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Home My WebLink AboutPhilip Gosch / IHC/Miami Beach ..Jo;~r-.. 1;1.-.;:'1 b:C:d ~lfF m ..;:l..{lj - - 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 Of 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, dedsion, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any dty personnel defined in any manner in this section, during the time period of tile 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 LOBBYlST: Gosch (Last) Philip (First) A. (~U) Wvndham International , BUSINESS NAME AND ADDRESS 214-863-1102 Inc. 1950 Stemmons Freeway #6001, Dallas, T.K 75207 (Number and Street) (City) (State) (Zip Code) 214-863-1986 TELEPHONE NUMBER: FAX NUMBER: pgosch@wvudham.com EMAIL: 1. LOBBYIST RETAINED BY: IHC;Miarri Beach Corporation NAME OF PRINCIPAL/CLIENT: 1950 Stermons Freeway, Suite 6001, Dallas, Texas 75207 BUSINESS NA~1E AND ADDRESS (Number and Street) (City) (State) 214-863-1285 (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) FiJI out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Challenge to possible designation of Wyndham Miami Beach Resort Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Jorqe Gomez, Director of Planning None - William Cary, Director, Design, Pn servation and Neighborhood Planninq Dilv Thomas ~roney, Design and Preservation Manager - None 'is ion - None Hlstorlc Preservatlon Board - None Planning Board - None City Cmrnission and Staff - None City Hanager and Staff - None IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLATRATEOROTHER): A) LOBBYIST DISCLOSURE: (Required) salaried employee of Principal B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Sa 1 ad P.O PICp 1 oyee of Principal 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": D Yes Iii No: Are YOU lobbying on a Dresent or Dendina bid for aoods. eauiDment or services, or on a Dresent or Dendina 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 00 No: Are you lobbyina on a Dendina aDDlication for a DeyeloDment Aareement with the City or aDDlication for chanae of zonina maD desianation or change to the City's Future Land Use MaD? 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 required to pay any registration fees.. DYes Ji No: Are you reDresentina a not-for-Drofit corDoration or entity without sDecial comDensation 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. ~~ 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. ~~/ Signature of lobbyist: Y,.;;/(.4 Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: o Produced ID o Produced 10 Form of Identification Form of Identification ~SOnaIlY known (Principal) li Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: -""--)Cas DCt.J..lo. S State ofi=leride, County of rJtiemi Daae Sworn to and subscribed before me Thi~ 3\5\ day of-:ki"u.<>.r.. . 20ClS '--Y t \~ '-;f:,,"~ Signature of Public Notary - State of Florida Notarization of Lobbyist's signature 1i~i-a CwUlLS State of " County of ~'iu, "i Dade Sworn and subscribed before me This _day of , 20_ Signature of Public Notary - State of Florida Notarization of Principal's signature ..."'~~.'!:Yi ...'P..../h '-.<n\ IIW !)\NUMAI\ 4.,.7"l. i* ~"i 'lMMI~SI()Nt=X'P'JJG ' ,~,:>;..;...._~.~'ffr) ,.'-or, n 2')1.) .~~\ Date paicbf 1'/ f)J FORCLERK~ USE{)NLY Yfl Annual Registration fee: [ ] Yes [ ] No Amo n id J. /) ./)() MCR ~1. f Lobbyist Registration Form received and verified by,' F:\CL ~:,tl!',rl:.rUA.M\Le9b~L-6BIl'I'IS'f S. 0 Revised 12/08/04 IV. DISCLOSURI OfTlRMS AND AMOUNTS Of LOIIIYZST COMPI!NSATJON (DISCLOSE WHETHER HOl/RtY, FtATRA'TFOROTHER) A) LOIl8YIST DISa.o5URE: (R~ulred) B) PRlNOPAl'S DISClOSURE (OF LOBBYIST COMPENSATION): (Required), Salaried euployee of Principal !;;o';",iF'i'l ""1p''W'"'' of Principal The followlnlllnfonnatlon must be answered: 1) Pursuant to Miami Beach Oty Code SectIon 2-488 Entitled "Prohlblted Campaign Contributions By lobbyists On Procurement Issues": n Yes Ii No~ Are vou lobbvina an a Dl"e!Ient or aendina bid far Goads. .auIDm.nt or .tv'eeL Dr on a Dresent Dr Dendina BWltrd for aoods. eaulDment or AlI!I'Vla? 2) Pursuant to Miami Beach oty Code 2-490 Entitled "Prohibited Campaign Contributions By lobbyists On Real Estate Development Issues": DYes ~ No: Are vou lobbvlna on II aendlna .Dalk-atton for a DlIl!!velomnent AOl"I!ement with the Cltv or aDDllcatlon for chanae of zonino maD deslonatlon Dr chanae to the Cltv's future Land Use Hul 3) Pursuant to Miami Beach CIty Code 2-484 (h) My 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 relmbursement for the appeararn;e, whether dlrea, or Indlrea, to express support of or opposition to any Item, shall register with the derk as required by this section but, shall not be required to pay any registration fees.. o Yes ~ No: Are vou I1!lDresentlna a not-for-aroflt mraoratlon or entltv without medal mmaensatlon or reimbursement. . V. SlGNATURI! UNDEROATlt: 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 COMPENSAnON RECEIVED, IN THE CITY Of MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILm EVEN If THERE HAVE BEEN NO EXPENDITURES OR COMPENSAnON DURING THE REPORTING PERIOD. ~ ~ 591atul1! 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 5ectlon 2-482 of the Miami Beach City Code and all reporting requirements. ~~/ Signature of lobbyist: 7U.4 ~ Signature of PrIncipal/alent: . VI. LOIBYIST IDENTJI'lCATJON. PRINCIPAL IDIN11F1CATJON. ~,\\I\llIllItllllll l\"~!C:. ~. ROBIN, ~"~ ~~~~~yp(jiJi~^ ~ .~~*v"... ~ ~ l , 'i ~\ ;.p1~ ~ -. ">;.,,.... . . E.. "- . "7~c Of . ~ ~ ....f.XPIR~.... ; ~ ...~ ~, ~'l '2.7-_' ~,,~ 111111"flli"\\\\~ o Produced m DProducedID Fonn of Identification )( Personally known (lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: ...~ in.U... s State of JiIerIde, County of iIllDmI Bade Sworn to and subsaibed before me This. 3\st" day of-:lo.",""<,, 20~S \....k l \~-. ~I"k__\. -..-n.l_- Signature of Public Nolilry - State of Florida Notarization of Lobbyist's signature Fonn of Identification ~rsonally known (Prindpal) FOR CLERK'S USE ONLY Annual Registration fee: [ ) Yes [ J No Amount Paid MCR /I lobbyist Reg1stratlon Form reCl!lved and verified by: F:, lelIb\'IIlI.l.etllWlil' OS.doc 1"11' 'AIllUMM ......, . "MMI~!:.I{lN r::(P!~63 I Dale Paid Revised 12/08/04 ., .(1(', ;:" 1'-,':