Harold Rosen/Fairfax Hotel
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beachl FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the p<l~Ge, defeat
or modification of ~ny ordinance, resolution, action or decIsion of any commissioneri any action, decision, recommendation of the
City Manager or any cIty board Or committee; or any action, dedslon or recommendation of anY' dty personnel defined In any
manner In this section, during the time period of the entire deosion-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. . "
ROSEN HAROLD
NAME OF LOBBYIST: ~ (Last) (First)
407 LINCOLN ROAD, PENTHOUSE S.E. MIAMI
BUSINESS NAME AND ADDRESf (Number and Street) (City) ~
(305) 534-4757 (305) 538~5504
TELEPHONE NUMBER: FAX NUMBER; .
FLA
(State)
(M.l)
33139
(Zip Coder
EMAlL:
I. LOBBYIST RETAINED BY:
F'A1RfbX HOTEL
NAME OF PRINQPAL/CLIENT:
1770 COLLINS AVENUE,' MIAMI BEACH, FLORIDA
BUSINESS NAME AND ADD~SS (Number and Street)' (City)
(State)
(2;lp Code)
TELEPHONE NUMBER:-"-
-
FAX NUMBER.: (Optional)
EMAIL: (Optional)
Fill out this section If prindpal is a Corporation, Partner5hip or Trust (Section 2~2 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
LARRY LEVY
. IDENTIFY Al.l PERSONS HOLDING, DIRECfLY OR INDIRECTLY, A SOlo OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE;
REHAB. OF HOTEL' f A I (Z f'~ 'f..
Issue to be lobbied (Describe In detail):
III. CITY AGENCIES/INDlVIDUALS TO BE LOBBIED:
f7 7~~1 aLLI.......~ 1"<2""'/H~
A) Fun Name of Individual/Title B) Any Financial, Ff.;\j~~~-'Reta~hlp
~' ...r~.~~o .."I\!W':::; .".'~~',;I~;
. a...'J :.'~~: t i)l1;"I' ': , :~ . '. :'7i~>" "
.
DEPARTMENT .
PLANNING & ZONING
HISTORIC PRESERVATION BOARD
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IV. DIsCLOSURE OF TERMS. AND A.MOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,.
FLAT.RATE OR OTHER);
A) LOeBYIST DISCLOSURE; (R.equired)
$450.00 an hour
a) PRINClPAL'S DISCL.OSURE (Of LOBBYIST COMPENSATION): (Required), $ 45 Q . 00 a 11 n nll r
n Y@s-.F11No: Are liou representing it not.for-Drofit corporation or entitv without spsdal com6ensatlon Qr
reimbursement. Pursuant to Ordinant;e No. 2004-3435.
1) .
p~~~~nt ~ .~r~inance ~a. ~003-3393 Ame~dina Miami. Beach City Code, Chapter 2. A~cle VII. Division ~
T r f E tl e "CampalQn Finance Reform" Via The Addition Qf C9d~ Section 2-488. Entitled "~rohibited
Campaign ContrlbutiQns By Lobbvists On Procur.emel'ltlssues":
nY
2)
r~~~~~~~~~ ~rdi~;~~~ ~~. 2003-3395 Amending Miami Beach CIty Code Chagter 2. Article VII Division ~
~ it d \\ i n Finance Reform'l. Via The Addition Of Code Sectlol'l 2-490 Entitled "Pronibited
Camoalgn Con~ril;lutlons By Lobbvists On Real Estate Develooffient Issu.es":
D.Ye~No:
Are vou lobbvinG on ill Dending aDplication for ill Dev~lopment A.Cjreement with the Citv or
~j,pli~ation for change of%oning map designation or change to the City's Fu.ture land Use Map'?
SIGNATURE UNDER OATH:
v.
ON OCTOBER 1ST OF EACH YEAR/ EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH/ LISllNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
~~::;'R~~:;:~~~~N IF THEREIlAIfE BEEN NO EXP:::~~_f!SAno" DIJRJNG THE
. .,.... Signature of L ylst . ._- . ..,.,..,..
......--,.,..;
I do solemnly swe~r that all of the foregoing facts are true and correct and that I have ~E!ad or am
famlliar with the provisions contained .if1. Section 2-482 of the Miami Beach City Code and all reporting
reql,lirements. .
Signature of Lobbyist
Signature of Principal/en
VI.
LOBBYIST IDENTIFICATION:
ENTlFICATION: '
CJ Prod uced 10
o Produced 1D
Form of Identification
~OnallY known (Principal)
FOR CLERK;' U5epNL Y
Annual Registration fee:., [ 1 Yes [ ] No Amount p.aid MeR #
l.obbyig Registration Form received and verified by:
Revised 02/10/04 F:
pi '1 j ~ () Date Paid
,
State of Florida, County of Miami-Dade
Sworn tQ 9nd sllbsr:rlbed before me '
This ~ day of dr).'\Q I 20..QO
~ ex .a~.>W')
Signature of Public Notary - State of Florida
No 5 signa re
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