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Alfredo Gonzalez/Seth Joseph 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 defined in any manner in this section, 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. NAME OF LOBBYIST: Gonzalez A1 fredo L. (Last) (First) (M.I) Adnrnn g Yn~/?_~?R Pnnnm d~ I~nn Blvd. Miami FI 33134 BUSINE~ NAME AND A~DRE~ (Number and Street) (City) (State) ' (Zip Code) 305-460-1000 305-460-1422 a 1 q@ado rno. com TELEPHONE NUMBER: FAX NUMBER: ElVtAIL: LOBBYIST RETAINED BY: Seth P. Joseph NAME OF PRINCIPAL/CLIENT: Adorno & Yoss/2525 Ponce de 1Pon Rlvd. Miami Fl BUSINESS NAME AND ADDRESS (Number and Street) (City) 305-4~0-1000 TELEPHONE NUMBER: ~05-4~0-1422 FAX NUMBER: (Optional) (state) (Zip Code) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] · NAME OF CHIEF OFFTCER, PARTNER, OR BENEF[CTARY: · IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SPECIFIC LOBBY ISSUE: FynlnrP cln~Jrm of ~walp. in Pine Tree Drive Circle Issue t'o be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title Mike B) Any Financial, Familial or Professional RelatJo-ltshi~ Alvarez, Asst. Dir./Public Work., No Yes iv. DZSCLOSURE OF TERMS AND AMOUNTS OF LOBBYZST COMPENSATZON (DZSCLOSE WI-Ib-I'HER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) hourly fee B) PI~NCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSA'I-[ON): (Required). h0u rl y fee ~ Are you represent#hq a not-for-profit corporation or entity without special compensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Yes ~ 2) Yes CN'-~. Pursuant to Ordinance No. 2003-3393 Amend#hq Miami Beach City Code Chaoter 2. Artide VT:[. Division 5 Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaiqn Contributions By Lobbyists On Procurement :[ssues": Are you Iobbyinq on a present or pendinq bid for qoods~ equipment or services~ or on a present or pendinq award for aoods, eauioment or service? Pursuant to Ordinance No, 2003-3395 Amend#no Miami Beach Cib/Code Chaoter 2. Article VI:[ Division 5 thereof Entitled "Campaign Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaiqn Contributions By_ Lobbyists On Real Estate Develooment :[ssues': 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 Map? V. SZGNATURE UNDER OATH: ON OCTOBER 1sr OF EACH YEAR, EACH LOBBY]:ST SHALL SUBMI'r TO THE C]:TY CLERK A S]:GNED STATEMENT UNDER OATH, LZST]:NG LOBBY]:NG ~I'rURES, AS WELL AS COt-tPENSAT]:ON RECE]:VED, TN THE CI'TY OF t. lZAt4'r BEACH FOR TILE" PRJECEDI'NG. CALEF~AR. YF.,AR. A STATEMENT SHALL BE FZLED EVEN ZF THERE HAVE BEEN NO//J~XP~)I'IU~E'S O~/~iI~.J~ISrATZON DUR/NG THE RE POR'DZNG P ERZOD. / // / I do solemnly swear that all ~ foregghn~O facts are .true~d correct and that I have read or am familiar with the provision~s~,g~,p/ed i~'~on/~~f the IVliami Beach City Code and all reporting r .ir m n,. Signature of Lobbyist: ! / Produced ID ~ Produced ID Form of Identification Form of Identification Pe.~.,.,~n (Lobbyist) P~n (Principal) VT]:. S]:GNATURE AND STAMP OF NOTARY: State of Florida, County of MiamiiDade Sworn to and subscribed before me This ~ day of ~_. 20~ ~.. §igr~at_~ of Public Notary - State of Florida NotariZation of Lobbyist's signature +~* ~.~..".~.~:o MAP. K)RIE L OWEN-BAILLIE · , . MY COMMISSION# D0 351598 ~~~ EXPIRES: 8, October 2008 · or e~.o Bonded Thru Budget N0tan/Sewices State of Florida, County of Miami-Dade Sworn and subscribed before me This ~ da,y ofv ,20e (o Notarization of PHncipal's signature ,~ ;-'-; ~, MAR~)RIE L OWEN-BAEJJE **.~.., MY COMUISSION # DD 351598 EXPIRES: October 8, 2008 eof ~v~'- Bol~d Thru Bud~t Nota~/Se~ices ~--'~" FOR CLERK'S USEONLY .-.-, . Annual Registration fee: [ i,~,]~s [ ] No Amount Pai~.? ~'~' ~'.--~ IvlCR ~ 2 r/7 / 7 Date Paid Lobbyist Regis~fion ~rm rec~ved and verifi~ by: Revised 02/10/04 F: ~LE~~-M~LOBB~S%LOBB~