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Alfredo Gonzalez/Icrave design lt1~i ec-h ItdId U .xJU! ~ - . 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 dty 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. Gonzalez Alfredo J NAME OF LOBBYIST: (Last) (First) (M.!) Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0588 305-961-5588 gonzalezaj@gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: de. NAME O~LjCuE: t!-2A- u e. ~S i ~ AJ #/ I Iu'f'~ IJla ~7. ~"lf~(J(l. A) re. (Number and Street (City) ... S'"> ~D 2tl OJ Zq- tj3 FAX NU ER: (Optional) AlY (State) /DOIt../ (Zip Code) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] . NAME OF CHIEF OFFICE}~RTNER, OR BENEFICIARY: Dtr" I 0 (JTt.. If -Z I It n D IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: . II. SPECIFIC LOBBY ISSUE: Issue to be~~~~I): -p ~ "2. :c ~ s U~ <; III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship w\, 1io~\Q AJ Mt '" \" '" U,,, "'-J to :g on 52 ~ u.. ~ "0 8 .1BNOo:) .'!! 8. c: g VI. cno_Q~ .~ -.J ~ C"') :g ~E ~ 0.. Q E c,,? ~.~8-~ ~~;jfU) Ii) .. VII. \ v 0 "01\1 . S\(t IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $315.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $315.00 Hourlv 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 lobbyinG on a Dresent or DendinG bid for Goods. eGuiDment or services. or on a Dresent or oendinG award for GOods. eGuiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes MNo: Are you lobbyinG on a DendinG aDDlication for a DeyeloDment AGreement with the City or aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD? 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.. n Yes ~No: Are YOU reDresentinG a not-for-Drofit corooration or entity without SDecial comDensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1 sr OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDIT ES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC ING CA NDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN XPEND R PENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all of familiar with the provi . c requirements. Signature of Lobbyi t: LOBBYIST IDENTIFICATION: :J Produced 10 = Produced lOb". ~L.~. \-:"'n~b"t.~S- Form of Identification Form of Identification )( Personally known (Lobbyist) SIGNATURE AND STAMP OF NOTARY: = Personally known (Principal) State of Florida, County of Miami-Dade Sworn to and subscribed before me This ~ da 20.Q..6 State of Florida, County of Miami-Dade Sworn and subscribed before me This ~day of _ / FORCLE~AuaEONLY Annual Registration fee: V ] Yes [ ] No Amount Paid . MCR # ~ Date Paid ~ Lobbyist Registration Form received and verified by: n-~c;;. F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05:Croc Revised 12/08/04 ~91l"'OJo. {,Jjt ~ ~~tf O.f:?OA . .,<' \ i I ! ~ 2'" ,,- Z ,r., =::-' :;;;,0. r"\ ~fi,-g ~'~ ~\, ~j. g g ~ .,. h.) :::': (t> C5 \ 0i t6 r' F; ,~g'~ ~ \goNro 8 9- .... v.> co '" '" Miscellaneous Cash Receipt CITY OF MIAMI BEACH o Cash o Credit Card .>QCheck#~ Receiyed of A\~C'\ ~;:)~ OQ~ Address ~ For-1 Chy,~~ I~\~cd-;C\C\ (THIS INFORMATION MUST BE COMPLETED) Account Number: Dl\-<a:::ro-3lcf\' _~ Prepare~ Dept: .~ 2 8 6 9 'ro No. :3: f': (""') ,:t. ~J to.: I ...( $ ?5.00 t f~ Oc..b~ ~~ 200ce ~I 1~ Cf .;r;~ 'i~~:: I"') t< 0) -f.' fl. ~~; t~: cl,F - IT -1ft" I t~ :~ By Finance Dire6.iDr :/ V C\ercc:; EXT1:1!L