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Gaston Safar " ria::! 27 OS 06:.01p 4 G$- 6J..?2673686 p.2 Mi;r.'r.iBf":ld1: ... ..-...... ::.'-.....-~~.. qITP & - - ..:1JV$ City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beachr FL.33139 LOBBYIST REGISlRATION FORM Lobbyist means aft pe~ns employed or retained, whether paid or not, by a principaL who seeks to encourage tne passage, defeat or modification of any orcfmance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City !'tanager or any city board 01 committee; or any action, decision or recommendation of any dty personnel during the time period of the entire deCisIon-making process on such action, decision or recommendation that fcreseeably will be heard or reviewed by the city commlSSion, or a dty board or committee. The term specifically Includes tt-.e principal as welt as any employee engaged in lobbying activitjes. 'the term "lobbyists- has specif"rc exclusions. Please refer to Ordinanc;e 2004-3435. NAME OF LOBBYIST: 2 South Biscayne BUSINESS NAt-1E AND ADDRESS (305) 376-6069 TELEPHONE NUMBER: FREY, (last) ANDREW (First) ,,1. (State) (M.I) 33131 (Zip Code) Boulevard, Suite 3400 Miami, (Number and Street) (Cily) (30S) 376-6010 FAX NUMBER: FL afre~ gunster_com EMAIL: I. l088Y1ST RETAIIIlED BY: Gaston Safar NAME OF PRlNOPAl./CUENT: Miami Beach, LLC BUSINESS NAME AND ADDRESS (8571 891-4262 TaEPHQNE NUMBER: 132 Newberry street {Number lInd Street} (City) (617) 267-3686 FAX NUMBER: (Optional) Boston, ~m 02i16 (State) (Zip Code) ga5tonsafar~earth~ink.net fMAll: (Optional) Mil out this section if principal 15 is Corporation, partnership or Trust [Section 2-482 (c)] NAME OF o-tlEF OFFICER, PARTNER. OR BfNeACIARY: Gaston Safar i I !DENTIFY ALL PERSONS HOLDING, DIREcn.V OR INDIRECTlY, A 5% OR MORE: OWNERSHIP INTEREST IN SUCH ! CORPORATION. PAAn~ERSHIP OR TRUST: Gaston Safar 60%; Al.exander Safar 1 O't; ~oelle Safar 10%: Allison Safar 10~; stephane Safar.10~- II. S1'ECIfIC lOBBY ISSUE: Dis ute reaardin access acroSs a cit Issue \0 be lobbied (OesuiOe III detal/): DI. CITY AGENCIES/JNDIVlDUALSTO BE l0881ED: ! I -1 I I i A) Full Name of Individual/Title ! B} Any Financial, familial or Professional RelationshIp Ci ty L"lanager No Planning Board No OS/27/05 FRI 17:52 [TX/RX NO 8145] Ra~ 27 05 06:?lp G~ 6!.]26736B6 p.3 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHI:R. HOURLY, FLAT Il4 TE OR OTHER): A) LOBBYlST DISCLOSURf: {Required} HourI v $180.00 B) PRINCIPAl'S D1SClOSURE (OF LOBBYIST COMPENSATION): (Required). $180.00 - hourI v The following information must be answered: 1) Pursuant to Miam; Beach City Code Section 2-488 Entitled ~Prohiblted Campaign Contributions By Lobbyists On Procurement Issuesu: [1 Yes ;;;oNo: Are YOU lobbvinQ on a Dresent or oendina bid for QOods. equipment or services. or on a present or pendinq award for QOods. eouiDment or service? 2) Pursuant to Miami Bead'l City Code 2-490 Entitled ~Prohibited Campaign Contributions By lobbyists On Real Estate Development Issues'": ~Yes Y.I No: Are YOU lobbvinq on a Pendina application for a Develooment AGreement w: the City :: !!.p-plication for chanGe of zoninG maD desianation or chance to the City's Fu re Land U :-~~....'7 3) Pursuant to Miami Beach City Code 2.....84 (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 corpomlion or entity without special compensation or reimbursement tor the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the derk as required by ltlis section but, shall not be required to pay any registration fees.. n Yes XJ No: Are YOU representinq a not-tor-profit corporation or entity wiit;hout soecial compensation or reimbursement. V. SIGHA"JURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTIIIIG LOBBYING EXPENDITURES, AS WELL AS COMPENSA110N RECEIVED, IN THE CITY OF MIAMI BeACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO I!;XPENOrruP.ES OR COMPE~S^T!ON DU?.!NG TH~ REPORTING PERIOD. ~.... ~ ~ --A Signa of lo y' t I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am ;:~:~.::.the pmv;slons ~~ Beach aty Code and .11 _rtlng Signature of Lobbyist: 4"-*"" Signature of prlndpal/Clie,{ _.....~ VI. LOBBYIST IDENnFICAnON: . -...:> PRINCIPAL IDENTIFICATION: C Produced ID fJ Produced 10 SURINOER SINGH fornI of IdentificatlqqOTARY PUBlIC . Personall known (P~WEAl TH OF MASSACHUSETTS y ~AY-e'cSMMISSION EXPIRES ON.10129/2010 Form of ldentification lX,PersonallY known (LObbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dude SW~O ~!Jd 5UflSCribjd efore me :- ThiS----:- q..H--clay of '- . 20.D;) .' ~ ~L1 SIgnature of Public Notary . St e of Florida Notarization of LobbVi 5 signature - FORCLER~tNLY Annual Reg,stration fee: r;>c::(Yes [ ) No Amount Paid _ MCR I; ~ Loate Paid I lobbyist Registration Form received and veriried by: b I F:\ClER.\$All,MARIA-M\labbyist\LOBIMST rORM o~ Revised 12/08104 OS/27/05 FRI 17:52 [TX/RX NO 8145]