Steve Marin/B. Rafael Barba
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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 dedsion of any commissioner; any action, decision, recommendation of the
City Manager or any city board or committee; or any action, dedsion or recommendation of any dty personnel during the time
period of the entire decision-making process on such action, decision or recommendation that foreseeably wlU be heard or reviewed
by the dty commission, or a dty 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:
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(Last)
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(First)
(M.!)
PA.~'('\V'\ Or..v\~ ~o'V\~
BUSINESS NAME AND ADDRESS
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TELEPHONE NUMBER:
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(Number and Street) (City)
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FAX NUMBER:
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(State)
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(~p Code)
EMAIL:
I. LOBBYIST RETAINED BY:
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NAME OF PRINGPAl/CUENT:
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BUSINESS NAME AND AODRESS
2."1\\ NW ...... :;.~. 1\.\......""',
(Number and Street) (City)
FL.
(State)
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(Zip Code)
t'bO'i,J '''10 '1:,\::'
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIGARY:
~. ~S'....c..\ "\3,.......""_
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A So/, OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Describe In detail):
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0"
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III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financia', Familial or Professional Relationship
C. i'\. '\
(.'1'1'\,..., ..~: ",t,t' S
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IV. DISCLOSURE OF TERMS AND AMOUNlS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FlATRATEOROTHER). ~
A) LOBBYIST DISCLOSURE: (Required) /..::L.c ~b -
B) PRINOPAL'S DISCLOSURE (OF LOBBYI;COMPENSATION): (Required). II ~ <:::L:> cYO
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":
: Ar lob in n r nt or din bid f r d e ui
Dresent or oendina award for Doods. eauiDment or service?
nt r lVi
r n a
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
Ar ou I bb in on ndin Iicati f r D velo mAr m n wih Ci or
aDDlication for chance of zonina maD desianation or chance to the City's Future Land Use
~
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"iobbyist" 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 registra~on fees..
Y
Ar u r r enti" not-' r- r fi r oration or enti
or reimbursement.
ial m "sa ion
V, SIGNAlURE UNDER OATH:
ON OCTOBER 1ST 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 OMPENSATlON DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
famUlar with the provisions contained in~ L-'Il'l~ of th" M;~m; P."~:h_<:ity Code :.nn ~II r~orting
requirements. '--. - -
--.~~-~
Signature of Lobbyist: -' -
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
U Produced ID
U Produced ID
Form of Identification
~nallY known (Lobbyist)
Form of Identification
~IIY known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn, ~~~d subscrib b ore me
This ~ay of
Ignature of Public Notary - Stat
Notarization of Lobbyist's sig
State of Florida, County of Miami-Dade
n n subscribed before me
IVETTE PINTO This da of~ B . 2
MY COMMISSION #00510978 .
EXPIRES: FEB 11, 2010
<!ondedthroUghlstStatelnstiilllll ture 0 lic ry - tate
rization of Principal's signature
IVETIE PINTO
MY COMMISSION #D051 0978
EXPIRES: FEB 11, 2010
hlstStatelnsurance
/ FOR CLE~ U~ ONLY
Annual Registra~on fee: lVl Yes [ 1 No Amou~ Paid . .. MCR # :2~Date Paid ~
lobbyist Registration Fonn received and verified by: ~"'.A:-"
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 0 ' Revised I2/0B/04
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
l'U':'...IJ~-.:. UUli::- U.i..il." i....._._,;' U'_!.i. ';-
rlCP-Ci ty Cl (:(k
2::-:.e754 $2::~. en:)
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No.
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CJ Cash CJCredit Card c!Check t31'94
$ .2'5~o
5eb '-4 20a-
Received orJ'-,\a. (' i t'\ a: Son:::,
Add.....
For STeve... ~o...'\~ \~\::bH..s..-T ~\s+rO--Tlon
By
Director
(THIS INFORMATION MUST BE COMPLETED)
Account Number:..Q1\ - Aoro -3 ~ ""'\~
P...pa...r:.......A~ke~ Dept:
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