HomeMy WebLinkAboutNeisen O. Kasdin/Gladisco USA
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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 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, dedsion or recommendation that foreseeably will be heard or reviewed
by the city commission, or a dty board or committee. The term specifically includes the prindpal as well as any employee engaged
in lobbying activities. The term "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435.
Kasdin
Neisen
o.
NAME OF LOBBYIST:
(Last)
(First)
(M.!)
Gunster, Yoakley & stewart, P.A., 2 South Biscayne Blvd., Suite 3400, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 376-6062 (305) 376-6010
TELEPHONE NUMBER:
FAX NUMBER:
EMAIL:
I. LOBBYIST RETAINED BY:
Gladisco USA, Inc.
NAME OF PRINCIPAl/CUENT:
410 16th Street, Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (aty)
(State)
(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}l
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
D. SPECIFIC LOBBY ISSUE:
420 Lincoln Road Site Plan Approval
Issue to be lobbied (Describe in detail):
m. CITY AGENCES/INDMDUALS TO BE LOBBIED:
A} Full Name of IndividuallTltle B} Any Financial, Familial or Professional Relationship
Historic Preservation Board
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
$400.00 Hourly
A) LOBBYIST DISCLOSURE: (Required)
B) PRINOPAL'S DISClOSURE (OF LOBBYIST COMPENSATION): (Required).
$400.00 Hourly
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":
D Yes "No: Are YOU lobbyinG on a Dresent or oendinG bid for Goods. eauiDment or selVices. or on a
Dresent or oendinG award for GOods. eGUiDment or selVice?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes rlNo: Are you 10bbvinG on a DendinG 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
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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-for-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 liNo: Are you reDresentinG a not-for-Drofit corDoration or entity without soecial 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, USTlNG 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 EXPENDI:rU OR COMPENSATION DURING THE
REPORTING PERIOD.
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 containe . Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VL
LOBBYIST mENTIFICATION:
PRlNCPAL IDENTIFICATION:
D Produced ID
D Produced ID
Form of Identification
Form of Identification
ci Personally known (Lobbyist)
D Personally known (Principal)
VII.
SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn a...nd sUbscr~ bef1. ore me _ ~~ KarwI S RuIz
This~dayof 'If . 20~ ! ~j MyComrniulonOO336llO
<:_~-~tW.< (. R.,-^t/ ~.,-:; ExpIrMAugulI31.2008
Signature of ublic Notary - State of FlOrida
Notarization of Principal's signature
Date Paid
FOR CLE
Annual Registration fee: Yes [ ] No Amount Pa'
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL \MARIA-M\Lobbyist\LOBBYIST fORM OS.doc
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Revised 12/08/04