Anthony Leon/Wino, LLC
.-~
.
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.
Leon
NAME OF LOBBYIST:
(Last)
Anthony
(First)
(M.!)
3Design, Inc.
BUSINESS NAME AND ADDRESS
4300 Biscayne Blvd., suite G-04
(Number and Street) (City)
Miami, Florida
(State)
33137
(Zip Code)
(305) 438-9377
TELEPHONE NUMBER:
(305) 438-9379
FAX NUMBER:
EMAIL:
I. LOBBYIST RETAINED BY:
Wino, LLC
NAME OF PRINCIPALjCUENT:
Wino. LLC
BUSINESS NAME AND ADDRESS
411 Michiaan Avenue
(Number and Street)
Miami Beach
(City)
Florida
(State)
33139
(Zip Code)
(305) 469-1657
TELEPHONE NUMBER:
(305) 675-2940
FAX NUMBER: (Optional)
philippe@aquabluerealty.com
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: Philippe Harari
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Philippe Harari
II. SPECIFIC LOBBY ISSUE:
Annual/Board of Adjustment Application 930 10tl1 Street
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
BOA
None
~. .
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOUR! Y,
FLAT RATE OR OTHER): ,
AJ LOBBYIST DISCLOSURE: (Required) $145.00
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $145.00
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 X No: Are yOU lobbyinG on a present or DendinG bid for Goods. eauipment or services. or on a
present or pendinG award for Goods. eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes X No: Are you lobbyinG on a pendinG application for a Development AGreement with the City or
application for chanGe of zoninG map desiGnation or chanGe to the City's Future Land Use
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set furth in Section 2-481 above) who only appears as a representative of a not-fur-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..
D Yes X No: Are you representinG a not-for-profit col'DOration or entity without sDecial compensation
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, USTlNG LOBBYING EXPENDITURE AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDIN CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITU OR PENSATI DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the tJ regoing facts are true and correct and that I have read or am
familiar with the provisions contain in Se on 2-482 the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Ei'prodUCed ID L5 00 000 71 30<( 0
Form of Identification
PRINCIPAL IDENTIFICATION:
o Produced ID
o Personally known (Lobbyist)
VII.
Si ature of Public Notary - State of Florida
Notarization of Lobbyist's signature
Annual Registration fee: ~NO
Signature of Public Notary
Notarization of Pri't
FOR CLE~S USE ONLY /) ~ () Y\ I \J \ r1
Amount Paid. O.l')b MCR # ~Date Paid \ -r -0 I