~NSATIOS RECEiVED, rN THE CITY OF MIAMl BEACH fOR THE PRECEDfNG CALENDAR YEAR. A ST:rgM ~T SHALL BE FILED EVEN IF THERE HA VB SEEN NO EXPENDITUR~S OR COMPENSATION DIJRlNCi T ~p TfNG PER D. SignutLlfe of Lobbyist: I do ~Qlemnly swear that i:111 ofthc rl.)r~BPJI1g ro.ct~ :lrc true::m con'ect :md th:1t I have rC~id or am familiar with the provision!:i con\ained in Section 2-481 at'the . JrBcachty Cod ~ d nIl rcporLing rcqUlrements. ..., .'. . . . . . _ . I . . ..'.......,~.. :~;>:>:: . . . , . ~ ~: \::::: ~ ~ ~ n: \ ~ ~ z '" :G m S ign:lrur~ or' Principal/Client: VI. LOnBYIST lDENTU'ICA TION: l:tRINCWAL IPI!:NTIFICATlON: /0 . Produced tn Form of Ldcntirictltion . perl>onal1y k.nown (Lobbyist) o Produced ro Form of {den titiclltion LJ Personally lcnov.m (Prlnc:ip:tl) Sr~~ll: l'lfFloridl.l, County ofMio.mj.D~\dc SWIm' to ~nd ~ub ribed before me Thi~ - of _, 10~. .......... ."....... . . ............... Sl:\te of Florida, COll'nlY of Mlarl"1l-D3dc SW(ll".' Jnd subscribed before me Tnis _ day of _._..__.,,20- . . . .. . . ....... ....4.......... ....1........... SI.E~m\lul.e ofPublJL: -r~O[~uy- Sr::l.lc orrlol~~'- ... ~ntart'at~nn orPrin~ipal's siC1\llturc . __ FOR ClERJ('S USE ONt y Annu:l1 Rcgl~lraljQn rec~ [ ] Yes (J No Amount Paid_. _ MeR #_....__ Dllte Pald _.._ LobbYl~t R~Sis[1"~tion rQr..~ recc\wd o.nd veriIied by__.__ .._,.__. Revllied 02/10/04 f: CLt:R.\ALI..\MAR.{A-M\LOBBYIS"I\LOBBYlS'r FORM 04 Mr"Ml~417n.1731l)1l102()O 1 ~/21/04 1\:27 AM