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Home My WebLink AboutMarin, Steven/Recreational D&C ~ ,.'niT' .- . j m fJ,... '''')1 U,. ~t t, :UIJ:. - 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. ~i:'//) ~J.pt'^ NAME OF lOBBYIST: (last) (First) (M.!) , _ :;I:B;;r I BUSCI:2s~~~NDi.~ffA<' ~tu~~~~s~r~ IYJ/CIC- (f:!e) 3~i:cl)7 ~~ <:1-7/ ~~~ -.=:?~C" q7/_~ 7/ J --5"1n~dla..~irvtAAJ.<'(Ar\.S.~ TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINE;ZY: J2~~kPd\.. ~A Ai NAME OF PRINCIPAL/CLIENT: ' I. ,~--.:s::/q A ;. (I~A$~oeh~~ 1 9 /. .3 0 BUSINESS NAME AN ADDRESS (Number and Street) q-.scJ'-~h ~$;>~~ TELEPHONE NUMBER: (City) 9<:' ~l de4?- ~ 3 6... c: FAX NUMBER: (Optional) EMAIl: (Optional) ill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (c)] . ~M~ OF CHIerf'FFICER, PARTNER, OR BENE'flTIAR.Y: jV\J~ l~~, \I~lj'teS"~ . IDENTIFY All PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OW;r::SHIP INTEREISIN' SUCH CORPORATION, PARTNE SHIP OR TRUST: 5 - \ L ~ ~'C~~ I S~ ') \tel-" Je~) ( \r---B ~( SPECIFI~ LO~Y ~SSU~ -3 OL-Q. 0 II. ~ r~ (?~~~ddr~f'..--.... ~V-P~"-- Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: ',) 0 t U1 ;tJ ..- ~ -0 rn ....- <- B) Any Financial, Familial or Professional Re~loniMp /A~ /) .t:'" (") 0 rn A) Full Name of Individual/Title ~ n IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLATRATEOROTHER): . ., . ~ ' A) LOBBYIST DISCLOSURE: (Required) -i... I OtJ[) ~ 00 ~ f./. ~~_ B) PRINCIPAL'S DISCLOSURE (OF LOBBYISTCOMPENSA110N): (ReqUired).$ fooD ~ y-1';l'tl. " 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 0 No: Are vou lobbyinG on a Dresent or DendinG bid for Goods. eGUiDment or services. or on a present or DendinG 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 0 No: Are you lobbyinG on a DendinG aDDlication for a DeveloDment 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 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-far-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 0 No: Are YOU reDresentinG 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. -V ~_.. .~ 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. ~~ "X- Signature of Lobbyist: ~ ~ Signalure of PrincipaVClienl: (. . . (." - VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ! I Produced 10 Ii Produced 10 Form of Identification ~allY known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: OFRCIAl NOT MY SEAl IVffie PINTO nature of Public Notary - State of Florida Notarization of Lobbyist's signature Signature 0 Ie" 0 ry State of Florida Notarization of Principal's signature FOR Annual Registration fee: [' es [ ] No Am Lobbyist Registration Form received and verified by: F: \CLER\$ALL \MARIA-M\Lobbyist\LOBBYIST fORM ~~~ ON~~? 7h G, cf; Date Paid Revised 12/08/04 " M'-lINdl 'W !IiIW Ir\....i./.'.... ........'....... ~ - City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 A-fY) (...A. * - LOBBYIST REGISTRATION FORM Lobbyist means all per~~~tained, 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 "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. /f)~~/) ~/~-er-- NAME OF LOBBYIST: (Last) (First) (M.I) . t-f / / ht r~ f f r- ~rlJ /2//\~-5cr~ ~ /Ifll-. <;:"<:;s:--~')I/7'~ ~~ 33(7"7 BUSINESS NAME AND ADDRESS '(Number and Street) (City) (Sta e) (Zip Code) TELEP~MBERr7( 8~"::>- F~~R: '17/37 /1 -S~~~/()a{^~~ I. LOBBYIST RETAINED BY: NAME OF PRINCIPAL/CLIENT: () o --I U1 .~ (~ode:)i"J :~ m :~ 4::) BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) C) TELEPHONE NUMBER: FAX NUMBER: (Optional) r' EMAlL: (Optio~~ ~~ -.I m . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: a " ..." Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] .&- ~ 0 IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: . II. SPECIFIC LOBBY ISSUE: p(}ll'~ (u/\ c; J~ { (I" Issue to be lobbied (Describe in detail): .-,- \ j S ~lJ6J III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship HI] y:/r )Ju (~i\I1ll-1l>iV^ );6 )' 40-fP )JJ IV. · DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, ~ F/jI\ T RATE OR OTHER): , i " /), "_ ~ A) LOBBYIST DISCLOSURE: (Required) * I, DC, fj i'" (0 ~O, \ 11 {> r-.9i ~ 1 ~ 1 { ~, (UW\~ V w.d 6. f ~ B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Yes No: Are YOU reDresenting a not-for-Drofit corDoration or entity without sDecial comDensation or reimburse~ent. Pursuant to Ordinanc~(No.-,20Q4"1343S. 1) . PLrsuant to Ordinance No. 2003-339~'A1nendina Miami Beach Citv-i!6deOlaoter 2. Mide VII. Division 5 Thereof Entitled "Camoaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes No: Are YOU lobbving on a Dresent or Dending bid for goods, eauiDment or services. or on a Dresent or Dending award for goods. egUiDment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Artide VII Division 5 thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaian Contributions Bv Lobbyists On Real Estate Develooment Issues": Yes No: Are you lobbving on a Dending aDDlication for a DeveloDment Agreement with the City or aDDlication for change of zoning maD designation or change to the City's Future Land Use MaD? V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTlNG LOBBYING EXPENDITURES, AS WELL AS COMPENSAllON 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 REPOI<J1NG PERIOD. ~ .~r '.~ ~ 1...,,,"- - '. 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~f the Miami aeach -Gity-Gode and all reporting ::=e:~~bI"st~, ~----- c Signature of Prlndpal/Cllent: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID / Form of Identification lA'ersonally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: Produced ID Form of Identification Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This _day of . 20_ Sign No rc~ obbfM'iFMPatil .... ~ COMMI~ION NUMBER ~ ~ 00087452 (:'0 O(f. MYCOMMISSIONEXPtAES F FI. FEB. 11 ,2006 'da Signature of Public Notary - State of Florida Notarization of Principal's signature ,/ '. . FOR CLE Annual Registration fee: ~ ] No Amount Paid Lobbyist Registration Form received and verified by: Revised 02/10/04 F: CLER'I,P; \M ON;~ # 27 b J, 0 Date Paid i/2 -!a{ \LOBBYIST\LOBBYIST FORM 04