Gambach Roberto J/Eduardo Botte
Mi;wni IIl:adl
W
l:lIU'
~
-
J
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 dedsion 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 proc:e$ 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 prindpal as well as any employee engaged
in lobbying activities. The term -I..obbyists'" has specific exdusions. Please ~ to Ordinance 2004-3435.
G.qf\"),t)ACt;f
NAME OF LOBBYIST:
et? Ij t:,~ r 0 J.
(Last) (First) (M.!)
AFZ.w/ rt.C-/~ I";(.~ ; J 3 z... ~~ t.t'Ah.?'p(,I;Z!>'e ;:SAY fjM~ :>:?J5 tJ
(Number an Street) (City) (State) I (Zip Code)
(:3(.'s)8~~- Cil?JI ~~ ~.~''">r\
FAX NUMBER: EMAIL:
GIJ (y)fbl) e.J-I
BUSINESS NAME AND ADDRESS
(::)/:7) yfvt; - <f7c10
TELEPHONE NUMBER:
I. LOBBYIST RETAINED BY:
f.VvA f<. 00 f 0IJJ{tz-
NAME OF PRINOPAL/CLIENT:
J 0 2.15 Cc, t.--L--/ !'vI ~
BUSINESS NAME AND ADDRESS
('?'cSl C;8.(P '~o 53'$
TElEPHONE NUMBER:
/fv' G IS:jo OA l ;JrJ~3>r..~(),'<.. F,- ':;;'3;$ J--
(Number and Street) (aty) (State) (2Jp Code)
C~<)S)8~'8.. Y~77 e.A('d-~~({!~~~
FAX NUMBER: (Optional) EMAIL: (Optional) }'1.
PlU out this section If principal Is a Corporation, Partnership or Trust [SectIon 2-482 (c)]
. NAME OF CHIEF OffiCER, PARTNER. OR BENEFIOARY:
. IDENTIFY AU. PERSONS HOLDING, DIRECTLY OR INDIRECnY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
n. SPECIFIC LOBBY ISSUE:
'7; I ~~ f} ~ I' ,4~ y I'J r..- g I ;;.. 7 G/2. e~5,;. rf /3 l- V () J 11'1 ;8
Issue to be lobbied (Describe in detail):
323/y~J
In. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
.J-'") G '71 ~;t/ i2;; v 'G wi ,-:,SCA rZ P
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FlATRATEOROTHER):
A) LOBBYIST DISCLOSURE: (Required) .J 1/C.l.(/N /> /# IJ f7...c.-l.IJT (., c r;.I;e.AL- ,ere f'
B) PRINOPAl'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
The following infot mation must be answered:
1) Pursuant to Miami Beach City Code section 2-488 Entitled "Prohibited Campaign Contributions By lobbyists
On Procurement Issues":
II
II
~<t <. D(~jO, ():.; )
1-,
1/ L 1> il t;i~f) O{;.)
D Yes l1I'No: Are YOU Iobbvina on a ore5ent or DelKlina bid for GOOds. eauiDl11ellt: or serviCles. or on a
DI'1!SeIIt or oendina award for aoods. .....,oment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign COntributions By lobbyists On Real
Estate Development Issues";
DYes ~o: Are ~ IobbYina on a aendina aDOlication for a Develooment AGreement with the CitY or
aDOl'cation for chanae of amino maD clesianation or chanae to the atv"s Future Land Use
!tiUiZ
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-fur-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..
D Yes INo: Are YOU reoresentinp a not-for-orofit COI"DOration or entitY without soecial comoensation
or reimbursement. .
V. SIGNATURE UNDER 0A11t:
ON ocroBER 1 Sf OF EAOI YEAR, EAOI LOBBYIST SHALL SUBMIT 10 THE 01Y CLERK A SIGNED
STATEMENT UNDER OAnt, US11NG LOBBYING EXPENDITURES, AS WEll AS COMPENSATION
RECEIVED, IN 11IE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHAll BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITU SO COMPENSAnON DURING THE
REPOIn1NG PERIOD.
{
......
I do solemnly swear that all of the foregoing facts are true and cx>rrect and that I have read or am
familiar with the provisions ~i i . n 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Oient:
"'U'P::~".
it}" :~~ DAVID BOERGER
~ ,J;} MY COMMISSION' DD 132722 Ii
~~. ~~~~ EXPIRES' ./lW.9..2OOb I'
L ....,.~f;}~'f.;.. BondedThru~~ly,.kn.
:"<ir',l.~,~",).... ~~ '
YD. SIGNATURE AND STAMP OF NOTARY:
PRINCIPAL IDENTIFICATION:
.p(roduced 10 FViJ t.. e. 300 - ).06 -~ er ,OCR .0
Form of Identification
VI.
LOBBYIST IDENTIFICATION:
State of Rorida, County of Miami-Dade
Swom to an~i~e me
This ~aay of . 200>
_red~
Notarization of . nature
r Personally known (Prindpa ..~~......:~. DAVID BOERGER
f*: :~ MY COMMISSION 1/ DD 132723
~.....~l EXPIRES: July 9. 2006
. ,P.r,.f1l" Bonded Thru Notaiy PullIic Unde!writers
State of Aorida, County of Miami-Dade
Sworn and~ubscribed before me
This ~ay of ^<>y . 200>
Annual Registration fee: ~'] No Amou
lObbyist Registration Form received and verified by:
F:\ClER\$AlL\MAAIA-M\l.obbyist\LOBBYIST fORM 05.
0Iida
I's signature
Date paldS If--{)(''
Revised 12/08/04