Phillip Rich/Orange Bowl
RECEIVED
CITY CLERK'S DEPT. ~
AUG 2 9 2005 ~
-
~liami Beach
2.\lO:li
City of Miami Beach Office of the Ci~(lirk
1700 Convention Center Drive, Miami Beac~"J!l33Bg
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, recommendation of the
City Manager or any dty board or committee; or any action, decision or recommendation of any city personnel 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 well as any employee engaged
in lobbying activities, The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Rich
NAME OF LOBBYIST:
(Last)
Phillip
(First)
703 Waterford Way. 590 Miami
BUSINESS NAME AND ADDRESS (Number and Street) (City)
(305) 341-4722 (305) 341-4783
FL
(State)
A.
(M.!)
33126
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER:
prich@orangebowl.org
EMAIL:
I. LOBBYIST RETAINED BY:
Orange Bowl Committee
NAME OF PRINCIPAl/CUENT:
703 Waterford Way. 590 Miami
BUSINESS NAME AND ADDRESS (Number and Street) (City)
FL
(State)
33126
(Zip Code)
TELEPHONE NUMBER:
(305) 341-4722 (305)341-4783
FAX NUMBER: (Optional)
prich@orangebowl.org
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Miami Beach Visitor and Convention AuthoritvTo~\~~ &.. to k"\.\, bS",ob
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/TItle B) Any Financial, Familial or Professional Relationship
Grisette Rogue Marcos
Executive Director
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOlJRLY,
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) Not Applicable
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), Not Applicable
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
D Yes ~ No: Are YOU lobbying on a oresent or oending bid for goods. eguioment or services. or on a
oresent or oending award for goods. eguioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes j; No: Are you lobbying on a oending aoolication for a Deyelooment Agreement with the City or
aoolication for change of zoning mao designation or change to the City's Future Land Use
Mao?
3) Pursuant to Miami Beach City Code 2-484 (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
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
~ Yes D No: Are you reoresenting a not-for-orofit corDOration or entity without soecial comoensation
or reimbursement.
V. SIGNAlURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A 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 EXP OR CO N DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are true correct and that I have read or am
familiar with the provisions contai 'n Se' -4 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
FO
Annual Registration fee: [ ] Yes [ ] No Amou
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 (l
PRINOPAL IDENTIFICATION:
VI.
D Produced ID
D Produced ID
Form of Identification
.!Personally known (Lobbyist)
Form of Identification
~rsonallY known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to c\nd subscrib befo~~e
This 01. day of U_I 20 t.5'"
~-~dw~
Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
Signature of Public Notary - State of Florida
Notarization of Principal's signature
Revised 12/08/04