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Robert Fine/Green Comet LLC 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 CiD/Manager or any city board or committee; or any action, decision or recommendation of any db/ 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 db/commission, or a city board or committee. The term specifically indudes the prindpal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions, Please refer to Ordinance 2004-~435. Fine Robert S. NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0826 305-691-5826 finer~gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Green Comet, LLC c/o Alessandro Ferretti NAME OF PRINCIPAL/CLIENT: 119 Washington Avenue Miami Beach Florida 33'139 BUSINESS NAME AND ADDRESS 305-672-5152 TELEPHONE NUMBER: (Number and Street) (City) (State) FAX NUMBER: (Optional) EMAIL: (Optional) (Zip Code) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] · NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Alessandro Ferretti · IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Same as above SPECIFIC LOBBY ISSUE: Certificate of Appropriateness / Variances 344 Ocean Drive Issue to be lobbied (Describe in detail): CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title Planning and Zoning Department HPB Approvals ZBA B) Any Financial, Familial or Professional Relationship ZV. DZSCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DZSCLOSE WHETHER llO~JR£ Y, FL,4 T RA 7'E OR OTI.IER): A) LOBBY]ST DISCLOSURE: (Required) 450.00 Hourly B) PI~NCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $450.00 Hourly 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 m No: Are you Iobbyinq on a present or pendinq bid for .qoods, equipment or services, or on a oresent or oendina award for aoods, eauinment 0r servk;e? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": []Yes Ix No: Are you Iobbvina on a oendina aDDlication for p Development Aqreement with the City or aoolication for chanoe of zoninq map desiqnati0n or chanqe tO the City's Future Land Use MaD? 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 renresenl;inq a not-for-profit corPoration or entity without special compen~ati0n or reimbursement.. v. SZGNATURE UNDER OATH: ON OCTOBER Is'r OF EACH YEAR, EACH LOBBYZST SHALL SUBMIT TO THE CITY CLERK A SZGNED STATEMENT UNDER OATH~ LTSTING LOBBYING EXPENDITURES~ AS WELL AS COMPENSATZON RECEIVEDt IN THE CZTY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT REPORT/NG PERZOD. 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 in ~i Beach City Code and all reporting requirements. ~~~__~~~~__. . Signature of Lobbyist: ~ ?l '---~---~__ ~ Signature of Principal/Client: ~ V'L LOBBY[ST ZDEN'I'~I~CAT~ON: PP~NC~PAL ZDENTZFZCAT]:ON: [] Produced ID [] Produced ID Form of Identification Form of Identification [] Personally known (Lobbyist) State of Florida, County of Miami-Dade Sworn to and subscribed before me NotarizaUon oTLobby~'s signature [] Personally known (Principal) S]:GNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn and subscribed before me ~c~l_otary~-~tate of Florida Notarization of ~'rinclpa~K~ signature / FOR CLER~'-~U-~E~!_LY~"~ ~Y'~I,~, ,l,-~i, . ~a, ~gi,ation f~: [ ~es[ INn ~ount Pa~d ~~. MCR.~Date Paid ~_ ~;~J~ ~ooyisc ~egi~Uon ~ received and vedfied by: ~ ~ ~ / - F:~CLER~$ALL~HAR~-H~Lobbyi~LOBBY[~ ~R~ ~ ~ Revi~d [2/08/04