Jeffrey S. Bass/TRG-Block One, Ltd
I
lD
.....
MIAMI BEACH
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 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.
ru ):ff ~.
NAME o~~~s.f: (-r' (~~J) (First) (M.!)
0\lt)h'n r~~ J/.A-. 4lt> 5vJ let6~ee+ H~oYY),. B. ~~,30
BUSINESS NAME AND ADDRESS . (Number and Street) (City) (State) I (Zip Code)
T~~H~JBE?15' - Coo ~ NUMBER:@OE?') B D \ - ~~
I. LOBBYIST RETAINED BY:
TRC7- 'B\r)(=l~" C)(lP Lid
NAME OF PRINCIPAljCUENT: '
I (0'615 t:~:Je.rid ion Avefl0e
BUSINESS NAME AND. ADDRESS (Number and Street)
( ;7Y -~~\O
2XJite fJOO MiQrYli BecQ; F)
(City) (State) (Zip Code) I .a31:3Ci
6 04 - '80 Y
ER: (Optional
EMAIL: (Optional)
FAX NU
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARV:
-r~ ~\'/
IDENTIFY ALL PERSONS HOLDING, DlRECTL V OR INDIRECTL V, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
l("e\co L-td. TOrr) \y
II. SPECIFIC LOBBY ISSUE:
'f2:>\a-J'~ o~'/e
Issue to be lobbied (Describe in detail):
o~iccrhOl
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship-,
......'
~:...,r; .,.... ,.,,-
.....
-.:.: /11
c::; CJl CJ
I
.,j
'1
C)
en
;:0
rn
':'")
,17
"
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required) ~ L.160 . CD
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
~ \--yDl
<..1 ~O (h V-
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":
DYes
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes
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..
V. SIGNATUFlE UNDER OATH:
IGNED
SATION
ATEMENT
DURING THE
true and correct and tha I have read or am
of the Miami Beach City Code and all reporting
VI.
PRINOPAL IDENTIFICATION:
D Produced ID
D Produced ID
Form of Identification
~OnallY known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identification
~erSOnallY known (Principal)
Date Paid