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Safar, Gaston/Miami Beach LLC Hi::! 31 05 11:02a Gs 6172673686 p.2 ~ MI.;'!miiJ~l'h b:ttd fijjf.' ~uUJ m ..... City of Miami Beach Office of the City Clerk 1700 Convention Center Drivel Miami Beach, Fl33139 LOBBYIST REGISTRATrON FORM Lobbyist means all persalls employed or retained, whether paid or not. by a prlndpat who seeks to encourage the passage, defeat or modifiGllion of any ordinance, resolution, actIOI1 or deds!cn of any commissioner; any attion, decision, recornTlcndation of the City ~lanagcr or any dty board or Commiltee; or any actlon, dedsion or recommendation of any city personnel during lhe time period of !he entire decision-maktng precess on such action, decision or recommendation that roreseeallly wiU be heanl or reviewed by the city commission, or a city ooard or comnliltee. The term speclrlcaUy Includes the prlnclpal ilS welf as any employee (!~ in lobbying activWes:. The term "lgbbyists~ has specific; eXduslon"l, Pleasa rlilfor to 01lfillllllee: 2004-34.):;. NAME OF LOflSYlST: 2 South Biscayne BUSINESS NAME AND AOOR1;SS KASDIN NEISEN (I.,)st) (FI/'St) Eoulevard, Suite 3400 Miami, (Number and Street) (City) (305) 376-6010 FAX NUr~BER: (M.l) FL 33131 (State) (Zip Code) nkasdin~gunster.com EMAll; (305) 376-6062 TELEPBONE NUMBER: L LOBBYIST RETAJNED 8Y: Safar, Gaston NAfolE OF PRrNOPAl/OlENT: Miami Beach, LLC SUSlNESS NAME AND ADDRESS 132 Newberry Street (Number and Street) (City) (617) 267-3686 FAX NUMBER; (Optional) Boston,}~ 02116 (State) (Zip Code) gastonsafa~earthlink.net EMAIl: (Optional) (857) 891-4262 TaEPHONE NUMBER: Fill out this section It principal is a Corporation, P:ll'tnership or Trust [Section 2-482 (en NAME OF CHIEF OFF1CER, PARTNER, OR BENEFlOARY: Gaston Safar IDENTIFY ALll'ERSONS HOLDING, OIRECTt. Y OR INDIRECll Y, A S% OR MORE OWtlERSHlP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR iRUST: Gaston Safar 60~; Alexander Safar 10\; Noelle Safar 10~: Allison Safar 10~n Stephane Safar 10%. II. SPECIFIC lOBBY ISSUE: Dis ute regarding access across a city parcel. Issue to be lobbied (Oesalbe In detail): ID. crrv AGENOES/INDIVICUALS TO BE LOBBIED: A) Full Name of !ndividual/Title 8) Any Finanda', Familial Or Professional Relatlonship City !>lanager No Plamling Board No - M;~ 31 05 11: 03a ~ ..,~ . "0 _., ~ .~ .;:'; ~ .....~ ~ eo :z'sl.....tJ 0.51 O:z >-3!loa z Cf.I "a.lQl 8 .(fWC= >-!,!!~.. -:;;. ..% '>:J. .~ :>.. 's ~oE-g .:900'0 o~l,.) ~ :<::- co .i'~~"":':~I~ ::~ ~ =;, ~ \~ ~~.. ~",",;"~"",, Gs 6172673686 IV. DISCLOSURE OF TERMS AND AMOUrnS OF L08BYIST COtolPENSATION (DXSCLOSE WHETHER HOURLY, FLATRATEOR OTHER). A) lOBBYlST DISCLOSURE: (Required) Hourly - $400. 00 a) PRlNCI?AL'S DISCLOSURE (Of LOBBYIST COMPENSAllON): (Required). $400 - 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 Issuesn: n Yes rxNo: Are yOU lobbvinCl on a pre....ent 01" pendin9 bid tOI" C1oods. eouipment or services. or on a present or pendinCl award for C1oods. eQuipment or service? 2) Pursuant to ~1iami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development rssuesn: '':Yes ;<; No: Are YOU Jobbvina on a pendinq aD plication for a Development Aareement with the City or aoplication for change of zoni"" map desiCl"ation Dr ch<tnae to the City's Future Land Use MaD? 3) Pursuant to Miami Beach City Code 2.4&; (h) Any person (except those exempt from the definition of ~robbyist" as set forth in section 2-"lB1 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 derk as required by this section but, shall not be required to pay any registration fees.. n Yes Tl No: Are YOU reprcsentinQ a not-for-orofit corporation or entity without special compensation or reimburs.!l!!lJm.!;. V. SlGNATURE UllDER OATH: ON OCTOBER 1ST OF EACH YEAR. EACH LOBBYIST SHAU. SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTJNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT StiALL BE i".!.UiD fliEI1i if crieR!; nAVe BeEN NO fXPENDITURES/lli! ;=OtPfNSATION DURING THE REPORTING PERIOD. f II JI V I . Signature of Lo byist 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 contained in Sectio 482 of the I\1lami Beach City Code and all reporting requirements. Signature of Lobbyi::;l; Signature of Prlndpal/Client: VI. ___..-.r.::..,: ~--~ LOBBYIST IDENTIFlCATION: PRINOPAL IDENTInCATlON: :J Produced to _ Form of IdenUfication ~ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: C Produced 10 Form or Identification ;: Personally known (Principal) State of Florida, County or Miami'Oade Sworn and subscribed before This ~day of "'^ O;:S- \ .- /. &-;Y?/Z--?;"// ~ ". ..;'7;/7/):.4"~ Signature of PubRc Notary - Stale 0 - - Notarization of Principal's signature o SI ature of Public Notary - f Notarization of LobbyiSt'lf . \ I - .... ).. FOR CLE~.IJSE ONLY 'I Annual Registration fee; l )<JJYes [ J No Amount P(.id~.:s HeR #:2..~C lobbyist Registration form received ilnd ven1ied by: a I.::--S' ! F:\CLEIl.\$All\MAIl.Lo\-M\loObyist\LOB:lYIST roRM 05.W I Revised 12jOS/0i p.3 $:() ~: 0 ()~ O~ s:o :s::z cn::E (./)mzOO. 6~O~ 2"'-4>2 :Tl::I:::I)O XO-<m ~"Tl""O;D ;D~cen m~CJ- OOen'Z ooooe> z~ ::I: .....0 o::I: -c l\Jen ~m ~=J 000