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Ira Giller/1131 Kent LLC Jim Cavanaugh tD ..... MIAMIBEACH 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. NAME OF LOBBYIST: G( LLEZ (Last) trlA- (First) ~1{ Mtnl0L "fJ~~ n.-~. I ~IN.\ \ .~,~ (Number and Street) (City) (State) (~~ )~&-M"Ll FAX NUMBER: D. (M .!) "~14-0 (Zip Code) C; l \...LEl2 t\ Got L~ BUSINESS NAME AND ADDRESS (~On~s- "'24- 'TELEPHONE NUMBER: EMAIL: I. LOBBYIST RETAINED BY: \\ ~l ~T L..l-c.... JIM CAVlcAJA-O&H (1'fl1A./GtPIrl.-) t t..Af.Jt.e ~'TtefZ.~.~L.) NAME OF PRINCIPAL/CLIENT: I (\~ \ CDL..("'ltJ~ ~~. M,AMl (Number and Street) (6ty) for '2 .. b FAX NUMBER: (Optional) 8~C(.( ft.. (State) J"\~9 (Zip Code) 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: ~'M. CM/~A/4()Gt-l IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: J t tv\. CkV'AIJAVG H. - U"'/" II. SPECIFIC LOBBY ISSUE: ttf13 ft L€ :t\:. ;~1.,j - 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 >>-l~n>elc. Pr2:E::~ 12\1' t\'rlOW e>~A-t..D - - - . IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) "I, t;t:JO . r~ 1t.A'11S B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ;(, S-~" Ft.Irt rz-An 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": D Yes ~o: Are YOU lobbyina on a oresent or oendina bid for aoods, eauioment or services, or on a oresent or oendina award for aoods, eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes ~No: Are YOU lobbyina on a oendina aoolication for a Develooment Aareement with the City or aoolication for chanae of zonina mao desianation or chanae to the City's Future Land Use Mao? 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.. DYes 'IlNo: Are YOU reoresentina a not-for-orofit corooration or entity without soecial comoensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST STATEMENT UNDER OATH, LISTING LOBBYIN EXP RECEIVED, IN THE CITY OF MIAMI BEACH FO THE SHALL BE FILED EVEN IF THERE HAVE BEEN 0 E REPORTING PERIOD. LL SUBMIT TO THE CITY CLERK A SIGNED ITURES, AS WELL AS COMPENSATION CEDING CALENDAR YEAR. A STATEMENT DIT S OR COMPENSATION DURING THE Signature of Lobbyist I do solemnly swear that all of the foregoing familiar with the provisions contained in Secti requirements. Signature of Lobbyist: Signature of Principal/Client: true and correct and that I have read or am of e iami Beach City Code and all reporting VI. PRINCIPAL IDENTIFICATION: rI Produced ID 'fL 1:).,...., \Jf,r.s L.C Form of Identification ,Produced ID Pt.. 1m. . L\C~'.ser Form of Identification C Personally known (Lobbyist) o Personally know,:! (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn and subscri fore e This ---1Lday 20M, I'" a\. Honey Giller Signature of bl" otary - State of Flo( ./ E' miNion 00330115 Notarizatio Principal's signature <>,' xpwea August 27 2008 Revised 12/08/04