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Rebekah Lengel/Miami Light Project lD ~ MIAMIBEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRA nON 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 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. t ~ Q..,,~~ \C-c= \-.. (Last) L ~'^ ~e... \ NAME OF LOB T: (First) (M.!) Miami Light Project, Inc. 3000 Biscayne Boulevard, #1 00, Miami, FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 30 5 - 576 - 4 3 5 0--- TELEPHONE NUMBER: 305-576-6480 FAX NUMBER: ("\~....~~\ @miamilightproject.com EMAIL: I. LOBBYIST RETAINED BY: Miami Light Project, Inc. NAME OF PRINCIPAL/CLIENT: 3000 Biscayne Boulevard, Suite 100, Miami, FT. BUSINESS NAME AND ADDRESS (Number and Street) (City) 33137 (State) (Zip Code) 305-576-4350 TELEPHONE NUMBER: 305-576-6480 FAX NUMBER: (Optional) bboone@miamiliqhtproject.com EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Elizabeth Boone, Artistic & Executive Director IDENTIFY ALL PERSONS HOLDING, DlREcrLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached list of Board of Directors II. SPECIFIC LOBBY ISSUE: Miami L:ight Project Application to the Miami Beach VCA Grants Program Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A} Full Name of Individual/Title B} Any Financial, Familial or Professional Relationship VCA Grant Panel none IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) 0. If\. t\...J ~ \ -SA.c... ~ ':)c. \ ~ f.: B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 0"....'" oJ tt ~L OOD . I ~ ~ t=f' S...-l"'-\ "\ \ $( ~1.(,~;::'O The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists Of Procurement Issues": D Yes 'NO: Are YOU lobbyina on a Dresent or Dendina bid for aoods, eauiDment or services, or on a Dresent or Dendina award for aoods, eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real E te Development Issues": 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.. ,~,... lJ)W"s 0 No: Are YOU reDresentina a not-for-Drofit corDoration or entity without sDecial comDensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING E U S WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOIVI'fIE PRECED G LENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEI\V1IiO EXPENDIT OR COM PENS URING THE REPORTING PERIOD. ( VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: - Produced ID / Form of Identification . 0ersonally known (Lobbyist) -= Produced ID FOR Annual Registration fee: [ ] Yes [ ] No Am n Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARlA-M\Lobbyist\LOBBYIST fORM 0 ,doc Form of Identification ~nallY known (Principal) .",Jl'f~. Hoberta K Posner ~~ ~ '; My CommiSSion DD364496 ~,,;~,~./ Expires October 20. 2008 State of Florida, County of Miami-Dade Sworn and subscribed before me This to-dayof iJ'-..-- '\ . 20 Df.o '-,~ ~ ~ Signatu of Public Notary - State of Florida rizati n of Principal's signature VII. SIGNATURE AND STAMP OF NOTARY: r- ---- State of Florida, County of Miami-Dade Sworn to and subscribed before me ~~ ~~~~~~ Signature of Public Notary - State of Florida Notarization of Lobbyist's signature ----- Revised 12/08/04 MIAMI LIGHT PROJECT 2005-2006 Board of Directors Elizabeth Boone Executive Director, Miami Light Project 3000 Biscayne Boulevard, Suite 100 Miami, FL 33137 (305) 576-4350 Teo Castellanos Artist PO BOX 403715 Miami Beach FL 33140 (786) 271-2076 Kenneth Fields The Creek 2360 Collins Avenue Miami Beach, FL 33139 (305) 538-1951 Nancy Gelles (Chair) Patron of the Arts 1 Grove Isle, #1803 Miami, FL 33133 (305) 854-4108 Susan Gordon Patron of the Arts 9000 SW 87 Court #108 Miami, FI 33176 (305) Marlon Hill (Co- Vice Chair) DelancyHill, P.A. Wachovia Financial Center 200 S Biscayne Blvd #2680 Miami, FI33131 (786) 777-0184 David Le Batard Artist 12832 NW 23rd Street Pembroke Pines, FL 33028 Jonathan Lieberman (Treasurer) President ISN Communications 4770 Biscayne Boulevard, Suite 880 Miami FL 33137 305- 573-5300 _c__ Maricarmen Martinez Principal Upstairs Studio, Inc. 3850 NE Miami Court Miami, FL 33137 (305) 573-1400 Paulette Mintz Patron of the Arts 5655 Kerwood Oaks Drive Coral Gables, FL 33156 (305) 662-2997 Gihan Perera Executive Director Miami Worker's Center 6127 NW 7 Ave Miami, FL 33127 (305) 759-8717 Lida Rodriguez-Taseff Attorney, Duane Morris & Heckscher LLP 200 S. Biscayne Blvd., #3410 Miami, FL 33131 (305) 567-9005 Roberto Saco American Express Company PO Box 141672 Coral Gables, FL 33114 (305) 576-4350 Israel Sands Owner, Israel Sands Productions 5255 Collins Avenue, #11 F Miami Beach, FL 33140 (305) 951-3333 Jan Sebon Master Drummer, Visual Artist & Educator 657 Minola Drive Miami Springs, FL 33166 (786) 326-4207 Ana Salas-Siegel Executive Director Business & Legal Affairs Fox Latin American Channel, Inc, 2100 Ponce de Leon Blvd" #1000 Coral Gables, FL 33134 Vicki Simons Owner Simons & Green 5842 Sunset Drive South Miami, FL 33143 (305) 361-1714 Judy Weissman Patron of the Arts 7825 SW 48th Court Miami, FL 33143 (305) 663-4772 Christine Welstead (Co- Vice Chair) Partner Akerman Senterfitt 5333 Collins Ave #404 Miami Beach, FL 33140 (305) 868-6268 Alejandra Valdes-Fauli Everest Capitallnc 2601 South Bayshore Dr, #1700 Miami, FL 33133 (305) 666-1700