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Eden Roc LLP Key Int'l Ft'WOO'1! ~h ~W 'Iur .:wU3 ~ ~ 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 ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any city 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. Kasdin Neisen O. NAME OF LOBBYIST: (Last) (Rrst) (M.I) Gunster, Yoakley & Stewart, P.A., 2 South Biscayne Blvd., Ste. 3400, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 376-6062 (305) 376-6010 TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Eden Roc LLLP - Key International, Inc. NAME OF PRINCIPAL/CUENT: 848 Brickell Avenue, Suite 700, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 377-1001 TELEPHONE NUMBER: (305) 377-4113 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 BENEFIOARY: IDENTIfY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: U. SPECIFIC LOBBY ISSUE: Approval of demolition and site plan Issue to be lobbied (Describe in detail): IU. CTY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Planning Department None Historic Preservation Board None City Managers Office None Zoning Board of Adjustment None 3Si d ;~ 6S:( ; n " ;0, i 'I ;,' (' 0' t ':., nUl' .::J IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $400.00 per hour B) PRINCPAL'S DISCLOSURE (OF LOBBYlSTCOMPENSATION): (Required). $400.00 per hour Yes No: ~ Are YOU I"I!III'eSeI1tna a not-for-Dl'Dfit col"DOl"ation or entitY without saecial comnensation or reimbursement. Pursuant to Ordinance No. 2004-3435. . 1) Pu=n~=-= ~. 2003-3393 Amendina Miami Beach City Code ChaDter 2. Artide VU. Division 5 Th_f _~ "__ig_ R~e Refonn" Via The Addition Of Code Section 2-488 Entitled "Prohibited Glmoaign Contributions By Lobbvists On ProcurE!f11ent Issues": No:.,I Are YOU Iobbvina on a aresent or aendina bid for aoods. eauiDment or services. or on a oresent or Defllina award for aoads. eauiament: or service? Yes =~=~ No. 21103-:J39~ ~na Miarri IIead1 Ql:y Cafe Chaoter 2. Arlide VU Divip 5 . "m' n Rnance Remnn", Via The Addition Of Ca:Je Section 2-490 Entitled "Prohibited Glmoaign Contributions BY lobbvists On Real Estate rRveIooment Issues": No: -/ Ale::'" ~~on a aendina aaalic:atlon!'5!!: a DeveIaDment AareemeI!l; with the CItv or mol. nae of zonina maD desianation or chanae to the CitY's Future lMKI Use MaD? 2) Yes Y. SIGNATURE UNDER OATH: ON OCTOBER 1ST Of EAOt YEAR, EAOt LOBBYIST SHAlL SUBMIT TO THE aTY CLERK A SIGNED STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE aTY OF MIAMI BEAOI FOR THE PRECEDINGWfLE NDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITU~ PENSATION DURING THE REPORTJNG PERIOD. tll( /; Signature of lobbyist 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 ion 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: PRINOPAL IDENTIFICATION: y,ooUCEdID+la t'n'u.eYS UQ Fonn of Identification YL LOBBYIST IDENnFlCAnON: -- Produced ID Fonn of Identification X Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: = Personally known (Principal) m~~"\'~"!II"" VIVIAN YON l ~ " Notary Public - State of Florida ~ . . ~ My Con'llT1illlD1 EJcpiea May V, 2006 ~~ if! Commiaaion' 00 100245 "''1rt';T.~ ~ Bonded By National Notary Assn. Signature 0 Public Notary - State of Rood Notarization of Principal's signature State of Florida, County of Miami-Dade Sworn to and Subscri~~ This day o~ . 20.us- ., Signature of Public Notary - State ofJ A Notarization of Lobbyist's signa CLERK'S USE Annual Registration fee: [~[ J No Amount Paid ~- MeR # Date Paid Lobbyist Registration Form received and verified by: ~ ~ Revised 02110/04 F: CdR\AU\MARIA-M\lOBBYIS1\LOBBYIST FORM 04