Mark Cole/Mark Cole/Miami City Ballet, Inc.
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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.
NAME OF LOBBYIST:
Miami City
BUSINESS NAME AND ADDRESS
Cole Mark
(Last) (First)
Ballet. Inc. 2200 Liberty Ave.
(Number and Street) (City)
Miami Beach.
(State)
(M.!)
FL 33139
(Zip Code)
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TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Mark Cole! Miami City Ballet. Inc.
NAME OF PRINCIPAL/CLIENT:
Miami City Ballet, Inc. 2200 Liberty Ave, Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS
(Number and Street)
(City)
(State)
(Zip Code)
305-929-7000, ext. 1500 305-929-7002
TELEPHONE NUMBER: FAX NUMBER: (Optional)
markc@miamicityballet.org
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: Pamela Gardiner
Executive Director
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: N fA
n. SPECIFIC LOBBY ISSUE:
Grant application to City of Miami Beach Cultural Affairs Program
Issue to be lobbied (Describe in detail):
Tourism & Cultural Development (Cultural Anchors)
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Miami Beach Cultural Arts
(;ouncLl Members
'-------------- .
IV. DISCLDSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLATRATEOROTHER):
A) LOBBYIST DISCLOSURE: (Required) 0
B) PRINCiPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 0
The following information must be answered:
I) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
o Yes liNG: Are YOU lobbving on a oresent or oendina bid for DOods. eauioment or services. or on a
oresent or Dendina award for GOods. eauioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitied "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes J!I No:
Are you lobbying on a oendina aoolication for a Develooment Aareement with the City or
8oolication for chance of zonino maD designation or chanDe 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..
~ Yes [] No: Are YOU feoresentino a not-for-orofit corDOration or entity without soadsl comDensation
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, USTING 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.
S~ of Lb'oYiSP,,-
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements. ~ l:E'I ()CJ-.---i ~
Signature of Lobbyist: _ ~~~ L ...-
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Form of Identification
,/perSOnailY known (Lobbyist)
~ Produced ID
II Produced ID
Form of Identification
~rsonally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
FOR CLERK'
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MCR
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Revised 12/08/04