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Neisen O. Kasdin/E.D.Y. Inc. ,.. />1i.."..,; 9c",ch b*d mr .;WQ3 lD --- - 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 Oty 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 dty commission, or a city board or committee. The term specifically includes 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: (Last) (Arst) O. (M.!) Kasdin Neisen Gunster, Yoakley & Stewart, P.A., 2 South Biscayne Blvd., Suite 3400, Miami, FL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 331 31 (305) 376-6062 (305) 376-6010 TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: E.D.Y. Inc. NAME OF PRINCIPAL/CLIENT: 1051 Washington Avenue, Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (305) 538-2273 (305) 538-5309 TELEPHONE NUMBER: FAX NUMBER: (Optional) (State) (Zip Code) EMAIL; (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] . NAME OF CHIEF OFACER, PARTNER, OR BENEAOARY: . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: n. SPEOFIC LOBBY ISSUE: Temporary Parking Lot 1155 Collins Avenue Issue to be lobbied (Describe in detail): m. CITY AGENOES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Planning Board Planning Department City Managers Office ,. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $400.00 Hourly $400.00 Hourly 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Otv Code Chaoter 2. Artide VIT. Division 5 Thereof Entitled "Campaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaign Contributions By lobbYists On Procurement Issues": Yes 2) Pursuant to OrdinanO! No. 2003-3395 Amendina Miami Beach Otv Code Chaoter 2. Article VIT Division 5 thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaian Contributions By Lobbvists On Real Estate Development Issues": Are u lobb i on a i a lication for a Develo nt A reement with the C' or aDoIication for chanae of zonina maD desianation or chanae to the CitY's Future Land Use MaD? SIGNATURE UNDER OATH: Yes v, ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL 5UBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CA R YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES PENSATlON DURING THE REPORTING PERIOD. I do solemnly swear that all of he foregoing facts are true and correct and that I have read or am familiar with the provisions i eel in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of lobbyist: Signature of Principal/Client: Produced ID Form of Identification PUNap~I~R~~TION: Produced ID ----k4---- Q \~ ,., Form of Identifi ion VL LOBBYIST IDENTIFICATION: Personally known (Principal) VII. AND STAMP OF NOTARY: (. \ NYDIA R. MARTIN MY COMMISSION # DD 031308 EXPIRES: July 17, 2005 Bonded ThN Notaly Public Unde!wflt8l$ NYDIA R. MARTIN MY COMMISSION # DD 031308 EXPIRES: July 17, 2005 Bonded ThN Notaly Public UndtlWf1ltfl Annual Registration fee: [~NO Ani Lobbyist Registration Fonn received and verified Revised 02/10/04 ONML~ ~~te Paid \MARIA-M\LOBBYISl\LOBBYIST FORM 04 __~=r