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Mangos Tropical Cafe ......,-,k'..:~" b:ltrJd mt' m - - ;.IUJ City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means al per5OI1S employed or retained, whether paid or not. by a principal who seeks to encourage the passage, deIut or modification of any ordoanCe, resolution, action or decision of lIlY commiSSioner; any action, decISion, recommendation of the City Manager or lIlY city board or committee; or any action. decision or ,f:CCln'WfM!ndation of any city personnel defined in ." manner in this section, during the time period of the entire dec:ision-miIking process on such action, decision or rec~ that (oreseeabIy will be heiiIrd or reviewed by the city corM1ission. or a city board or committee. The term specifically indudes the principal as well as any employee engaged in lobbying activitieS. 11Ie term -Lobbyists- has specific exdusions. PIuse"'" to OnIiuna 2004-3435. Kasdin Neisen O. NAME OF LOBBYIST: (Last) (First) (M.I) Gunster, Yoakley & Stewart, P.A., 2 South Biscayne Blvd., Ste. 3400, Miami, FL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 33131-1897 (305) 376-6010 nkasdine. qunster .com FAX NUMBER: EMAIL: (305) 376-6062 TELEPHONE NUMBER: L LOIIYIST RETAINED IV: Mangos Tropical Cafe NAME OF PRlNCIPAl/ClIENT: 900 Ocean Drive BUSINESS NAME AND ADDRESS (305) 673-4422 TELEPHONE NUMBER: Miami Beach (Number and Street) (City) FL 33139-5013 (State) (Zip Code) FAX NUMBER: (Optional) EMAIL: (OPtional) Fill out this sec:tioI'I if princ:iJNll is II Corpor'lItion, PlIrtnenIlip or Trust [Section 2-482 (e)l . NAME OF OiIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIFY AlL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: U. SPEaRe LOllY ISSUE: Representing Mangos T~?pical Cafe re Noise Ordinance Issue to be lobbied (Describe in detail): m. CITY AGENCIES/INDMDUALS TO IE LOBIIED: A) Fun NlIme of Individual/Tttle I) Any Finllncilll, FlImililll or Professionlll Relationship City Commission None City Manaqers Office Nnn<> Planning Board None ~eighborhood Services Dept. None IV. DISCLOSURE Of TERMS AND AMOUNTS Of LOBBYIST COMPENSATION (DISCLOSE WHETltER HOUR L Y, FLAT RATE OR OTHER): $400.00 hourly A) LOBBYtST DISClOSURE: (Required) . B) PRINCIPAL'S DISClOSURE (OF LOBBYISfCOMPENSATION): (Required). $400.00 hour1 y Yes (EL.::= reoresentina a ~t-for-ol'Dfit corooration or entitY without. saecial camnensation or _=== = =- Pursuant to OrdIMnc:e No. 2004-343S. . ~=~== r:.~,=-3= Amendina Miarri Beach Cilv Code Chaoter 2. Artide vn. Division 5 __f _~ _-__ig _ ~ _lID" Via The Addition ex Code Section 2-488 Entitled "Prohibited Camoaign CDntributions Bv LobbYists On Procurement Issues": " 4' > . 1) Yes 8 2) Yes 8 v. Are YOU Iobbvina on a aresent or = b:.':t :;0-' eauiDment or services. or on a Dresent or aendina award for GOOds. eauiament or seMCIl!? ~=~=.:": No. ~::339S Amendina Miami Beach Otv Code Chaoter 2. Article vn Division 5 . m ion R Refonn". Via The Addition ex Code Section 2-490 Entitled "Prohibited Camoaign ("nnbibutions Bv lobbyists On Real Estate 0lM!I0Dment Issues": Are YOU IobbYina on a aendina aDDli~forai ~e~~ ~ ,DD1~ b ~ of zonina maD desicination or chanGe to the CitY's Future Land Use MaD? SIGNATURE UNDER OATH: ON OCTOBER isr OF EAOI YEA~ EAOi LOBBYIST SHALL SUBMIT TO THE aTY CLERK A SIGNED STATEMENT UNDER OATH, umNG LOBBYING EXPENDnuRES, AS WELL AS COMPENSA110N RECEIVED, IN THE CITY OF MIAMI BEAot FOR THE PRECEDING CA R YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDnuRES PEN5A11ON DURING THE REPOR11NG PERIOD, I do solemnly swear that all of th familiar with the provisions con requirements. oing facts are true and correct and that I have read or am Section 2-482 of the Miami Beach City Code and all reporting Signature of lobbyist: ~ ~ Signature of Principal/Oient: ----=:::. <:.- VL LOBBYIST IDENTIfiCATION: PRINCIPAl. IDENTIfiCATION: VprodUced ID +\f:)nt~ [)fi~ l,~ : Produced ID Fonn of Identification _ Personally known (Lobbyist) VIL SIGNATURE AND STAMP OF NOTARY: State of Flaida, County'of Miami-Dade swom~~ subsaitrt \~f~ me ~::~:~ Si ture of Public ry - te of Raida ....~.9.~ati~RfJs!fye5~~e~ Ii l \ NOTARY PUBLIC. STATE OF FLORIDA : : COMMISSION # 00408442 ~'to,,\.dt-~~.: EXPIRES 5/9/2009 -.. .. .... BONDED THRU 1-888-NOTARV1 Fonn of Identification ~ally known (Principal) State of Rorida, County of Miami-Dade Swom and subscri~ ",,~~e me _ This~dayof ~ 20.Q.\ -V-~Ch-~~ Sjg~a~re of Public Notary - Sta of Ronda ..~~~.~~zatio~"f&~~~~~8RA~re lM\ NOTARY PUBLIC. STATE OF FLORIDA ~ : COMf\.lISSION # D0408442 \">.: !t'. ..':'t0Pf\.dt-~.. EXPIRES 5/9/2009 ....... BONDED THRU 1-888-NOTARV1 FOR CLERK'S USE-ONLY ~/v Annual Registration fee: [/] Yes [ ] No Amount Paid d-)VJ!-- MeR # Date Paid Lobbyist Registration Form received and verified by: Revised 02110/04 F: CLER\ALL\MARIA-M\LOBBYISnLOBBYIST FORM 04