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Craig Webb/Howard Herring NWS .~ <9 MIAMI BEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM lobbytst means all persons employed or retained, whether paid or not, by iI principal who seeks to enctllKilge the passage, defeat Of modification 0( any ordinance, resolution, action or decision of any commissioner; ilny action, decision, recommendation of the Oty Manager or ilny city board or committee; Of ,my action, decision or recommendation of any c~ persomel during the time period of the entire clecision-making process on such action, decision or recommendation that foresetoilb~ will be heard or rl!viewed by the dty commiSsion, or a city board or committee. The term speciflCillly includes the principal as well as any employee engaged in bbbylng activities. The term -LDbbyists" h.s specific hduslons. PleUfl refe, to Ordinanctl 2004-3435. 4"S M/ t-l:JI? (Last) !,p (Number ilnd Street) (City) 1.! 0-1-/1, 1- - ~OC'(:. F NUMBER: Cr.' (F",~j /7-'5 L/ (M.I) 6blrltk 9: >~ M I CjooM (state) (Zip Code) erA:J w fJ fb",CI , ea&4-1 EMAIL: , ~ '2/o-t/K"L -1,000 TaEPHONE NUMBER: I. LOBBYIST RfTAINilm Ho {)/ ct-rd eif3 NAME OF PRINCIPAl/CUENT: . , Nb<>> UltJr(d' 5ij/HI'~ 01./' I~ f-c,,-I.., (lM~ IXach BUSINESS NAME AND ADDRESS (Number and Street) (etyl 105- r.7~-a?,v ~os-t7?-(,N1- TELEPHONE NUMBER: FAX NUMBER: (Optiooal) EMAIL: (Optional) (State) p:.. ?7/JC{ (lip Code) Fill out thll section if principalll a Corporation, Partnership orTrust [Sectlon 2-482 (e)] NAME Of CHIEf OFFICER, PARTNER. OR BENEFIClA.RY: lDENlTFY AU PERSONS HOLDING, DIRECTLY OR INDlREOlY, A 5% OR MORE OWNERSHIP IKfEREST IN SUCH CORPORATION, PARTNERSHIP OR. TRUsr: JL SPECIFIC LOBBY ISSUE': ~.... ~ It. ~Of1.L...D Issue to be lobbied (Describe In delail): D1 CITY AGENCJES/JNDMOUALS TO BE LO..lfD: ~-( "'-A.pJJo~ -{ .y:;-..u bJ I ...0 I '" I.- A) PUU Name of Indhrid",'/Ti1Je ') An, Fi""ndal, Familial or PrDr.uIonal Relationship oe~If..,...) a.="',J!:n' "'- A.Y 0"" ~ .;~ . N. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLQSf WHElltER HOURLY; FLATRATEOROTHER): --9- A) LOBBYIST DISQ.OSURE: (Required) -6l- B) PRIt<<:IPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). The following Information must be answered: 1) Pursuant to Miami Beach City Code Sectlon 2-488 Entitled "Prohibited Campaign Contributions By lobbyists On ClIrement IssuesH: 01 i ar orndlnbld ul Drenn!: or IH!!ndina aWl!lrd for QOods. eauioment Dr _rvlce" servlc s Dr 2) Pursuant to Miami Beach Oty Code 2-490 Entitled "ProhIbited Campaign Contributions By Lobbyists 00 Rea! ~ Estate Development IssuesH: No: Are YOU lobbvina on a Bendlna aDOllation for a Dl!yekloment AGreement with the City or aDDIic::ation for chanae of zonina maD desionation Dr chanae to the City's Future lJInd Use MGZ 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~profjt 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 sect but, shall not be required to pay any registration fees.. no - - r 1 .. or reimburseml!nt. . Y. SIGNATURE UNDER OATH: ON OCTOBER 1sr OF EACH YEAR, EACH LOBBYIST S STATEMENT UNOER OATHrSTlNG LOBBYING EX RECEIVED, IN THE CITY OF lAMI BEACH FOR THE SHALL BE FILED EVEN IF ERE HAVE BEEN NO EX REPORUNG PERIOD. ~ I I do solemnly swear tnaJi,l!toregOing facts are familiar with the provisiO~ co In Section 2-482 requirements. i I I , Signature of Lobbyist: Signature of Prlndpal/Cl VL BMIT TO THE CITY CLERK A SIGNED ES, AS WELL AS COMPENSATION G CALENDAR YEAR. A STATEMENT ES OR COMPENSAUON OURING THE ue and correct and that I have read or am the Miami Beach City Code and all reporting nON: o Produced ID o Produced 10 Form of IdentifIcation o/"PersonaNY known (Lobbyist) VII. SJGNATURl\AND STAMP OF NOTARY: CAJJ~,.. L-o.l /l7W2f state of RlM*, COunty of )1iu...1 ~ SWorn to and 5\Jbscrl before me This c..-I 200 Form of Identification *rsonallV known (Prlndpal) .~ OMA CAROL PETRoev ~.; MY COMMISSION # 00'91284 'tOFt\: EXPIRES; Aug.31.2010 (407) 398.0153 FIorla. Hoary Slnce.com Annual Reglstr 0] f'-C:: Paid lobbyist Registration Form recetved and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 .doc ONLY .~ f~ Date'" Revised 12/08}04 ~ - - - -JENN;Et~LE;NEHR~ ~ @-....Commlssion#1499199 ~ -.,;.. Notary Public - CaUfomla I . c~,. Los Angeles County - ~ _ ,.. _ ~.:o:m~Ex~r:J~6:.2~1 ATTACHMENT Jorge M. Gonzalez/City Manager Timothy Hemstreet/Assistant City Manager Hilda Fernandez/Assistant City Manager Robert C. Middaugh/Assistant City Manager Jose Smith/City Attorney Robert Parcher/City Clerk Maria Martinez/Assistant City Clerk Donald M. Papy/ChiefDeputy City Attorney Jean Olin/Deputy City Attorney Raul J. Aguila/First Assistant City Attorney Kelli Cohen/First Assistant City Attorney Rhonda Montoya HasanIFirst Assistant City Attorney Gary M. HeldlFirst Assistant City Attorney Sheri A. SacklFirst Assistant City Attorney Debora J. TurnerIFirst Assistant City Attorney Judith L. WeinsteinIFirst Assistant City Attorney Jeffrey T. Donner/Senior Assistant City Attorney Steve H. Rothstein/Senior Assistant City Attorney David Dermer/Mayor Saul GrossNice Mayor Matti Herrera Bower/Commissioner Simon Cruz/Commissioner Luis R. Garcia, Jr.!Commissioner Jerry Libbin/Commissioner Richard Steinberg/Commissioner Kent Bonde/City Center Coordinator - Redevelopment Agency Patricia D. Walker/Chief Financial Officer (City Finance Director) - Redevelopment Agency Alexandra RolandellilSouth Pointe Coordinator - Redevelopment Agency Stacy Kilroy/Redevelopment Specialist - Redevelopment Agency r '_ Manuel Marquez/Financial Coordinator - Redevelopment Agency Sandra Ortiz/Office Manager Redevelopment Agency Thomas Mooney/AICP, Design and Preservation Manager