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Dougherty Lucia/1831 James LLC ..-: Miumi ~ " ZAlOJ ~ - - 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 prindpal 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 dty board or committee; or any action, dedsion 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 indudes the prindpal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: Greenberg Traurig BUSINESS NAME AND ADDRESS 305-579-0603 TELEPHONE NUMBER: Dougherty Lucia (Last) (Rrst) 1221 Brickell Avenue, Miami (Number and Street) (City) 305-961-5603 FAX NUMBER: A. (M.I) FL 33131 (State) (Zip Code) doughertyl@gtlaw.com EMAIL: I. LOBBYIST RETAINED BY: 1831 James LLC NAME OF PRINOPAL/CUENT: BUSINESS NAME AND ADDRESS 1831 James Avenue (Number and Street) Miami Beach (City) Florida (State) 33139 (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 OFACER, PARTNER, OR BENEACIARY: Carlos Oliveira . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: D. SPECIFIC LOBBY ISSUE: Variances Issue to be lobbied (Describe in detail): m. OTY AGENOES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Board of Adjustment / Historic Preservation Board Building Department Planning Department .. ~.~ ~~ ~.i ~ ~ 10'-< ~IH i8N~ !::l So ~ ~ ~ ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $480.00 Hourly B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $480.00 Hourlv 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": DYes 13 No: Are YOU lobbyinG on a Dresent or oendinG bid for GOods. eGuiDment or services. or on a Dresent or oendinG award for Goods. eGuiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes tJ No: Are you lobbyinG on a oendinG aDDlication for a DeyelODment AGreement with the City or aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use Mu1 3) Pursuant to Miami Beach aty 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-proflt 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 derk as required by this section but, shall not be required to pay any registration fees.. D Yes ~No: Are you reDresentinG 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 R COMPENSATION DURING THE REPORTING PERIOD. VI. 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 ion 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: LOBBYIST IDENTlFlCA o Produced ID Form of Identification '; Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This of...."" 20.0 , FOR CLE Annual Registration fee: p(J Yes [ ] No Amount Pai Lobbyist Registration Form received and verified by: . F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 . PRlNQPAL IDENTIFICATION: o Produced ID r:IJL 0 '//6 -003 ~7 -3~-o Form of Identification ! I o Personally known (Principal) g ~ ~ f ~i .. f ~2S!~ ! ~ J .t.. .~<t, i..- it ~~.... t 0... .. 'b-'\'t- 'S USE ONLY , ,...- !5 MCR tt2~1 '2-oate Paid -==t II J aD , I Revised 12/08/04