Jerry Guarch City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
..wbo¥ist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat
o, modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
C.ty Manager or any city board or committee; or any action, decision or recommendation of any city personnel during the time
~eriod of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed
~.¢ lhe city commission, or a city board or committee. The term specifically includes the prindpal as well as any employee engaged
.r, lobbying activities. The term 'Lobbyists" has specific exclusions, please refer to Ordinance 2004-3435.
Fine Robert
NA~ME OF LOBBY[ST: (Last) (First)
~ i~eenberg Traurig 1221 Brickell Avenue, Miami FL
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
~ 05- 579-0826 305-691-5826 finer~gtlaw.com
TELEPHC~NE NUMBER: FAX NUMBER: EMAIL:
S,
(M.I)
33131
_
(Zip Code)
I LOBBYIST RETAINED BY:
.1 erry Guarch
NAME OF PRINCIPAI.]C~ENT: ' '
I)iversificd Construction & Restoration, Inc. 13525 SW 288 street Homestead
Florida 33033
~USINESS NAME AND ADDRESS (Number and Street) (City)
(State)
(Zip Code)
qJ5-.246-4306
TELEPHONE NUMBER:
305-246-4328
FAX NUMBER: (Optional}
EMAIL: (Optional)
out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Jerry Guarch
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFZC LOBBY ISSUE:
Building / Permit Issues
Issue to be lobbied (Describe in detail):
III. ~ AGENClES/INDZVlDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
_.
I)csign Review Board / Board Of Adjustment
tqnlding Department
Planning Department
B) Any Financial, Familial or Professional Relationship
IV. DZSCLOSURE OF TERMS AND AHOUNTS OF LOBBYZST COHPENSATZON (DZSCLOSE WHETHER HOUR£Y~
FLAT RATE OR OTHER,):.
~ LOBBYIST DISCLOSURE: (Required) 420.00 Hourly
..~: ~RINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)._ $420.00 Hourly
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 B No: Are you IobbvinQ on a oresent or oendinQ bid for ~oods, eauioment or services, or on a
vmsent or ~endina award for eoods, eeuioment or service?
Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
.Yes I~ NO: Are you Iobbvine on a oendinq aovlication for a Develooment An_reement with the City or
aD=lication for chancre of zonine mao desi=nation or chamie to the City's Future Land
Ma~?
· ~ 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 .~.No: Are you re~r~z~-~n~;na a not-for-profit comoration or entity without special compensation
or reimbursement. .
State of Florida, County of Miami-Dade
Sworn t~d sub~fib~ before me
~,re o~ublic NO~ ~te of R~dda
V. SIGNATURE UNDER OATH:
ON OCTOBER IsT OF EACH YEAR, EACH LOBBY[ST SHALL SUBM11' TO THE CITY CLERK A S[GNED
STATEMENT UNDER OATH, LISTI*NG LOBBY"lNG EXPENDTTURES,, AS WELL AS COIqPENSATTON
RECEZVED, :[N THE CITY OF .IA":[ BEACH FOR THE PRECED:[NC.~.~LENDAR YEAR, a ST~T..E?E.N.T-
,.^,, T,E, .^VE o.J
Signature of Lobbyi~''''~''~
I do solemnly swear that all of the foregoin§ ~acts ~r~_tru. e and correct and that I have read or am
familiar with the provisions containefi~ Section-~4~7~> Miami 8each ¢iW Code and all re~ng
Signature of Lobbyist: \
Signature of Principal/Client:
ZDENTZFJCATZON: ~""'~// PRZNC3PAL iDENTiFiCATiON:
LOBBYIS-r
Produced ID L Produced
Form of identification Form of Identification
L,~rsonally known (Lobbyist) 'r~ersonally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
reda
/ FOR CLERK'S_U.~E ONLY ]
;mnua, Registration fee: ~ ]Yes [ ]No Amount Pa. icj =~,~-- MCR # ~Date Paid ~!(~"_
i.obbyist Registration Form received and verified by~ ~~
~,:~CLER\$ALL\MARIA-N\Lobbyist\LOSBYIST fORH 0~i~c Revised 12/08/04