Robinson, Randall/Mark Weithorn
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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 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 dty 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 dty board or committee. The term specifically indudes the
principal as well as any employee engaged in lobbying activities. The tel11l "Lobbyistsn has specific exclusions. Please refer
to Ordinance 2004-3435.
~bin~n 'Kclrdall
NAME OF LOBBYIsT: (Last) (First) r;{ll 0 -' ~ I ~ '&1-" -# 310 (M.I)
NOrlVl ~~f\(' H ~vel Of)Y)lf n-r- {{(JV~, .
BUSINESS NAME AND ADDRESS reNumber and Street) (aty) I
- ~ 06-. 05-80
TELEPHONE NUMBER: FAX NUMBER:
c.
rn Il\m, n::ft- Ii n
(State)
3314"1
(Zip Code)
t1CYIW'UI~Au1 . lV''!)
EM
I. LOBBYIST RETAINED BY:
JYUit \De.MO V ()
NAME OF PRINCIPAl./CUENT:
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (C)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEACIARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
~1v'fl (\ t- (\ nn \ i lcrhOv'l 'WI( \J c f+
~belncletail): ....
III. CITY AGENCIES/INDIVJDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
~CPr
t-00Nt'
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER "fOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
~~e
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). \'-.JOt0e.
1)
D Y~~O:
2)
DYes ~o:
V.
Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaion Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
CamDaion Contributions Bv LobbYists On Procurement Issues":
Are YOU lobbyinG on a Dresent or DendinG bid for Goods. eGuiDment or services. or on a Dresent
or DendinG award for Goods. eGuiDment or service?
Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code ChaDter 2. Article VII Division 5
thereof Entitled "Camoaion Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoai9n Contributions By Lobbvists On Real Estate Deyelooment Issues":
Are YOU lobbyinG on a DendinG apDlication for a DeyeloDment Aareement with the City or
aDDlication for chanae of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD?
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTlNG LOBBYING EX~NDITURtS,"')S WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR. THE pftEc~6ING ~ENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITlmES 0 COMPE ATION DURING THE
REPORTING PERIOD. . i.. ...
!
I / Signa of Lobbyist
;a~O.m:I~~~I~h~:~V~~~:~~ta~~?O~~2reof t eu::~_~~~rre~ha~~~h~~d~ ~a:: :~ar~;rt~n~
requirements. ___~+
i
Signature of Lobbyist:
_.~
---
VI.
Signature of Principal/Client:
PRINCIPAL IDENTIFICATION:
LOBBYIST JDENTIFICAnON:
o Produced ID
o Produced ID
Form of Identification
~OnallY known (Lobbyist)
Form of Identification
~rSOnallY known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
FOR CLE
Annual Registration fee: [./] Yes [ ] No Amount Paid
Lobbyist Registration Form received and verified by:
Revised 02/10/04
State of Florida, County of Miami-Dade
swo1c;~ subscrib fore me r-
This "\':ij , 2~
Signature of Pu
Notarization of Principa
, a\. I Pinec18
! ~ . My CommISSIon DD285722
"\!~ Exptres February 08. 2008
,,"'" a\. I Pineda
o ~ 0 My CommiSSIOn DD285722
"\-;.,:,,/ Expires February 08.2008
r
Date Paid ..s /20 /C:E;;
R\ALL\MARIA-M\LOBBYIST\LOBBYIST FORM 04