Eduardo F. Botte
Mi;ni IiIdIIelI
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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 ord"mance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
aty Manager or any c:lty board or committee; or any action, decision or recxxnmendation of any city personnel during the time
period of the entire decisIon-making ptOa!SS on such action, dedslon or I'ElCOI11IneIldation that fbreseeably will be heard or reviewed
by the city commission, or a city board or committee. The term specifically indudes the prindpal as well as any emplo)lee engaged
in lobbying ac:tivfties. The term .~ has specific: exclusions. Please '*" to Ordinance 2004-3435.
V~ MTo J_
(First) (M.I)
INC,. ;/32- ~ ttlA1~/~ tJM~ 3:3}5'/
(Number an Street) (City) (State) (Zip Code)
(. ~C:>) g ~(, - 1/ CJ I ~. & A.t:-I. ~,.,.,.,
FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
~j)t/,4 f< Po f 01J1le.
NAME OF PRINaPAl/OlENT:
oz ,S COU--j tJ~
BUSINESS NAME AND ADDRESS
(?Cs) tj8.{P -0 ~$'r;
TELEPHONE NUMBER:
frd {$ $~ t)fll- ;J8~3>c.')(.},€.. Fe.- ?3/S j--
(Number and Street) (Oty) (State) (2Jp Code) .
C?t?~~~'8'- 'f~77 ~~e~~~
FAX NUMBER: (Optional) EMAIL: (Optional) ru.:t-
FiU out this section if principalls a Corporation, Partnership or Trust [Section 2-482 (e)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
· IDENTIFY ALl PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTERESf IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
n. SPECIFIC LOBBY ISSUE:
~/'~ A~/~YI1 c- &' i:J-7 C~&-:;;i? /Sf-V (), 111;8
Issue to be lobbied (Describe in detail):
In. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
B:3/tj.-J
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
PEvewrh&l"./T K~ PIC/.tl 8t:'A~p
P P -;;'1 ~ M' ,& rJ /G w .,
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/37(;)/1' Ii. p t?P' A I?VV7rA7q.~ rr-r
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DIsa..OSE WHETHER HOURL Y,
FlAT RATE OR OTHER):
A) LOBBYIST DISClOSURE: (Required) i fP 7/~ooo, 0<:)
.
B) PRINOPAl'S DISClOSURE (OF LOBBYISTCOMPENSA1l0N): (Required). ... -'lJ O~ a. 00
T~ a.
The following inrOi .alilltion must be answered:
1) Pursuant to Miami Beach Oty CocIe Section 2-488 Entitled "Prohibited campaign Conmbutions By lobbyists
On Procurement Issues";
DYes lliNo: Are VOIIloIJbv\nq ~ a DI !ont or Dendi.... bid far ~_ ~inIn.nf. or SIeI"Vic'-.c or on a
Dr' ent oraeiIdina award for -..Ie _nament or ~?
2) Pursuant ID Miami Beach oty Code 2-490 Entitled "Prohibited Campaign Conbibutions By Lobbyists On Real
Estate OeveIopment Issues";
oy,..lN!!; --_...a--~"::..~~~_ca...
aDDliad:ion fordlanae ofzonina mao ~=~_.~. ~_ to ~ ~_ Land Use
MaD?
3) Pursuant ID M"lami Beach City Code 2-484 (h) Any person (except those exempt from the definition d
"lobbyist" as set forth in SectiOn 2-481 above) who only appears as. a representative of a not-for-profit
corporation. or entity without spedal CXJmpensation or relmbl..ll"SE!n1ent for the appearance, whether direct, or
indirect:, to express support of or opposition ID any item, 91aI1 register with the der1c as required by this
section but;. shall not be required to pay any regisLatiuo fees..
o Yes rl'No: Are YOU reDl'est!.ntina a not-for-omfit CDI'DOraI:inn or entft:v without SDec:ia1 mmoensation
or reimbursement.. .
V. SIGNATURE UNDER 0A11t:
ON OCIUBER 15r OF EAOI YEARr EAOI LOB8YISF SHAlL SUBMlT 10 THE Q1Y a.ERK A SIGNED
STATEMENT UNDER OATH, LISTING lOBBYING EXPENDITUREs, AS WEU. AS OOMPENSATlON
RECEIVED, IN THE aTY OF MIAMI BEAat FOR THE PRECEDING CALENDAR YEAR.. A ST~TEMENT
SHAU BE FD.ED EVEN IF THERE HAVE BEEN NO EXPENDIlU COMPENSATION DURING THE
REPORTING PERIOD.
(
-....
I do solemnly swear that aU of the foregoing facts are true and oorrect and that I have read or am
=~.. with .the provisions ;l)~. . . i .... 2-'182 Of the -.. Bead1 City Code and all reportil'lg
5ig .t1Jre of lobbyist. p.... I .
m. ~ ~
i
Sigmture of Principal/Oient:
r /
VI.
LOBBYIST IDENTIFICATION:
- .
VB. SIGNATURE AND STAMP OF NOTARY:
PRINCIPAL IDENTIFICATION:
.r'Produced ID I
DAVID ElOERGER
. MY COUI.tlssIoN , DO 132723
~. ~~ E1CPIRa .fIb.a.2lW.L .
L"P.r..~'f."'- 1bxIecI1InJb.Y~._
Form of Identification
r Personally known (Prind~
State of Rorida, County of MiamH:>ade
SwomlD ~~ me'
This ---i:.aav of , 200>
_~d~
NotarizatiOn of .
State of Rorida, County of Miami-Dade
SWom ar:xJ ~bscribed before me ..
1his~.::aayof 1,'0'.' .20...::....
-
Signature Of~. - . - r-aonaa
Notarization ."s signature
.,.
Armual Registration fee: [ es [ ] No _
Lobbyist Registration Form received and verified
F:\CLER\$AlL\MARIA-M\Lobbyist\LOBBYIST fORM .d
Revisec:ll2/08/04