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Vilarello Alejandro/El Ad Group ~-, ... w .. Oty of Miami Beach Office of the Cty Cerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM lobbyist means II persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modlftcatlon d any ordinance, resolution, action or dedsion d any commlssloneri any action, declsIon, recommendation of the ety Manager or any city board or commlttee; or any action, dec:Islon or reconmendation of any dty personnel during the time period d the entire dedsIon-maklng process on such action, decision or recommendation that foreseeabiy wi be heard or reviewed by the dty commission, or I city board or convnittee. The term spedflcally Includes the principal as well as any employee ~ In lobbying ac:tfvltles. T1Ie term ..~ hu spedftc uc:IuslOllL PIeue refw to Ordlna~ 2004-3435. VILARELLO ALEJANDRO NAME Of LOBBYIST: (Last) (First) ONE S.E. THIRD AVENUE, 28th FLOOR, MIAMI, FLORIDA BUSINESS NAME AND ADDRESS (Number and Street) (ety) (Mol) 33131 (State) (Zip Code) -:tn~_-::a".d._~&:.nn TELfPHONE NUMBER: ":In-;_":l'"1A_a::Olj)a:: FAX NUMBER: EMAIl: L LOBBYIST RETAINED BY: EL AD GROuP FLORIDA, LLC NAME OF PRINCPAl/OlENT: I~ 10 CuJ~LAl BUSINESS NAME AND ADDRESS J{L, ~~K (Number and Street) (etY) (State) 3316<1 (21p Code) TB.EPHONE NUMBeR: FAX NUMBER: (OptIonal) EMAIL: (Optional) flU out th.. section If prIncI,.t .. a CorporatIon, Partn.-.hlp or Trust [SectIon 2....2 (e)) . NAME OF OiIEF OFfICER, PARTNER, OR BENEFICARY: . IDENTlFY ALL PERSONS HOLDING, DIRECTlY OR INDIRECTLY, A 5'Ml OR MORE OWNERSHIP INTEREST IN SUOi CORPORATION, PARTNERSHIP OR TRUST: Do SPIClFIC LOBBY ISSUE: BOARD OF ADJUSTMENT APPLICATION Issue to be lobbied (Desalbe In detail): m. CITY AGENCES/INDMDUALS TO BE LOBBIED: A) FuU Name of Indlvldual/nt:le I) Ally FInancIal. Familial or ProfessIon" Relationship BOARD OF ADJUSTMENT IV. DISCI OSUU Of TERMS AND AMOUNTS Of LOBBYIST COMPENSAnON (DISCLOSE WHnHEIt 1IDI/ItLy, flUT/IA,.,OIl D7HSl~ A) LOBBYIST DISC1OSURE: (RequIred) 8) PRINCPAL'S DISClOSURE (OF LOBBYIST aJMPENSATION): (R8qulred). HOURLY RATE HOfl~t.Y Rl'm $~OO 00 The following Infonnatlon must be answered: ~) Pu to Miami Beach Oty Code Section 2-481 EntitJed "ProhIbited Campaign ContrIbutJons By lobbyists On rement Issues": . vou Iobbvlna on . DI esent or Deftdlna bid for aoodtI. eaulDment or..-a-. or on . -"" or aendlna _rei for aood&. lIOulDment or ..vb? 2) ~~ Code 2--190 EntItled -Prohibited Campaign Contributions By LobbyIsts On Real DY_ LI ~ AnI!~ ~ob~ln9 on' . Dendlna .DDI1atlon for . DeveloDll'lent Aoreem8ftt with the CItv or .DDlatlan for chanGe of zonlna maD dBlanatlon or chanae to th. Cltv's FutuI'l!lLand Use HIIlZ 3) Pursuant to Miami Beach CIty Code 2-484 (h) Arrf person (except those exempt from the deftnltlon of -lobbyist" as set forth In SectIon 2-481 above) who only appears as a representatfve of a not-for-proflt corpo or entity without special compensation or reimbursement for the appearance, whether dIrec.t, or IndI to express support of or opposition to any Item, shaH register with the derfc as required by this but, shall not be required to pay any regtstrat:ton. fees.. or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EAOI YEAR, EACH LOBBYIST 5tW.L SU.M.JJ-~ a.ERK A SIGNED STATEMENT UNDER OATH, LJSTING LOIIYING EXPENDIllIIdS, AS COMPENSAnON RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREelDING YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPpeDm MPENSAnON DURING THE REPORTING PERIOD. I do solemnly swear that aU of the famlllar with the provisions contained requirements. SIgnature d lobbyist: Signature d PrindpalJO PRINCIPAL ID VI. LOB8YIST IDENTlFlCAnON: o Produced m Form of IdentIfIcatIon ~Personally known (Lobbyist) Form of Jdentfftcatlon VD. SIGNATURE AND FORa.E~ISE.ONLY ,M? ~~ ~ Annual Registration fee: [ Yes [ ] No Amourt~ PIIcI o6V to, 27(,~ "r0 Date PaId 01' I..Ilbbyfst RegIstration Fonn received Ind verll'Ied by: _ _ F:\O..ER\$AL1.\MARIA-~B8YIST fORM O5.doc RevIsed 12/08104