Rich, Phillip A./Orange Bowl Committee, Inc.
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M1AMIBEACH
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:
Rich
(Last)
703 Waterford Way,
Phillip
(First)
590
A.
(M.!)
FL
BUSINESS NAME AND ADDRESS
(305) 341-4722
TELEPHONE NUMBER:
(Number and Street) (City)
(305) 341-4783
FAX NUMBER:
33126
(State) (Zip Code)
prich@orangebowl.org
EMAIL:
I. LOBBYIST RETAINED BY:
Orange Bowl Committee, Inc.
NAME OF PRINCIPAL/CLIENT:
703 Waterford Way, 590
Miami
(Number and Street) (City)
(305) 341-4750
FL
(State)
33126
(Zip Code)
BUSINESS NAME AND ADDRESS
(305) 341-4700
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
IDENTIFY ALL PERSONS HOLDING, DIR~CTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Miami Beach Visitor and Convention Authority Grant Application
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
Grissete Roque Marcos No
~ ivp Director
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLA T RA TE OR OTHER).
. No Compensation
A) LOBBYIST DISCLOSURE: (Required)
No Compensation
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
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 ~ No: 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 g No: Are YOU lobbyina on a oendina aoolication for a Deyelooment 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..
IK Yes D No: 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 SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEND S OR CO ON DURING THE
REPORTING PERIOD.
VI. LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
correct and that I have read O~d~^
mi Beach City Code and all rep iW~ R~ ~ .~
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Form of Identification
X Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identification
Signature of Lobbyist:
Signature of Principal/Client:
L Produced lD
o Produced lD
)(persOnallY known (Principal)
State of Florida, County of Miami-Dade
Sworn tq jmd subscribe~ before me
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Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn f~d subscrib before me I
This Jkday of . 20~1p r_.
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Signature of Public Notary - State of Florida
Notarization of Principal's signature
Date Paid
FOR CLERK'
Annual R gistration fee: [ ] Yes [ ] No Amount Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.do
Revised 12/08/04