Stewart Stewart/Deco Echo
Mi.'1mi Bt';>th
tdlr:d
W
~UJ
m
-
-
City of Miami Beach Office of the aty 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, reconvnendation of the
Oty Manager or any city board or cO''lRuittee; or any action, decision or recon.merldation of any city pefSOld!1 during the time
period of the entire decision-making process on such action, decision or reconvnendation that foreseeably win be heard or reviewed
by the city GOmnlission, or a city board or GO....littee. The term spedficaIty indudes the principal as well as any employee eng;IgtJd
in lobbying activities. The term -Lobbyists'" has spedtic exclusions. Please refer to 0nInance 2004-3435.
57eiUa%C SLe~vL
NAME OF LOBBYIST: r (~~ (Arst) (M.I)
C-e.rr~ ~ ~ '</ (~ f.2i;L
BUSINESS NAME AND (Number and Stleet) (Oty) . (State) (Zip Code)
30) -S- 3 <1- ~()7 CFCAWVfAL$ @ AoL,CeJ/Lf
TB.EPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
.-:DecO echo Am<;tslDe/~a:hi)J1 d/6/Q.. Cen~erGr (i;1k:-+- Com.mun,"',..1 ArT
NAME OF PRINCIPAlJQ.IEN: /' v
/~D HI~a-rt av.P-. "?rl1~'l3eqcQl (2_ '53/39
BUSINESS NAME AND ADDRESS (Number and Street) (Oty) (State) (ZIp Code)
305-53'1- tj~'01 3DS-S3'F-Lfo~( CFcA~UR.IfL~ €?t1oL.(ol-{
TELfPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
fill out this section if prlncipBI is a Corpondion, Partnership or Trust [Section 2-482 (e)] AJ III
. 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:
n. SPf....... ~C L08BY ISSUE:
~tMi: ~1J-'fIk-o~Cdr~1~~rub~J
Issue to be Iobbled ( in detail): '
m. an AGENClES/lNDMDUAL5lO BE LOBISIED: ?' "j /A
A) Full Name ofIndlvidual/11tle B) Any Financial, IWniIiaI or PI~~onaI ReIationsbtp
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAllON (DISClOSf WHETHER HOIJIlLY,
FLAT RATE OR OTHER):
A) LOBBYIST DI50..OSURE: (Required) - 0-
B) PRINOPAl'S DISClOSURE (OF LOBBYIST COMPENSATION): (RequIred). '- 0
The following information must be answered:
1) Pursuant to MIami Beach Oty Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
o Yes (~: Are YOU lobbYina on a Dr' ... or IM!IAdina bid for nIWVIc eauiDment or servi---- or on a
oresent or aendina award for aoods. eouioment or service?
2) Pursuant to Miami Beach Oty Code 2-490 Entitled "Prohibited CampaIgn Conbibutions By Lobbyists On Real
Estate Development Issues":
DYes~: Are YOU Iobbvina on a aendina :annliraHnn for a DeveloDment Aareement with the Citv or
aDoIlcation for chanae of zonina mao deslanatlon or chanae to the Cltv's Future Land Use
MHZ
~ Pursuant to Miami Beach Oty Code 2-484 (h) AiPf person (except those exempt from the definition fX
V "lobbyist'" as set forth in Section 2-481 above) who only appears as a representative fX a not-for-profit
corporation or entitv without special CXlfI'lper15ati or reimbursement for the appearance, whether direct, or
indirect, to express support fX or opposition to any item, shalt register with the dertc: as required by this
section but, shall not be required to pay any legistration fees..
IYM D No: Are YOU NDr---....-- a nat-for-arafit ~ or 8IItitv without _bol camlUllftCltiftn
or refmbunement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER lsr OF EACH YEAR, EACH LOII8Y1Sr SHALL SU8NIT TO THE an a.ERK It SIGNED
STATEMENT UNDER OAnt, LISnNG LOBBYING EXPENDITURES, AS WBJ. AS COMPENSATION
RECEIVED, IN THE an OF MlAMlII!ACH POll n~CM!NIMR Y!AR.]IE~T!MEN~rr
SIW.J. BE FD.ED EVEN IF 1HERE HAVE IIEEN NO lIB OR ~. fIG THE
REPOIUlNGPERIOD. -=- ~ _
" SIgnature of Lobbyist
I do solemnly swear that aU of the foregoing facts are true and correct and that I have read or am
~ u.. ~ ~,"---~2-482~~ndaeam Cty r aM ~I reJXXting
Signature of Lobbyist: /~~ ~L.J ~
Signature of Principal/alent:
VI. LOBBYIST IDEH1JFICAllON:
~Produced 10 r L ~L
Form fX IdentIfication
PRINCIPAL IDENTlFlCAllON:
o Produced 10
o Personally known (LobbyIst)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identlflcation
o Personally known (Principal)
State d FIorid8, County d Miami-Oade
Sworn and subsaibed before me
This_davof .20_
Signature fX PubIlc Not.aIy - State d Florida
Notarization of Princ:ipal's signature
Annual Registration fee: [ ] Yes [ ] No
Lobbyist Registration Fonn received and verified by:
F:\a.ER\$All\MARIA-M\lobbyist\lOBBYIST fORM OS.
Date Paid
(0 3--6J
Revised 12/08/04