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Ci~,pf(Mtiami~idiitQffice of the City Clerk
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1700 Convention Center Drive, Miami Beach, FL 33139
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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, derision, recommendation of
the City Manager or any city board or committee; or any action, decision or recommendation of any city 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 city commission, or a city board or committee. The term specifically includes
the principal as welI as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435. '
RILEY. JR.
NAME OF LOBBYIST:
(Last)
WILLIAM
(First)
W.
(M.l.)
Bilzin Sumberg Baena Price & Axelrod LLP. 200 So. Biscayne Blvd.. Suite 2500. Miami. Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-375-6139
TELEPHONE NUMBER:
305-351-2285
FAX NUMBER:
WRiley@bilzin.com
EMAIL:
1. LOBBYIST RETAINED BY:
ATLANTIC BEL AIRE. L.c.
NAME OF PRINCIP ALlCLIENT:
18851 NE 29 AVENUE. SUITE 901
BUSINESS NAME AND ADDRESS (Number and Street)
AVENTURA. FL 33180
(City) (State) (Zip Code)
305-931-4959
TELEPHONE NUMBER:
(305) 931-4606
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: JEAN PIERRE REIN
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Application (Variance) Board of Adiustment - 6515 Collins Avenue
Issue to be lobbied (Describe in detail):
III. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
A) Full Name of Individ ual/Title B) Any Financial, Familial or Professional Relationship
Board of Adjustment & Staff NONE
MIAMI 898022.1 7570519297
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE
WHETHER HOURLY, FLA T RATE OR OTHER):
A)
B)
LOBBYIST DISCLOSURE: (Required)
$240.00 per hour
PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSA nON): (Required).
$240.00 per hour
Yes No: X Are you representing: a not-for-profit corporation or entity without special compensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Code Chapter 2. Article VII. Division
5 Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled
"Prohibited Campaign Contributions Bv Lobbvists On Procurement Issues":
Yes No: X Are yOU lobbying: on a present or pending: bid for g:oods. equipment or services. or on a present or
pendin!! award for !!oods. equipment or service?
2) Pursuant to Ordinance No. 2003-3395 Amending Miami Beach City Code Chapter 2. Article VII Division
5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled
"Prohibited Campaign Contributions Bv Lobbyists On Real Estate Development Issues":
Yes No: X Are yOU lobbyin!! on a pendin!! application for a Development Ag:reement with the City or
application for chan!!e of zoning: map desig:nation or chang:e to the City's Future Land Use Map?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK SIGNED
STATEMENT UNDER OATH, LISTING 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 EXPENDITURES OR CO E A TION DURING THE
REPORTING PERIOD.
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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 Section 2-482 of th~ ch C' y Code and all reporting requirements.
Signature of Lobbyist: 0 '
Signature of Principal/Client:
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PRINCIP AL IDENTIFICATION:
VI.
LOBBYIST IDENTIFICATION:
o
Produced ID
Form ofIdentification
o
Produced ID
Form ofIdentification
%
Personally known (Lobbyist)
~
Personally known (Principal)
ida
- ta orida
I
~ MY COMMISSION # 00275973
~OF:,J' EXPIRES: December 18,2007
nature
MY COMMISSION # DO 113548
EXPIRES: May 18, 2006
Bonded ihru Pick18rd InllUl1llC8 NlMC'/
FOR CLERK'S USE ONLY
Annual Registration fee: ~s [ ] No Amount Paid .t:C> MCR # 2.':1'l363 Date Paid ~
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER\ALL - \LOBBYIST\LOBBYIST FORM 04