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Carol M. Hoffman/Arts at St. Johns Inc. ,~ . (9 MIAMI BEACH CIty of Miami Beach Office of the City Clerk 1700 ConventiOn Center Drive, Miami Beach, R.. 33139 LOBBYIST REGISTRA nON FORM Lobbyist means all persons employ<<l or r....ined. _ paid or not. by . principal who seeks to """,,"..go lI1e passage, defeat or modification d any ordinance, resolution, action or decision d any convrissioner; anyiJCtion, decision, recommendation of the City Manager or any city board or commi_; or any adion, decision or ~ of any city personnel during lI1e time period of tI1e entire decision.....1clng process on sucI1 action, decision or ,"'0"''''''_ _ foreseeallly will be heard or reviewed by lI1e city _, or a clly board or ,~...itlio... The lIlrm spedfic:ally includes tI1e principal.. well.. .ny _Ioyee engaged in lobbying ._. 11Ietann "LD..........._--.__ _..-lID 0nII_.. 20114-3435. tJ BUSINESS NAME NID ADDRESS (First) EMAll: (City) I. LOBBYIST RETAINED BY: . .~~ cd ~/. ( )I)/WS JjlC NAME PRI ttl/WENT: - . !k~ (rr~( J().k~);tC 47r:JO 7?vO?2LLD/2 -a/~~~ Fr-- .. 5__~ """"-~ ,." . ""'" ..~, ?J/Yd 3() ~b(? -,Q3a.s----- ar-&::zts-;~rfJ.. b~J/P~ TELEPHONE MJMIlER: fAX: (0pti0nIl1) EMAIl.: ( - I) FIR _III" _.If .............. OlIpond1.... P..Iio_....lpor-rn.[SectiN Z-482 (e)] . NAME OF OlJEF OFFICER, PARTNER, ~ 1l8lEFICIARY: C f/C2-l sn 4/.G PEA/I? . IDENTlFY ALL PERSONS HOLDING, DIRECTlY OR INOIRfCTl y. A 5% OR MORE OWNERSHIP INTERfST IN SUO! alRPORAllOll, PARfNERSt&P Of!. lRlI5T: ~ ~, IV. DI5Q.OSlIRE OF 1BlM5 AND AMOUNTS OF l.OIIIIYlST COMPENSATION (DISCLOSE WHElItfR HOIJRL Y, FlATRA7EORumBlj. . A) LOBB'IISTOISQ.05URE:(Requlrod} I am -1iw dJrt'clM-- (tluMs qf S-f Jofu,O B) PRINClPAL'SOISCLOSURE(OFLDBBYISTODMPEN5AllON):(~). rn~ -h-1a1 ."yJ}n../1 IS, $j,;{,OOD The foUawing infannationmust be answered: c::LtI"c;,- 1) Pursuant to Miami Beach Oty Code SectiOn Z-488 EntilIed "Prohibited Campaign contributions By Lobbyists On Procurement Issues": .< n Yes 'rll No: Ara vou a...w-Ina an _ --;:.t~.::=':; ;::::":;n-~ or lIMViC8&. or on a I "\ Dr --A. ar 'D8indlna award far MNVVIe _.IDIIH!IIIt.Gr ..-vice? 2) PlJ"SUiInt to Miami Beach Oty Code 2-490 EnliUed 'Prohibited Campaign Conbibutions By Lobbyists On Real Estate Development Issues": DYes (NOl ='~ on a .......nna _lication for a Develoament __ with the City or _ far r:hallll8 of' ~anina maD ....Iftftation 01' dtanae t:D the~. Fub.... Land U_ HitR1 3) Pursuant to Miami Beach Qty Code 2-484 (h) Any person (ec:cept those exempt from the definition of "lobby1st" as set for1h In SectIon 2-181 above) who ony appears as a representatIVe of a not-furilrofit corporation or entity without special compensalioo or reimtusement for the appearance, whether direct, or indirect, to express ~ of or opposition to any item, sIlall regis1er with the derlc as reql.ired by this section but. shall not be required to pal( amy registration rees.. )(Yes DNa: :-..:~~a~~for-f:;~~en~wl~~~i:"r..tion V. SIGNATURE UNDEROA1H: ON OCTOBER lor 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 EXPENDITURES OR. COMPENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all of the foregoing facts are true and and that I have read or am familiar with the provisionS comai in n 2-'18 of the Miami Beach City Code and all reporting requirements. Signature of lobbyist: Signature of PrincipaVCIient: VI. l.OIIIIYlST JDENTIFlCA11ON: <-(Produced 10 H { S:S"1 (~ 'IV~2.1l) form of Identification PR1HC1PAL IDENTJFICA11ON: "::J"Produced 10 P 5 D 0 - t \ ;,- S-O <1(7 i 0 form of Identification ~ Personally known ("db list) ~ Pl!lSOIlally e'~.... VII. SIGNATURE AN. D STAMP OF NOTARY, !\!' ....~\ \l\ .JiJ Slate of Aorida, County of Miami-Dade .~,~"" Sworn to and Slhsaibed before me T.s "2'" dayof ~ .2007 I~I~"" ijll If/.> I ~i_ Iii Annual . -: Res I ] ~~~~~#_ ~... 2f5/0't Loilbyist RAlg_ Form l'elIeived and vel1iIied by: ~ --::;:. I . F:\a.ER\$AU.\MARIA-M\Lo/Jbyist\LDBYISTfORM 05.~r-= Revised 12/08/04 ~~t,il~/n