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The Standard Hotel 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 dty board or committee; or any action, dedsion or recommendation of any city personnel dudng the time pedod 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 dty 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 2004-343S, Kasdin Neisen O. NAME OF LOBBYIST: (Last) (First) (M.I) Gunster, Yoakley & Stewart, P.A., 2 South Biscayne Blvd., Ste. 3400, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (305) 376-6062 (305) 376-6010 IELEPHONE NUMBER: FAX NUMBER: (State) (Zip Code) EMAIL: LOBBYZST RETAINEDBY: The Standard Hotel NAMEOFP~N~C~ENT: The Puck Building, 295 Lafayette Street, 7th Floor, New York, NY 10012 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Tip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [SecUon 2-482 (c)] · NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: · IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST CORPORATION, PARTNERSHIP OR TRUST: SPECIFIC LOBBY ISSUE: Assist in obtaining temporary certificate of occupancy, certificate of occupancy, and Issue to be lobbied (De~ribe in detail):other matters relating to the completion of construction of D~. CZTY AGENCIES/INDIVZDUALSTOBE LOBBIED: the Standard Hotel in Miami Beach. A) Full Name of Individual/Title City Commission City Manager B) Any Financial, Familial or Professional RelaUonship None None Building Department None 1V. DZSCLOSURE OF TERMS AND AHOUNTS OF LOBBY/ST COMPENSATZON (DZSCLOSE WHETHER HOUR£~ FLA T RA TE OR OTHER.):. $425.00 per hour A) LOBBYIST DISCLOSURE: (Required) $425.00 per hour B) PRINCIPAL'S DIscLOsuRE (OF LOBBYIST COMPENSA'IqON): (Required), 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": [] Yes fi/No: Are you Iobbyin.q on a present or pendin.q bid for goods, equipment or services, or on a present or pendinq award for qoods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": •Yes ~No: Are you Iobbyinq on a pendinq application for a Development Aqreement with the City or application for chanqe of zoninq map desiqnation or chanqe to the City's Future Land Use Hap? 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.. D Yes ~No: Are you representinq a not-for-profit corporation or entity without special compensation or reimbursement. . v. SIGNATURE UNDER OATH: ON OCTOBER Is'r OF EACH YEAR, EACH LOBBY]ST SHALL SUBIqTF TO. THE CITY CLERK A SZGNED STATEMENT UNDER OATH, liSTING LOBBY]NG EXPENDTrURES, AS WELL AS COIqPENSAT/ON RECEIVED, ZN THE CTI'Y OF I~ILAI~I! BEACH FOR THE PRECEDZNG CALENDAR YEAR. A STATEMENT SHALL BE FZLED EVEN ZF THERE HAVE BEEN NO EXPENDITU~0iR COMPENSATZON DUR]NG THE REPORTING PER]OD. Signature of Lobbyist ! do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am familiar with the provisions contained iR ~l~on 2-482 of the Miami 8each City Code and all reporting requirements. ~////// Signature of Lobbyist: Ill ~ ~ Signature of Principal/Client: . . ~ VZ. LOBBY]:ST TDEN'I'J:F]C4,T~ON: ~ ~ o ~ P~uced ID ~ ~ ~ Fo~ of Identifi~tion ~ ~ Pe~nally known (~bbyi~) ~. ~ ~I. 8I~T~R~ ~ ~~ O~ ~OT~R~: ~ ~ S~te o~ Rodda, Coun~ o~ Miami-Dade S~te of Florida, ~un~ o~ ~iami-Dade Sworn to ~d sub~fi~ ~fom me Sworn and sub~rJb~ ~fore me -. day or O . , is_ ay of ~~ Si~na~ o~.blic .o~ S~ ~f Flodda Signat. m~~~FIorida FOR CL ONLY ~nualR~i~afionf~: [( ~ ],o ~o~.CR~~/~atePa.d /~~ Lobbyi~ Regi~tion Fo~eived and vedfi~ by: F:,~ER,$ALL,~-M,Lobbyi~,LOBB~ ~RM 0g~ ;.~ R~i~ 12/08/~ PR/NC/PAL ZDENTZFZCAT/ON: [] Produced ID Form of Identification [] Personally known (Principal) [] Y_e~ i~--~: A~ ~F,,, _k*_~j'm~Al'Lq ~ M' ?mdi~qbid for ~nm~ ~K~iDm~nt or se~iaes, or_ .on~ Pursuit t~ Miami ~ CILy Code ~.-4~0 _ ~w~_ba l;~,~dcpmm~ Lfsue~-' _-~_ -u~_L,~ ~or ehanae Df ~onl~?a m-n d~iqn~O~_m' elm ~npe M t~ CitY's Future.t.~ ON OCTC)~E~ 1sr OF EACH YEAR;. F. AOI LOB~I'ZST SHALL ~ TO, 'THE CZ'I'Y O. ERK A ~, X'N THE C:XTY OF ]/lZA]~ BGACH FOR THE PRECB)ZNG CAL,END.4~ YEAR, A STATEHENT ! do solerrml,/swear that ali of' ~he fomc~.~9 fa0'cs are ~ ~ ~ a~ ~ X ~ ~ er am ~m]~ar ~ ~ ~~ ~~ i~ ~on 2~2 ~e ~mmi ~ ~ ~ ~ all ~~ / / ~ S~NATUR~ AND STAHP OF NOTARY: ~ IIoMrimtion of Lob m ~ 5~gnab.~ oF Public NoMr7 N~(don o1' Prindpars signature · FOR~ ~ ~y Annual ~~,~. ~ [ ] Ye~ [ ] No AnM:xJnk Paid _.. MCR ~ P.~LJ~5~,ALL\~~~~ fOP, J"I OS. doc _