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Andrew Frey/Mallory Kauderer 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 dudng 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 enga~ /n lobbying activities. The term "lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Frey, .Andrew W. NAME OF LOBBYIST: (LAS) (Fi~t) (M.T) Gunster, Yoakley & Stewart, P.A., 2 S. Biscayne Blvd. #3400, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 376-6069 (305) 376-6010 afrey~gunster.com IELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Mallory Kauderer NAME OF PRINCIPAL/CLIENT: 3701 Chase Avenue, Miami Beach, FL 33140 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (7ip 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 IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SPECIFIC LOBBY ISSUE: Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Zndividual/Title Planning Department Historical Preservation Board Planning Board B) Any Financial, Familial or Professional Relationship None None None ~V. DZSCLOSURE OF TERMS AND AMOUNTS OF LOBBYZST COIqPENSAT~ON (DXSCLOSE WHETHER HOUR£~ FLA T RA TE OR OTHER,):. A) LOBBYIST DISCLOSURE: (Required) $1 80/hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYiST COMPENSA'I~ON): (Required). $1 80/hour The following information must be answered: l) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": [] Yes I~ No: Are you Iobbyinq on a present or pendinq bid for qoods, equipment or services, or on a Dresent or ~endina award for aoods, eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": oYes E~No: Are you Iobbyinq on a pendinq application for a Development Agreement with the City or ao~lication for chanae of zonina ma= desianation or chanae to the City's Future Land Use lqap? 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 ~; No: Are you representin.q a not-for-profit corporation or entity without special compensation or reimbursement.. V. SIGNATURE UNDER OATH: ON OCTOBER :Lsr OF EACH YEAR, EACH LOBBY]ST SHALL SUBI~IZT TO THE C~TY CLERK A SIGNED STATEMENT UNDER OATH, LiSTiNG LOBBYING EXPENDTTURESf AS WELL AS COMPENSATION RECE:[VED, iN THE CiTY OF MiAMi BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN iF THERE HAVE BEEN NO EXPENDTTURES OR COMPENSATION DUI~NG THE REPORTING PER]OD. f ' Signature of L~yi~ at ] ~~a re ! do solemnly swear that all of the foregoing facts are true and correct and th ad or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Pdncipal/Clien .'~ VZ. LOBBY]ST ZDENT~F[CATZON: PRiNCiPAL ZDENI'~F[CAI~ON: [] Produced ID Form of Identification ~//Personally known (Lobbyist) ViZ. S:[GNATURE AND STAMP OF NOTARY: State of Flodda, County of Miami-Dade Sworn to and subscribed before me ,,// I' / FOR CI~E~NLY Annual Registration fee: (t~¥es£ ]No Amou~tP~t:l~ Lobbyist Registration Form received and verified by: F:\CLER\$^LL\MAR~A-M\Lobbyist\LOBBY~ST ~ORM 0~:~~ ~Z) [] Produced 1~D Form of 1Identification ~..Personally known (Pri State of Florida, Couoty of Miami-Dade Sw~n-a~d"subscribe~"~before me ~ Signature of Public/NtS~ - State of Florida Notarization of~rincipal's signature Date PaidRevl~ 12/,08/~r