Patricia Baloyra/Leviev Boymelgreen Vitri Developers, LLC
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MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, Fl33139
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 <:ity 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 toreseeably will be heard or reviewed
by the city commission, or a city board or committee. The term specifically includes the prindpal as well as any employee engaged
in lobbying activities. The term "LobbyistsM has specific exclusions. PIe.- refer to Ordinance 2004-3435.
Baloyra, Patricia M.
NAME OF LOBBYIST: (Last) (First) (M.!)
Broad and Cassel, One Biscayne Towe, 21stFL, 2 S.Biscayne Blvd.,Miami,
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) FL 3 3 1 3 1
305.373.9400 305.373.9443 PBaloyra@broadandcassel.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Leviev Boymelgreen Vitri Developers, LLC
NAME OF PRINCIPAl/CLIENT:
Leviev Boymelgree Developers, 3050 Biscayne Blvd.,Ste.700, Miami, FL
BUSINESS NAME AND ADDRESS (Number and street) (Oty) (State) (Zip Code) 3 3 1 37
305.573.8830
TELEPHONE NUMBER:
305.576.1689
FAX NUMBER: (Optional)
EMAIL: (Optional)
FII out tills ..u- If princlplll is a Corporation, Partnership or Trust (Section 2-482 (e)]
. NAME OF OOEF OFFICER, PARlNER, OR BENERCIARY:
. IDENTIFY AU. PERSONS HOlDING, DIRfCTL Y OR INDIREC1l.. Y, A 5% OR MORE OINNERSHIP INTEREST IN SUOI
CORPORATION, PARlNERSHIP OR TRUST:
IL SPECIFIC LOBBY ISSUE:
Virti Development Issues
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A} Full N_ '" IIIdIvidual/Tllle
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8) My RnanciaI, F8lRil1a1 or ProIaeIlh_ ~
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FlA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) Hour ly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hour 1 y
The following information must be answered:
1) Pursuant to Miami Beach Oty CcxJe Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
o Y~ lXNo: Are YOU lobbving on a Dresent or DerIding bid for aoods. eauiDment or services. or on a
DreSent or DerIding award for goods. eauiDment or service?
2) Pursuant to Miami Beach City CcxJe 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues";
DYes XI No: Are YOU lobbYing on a DerIding aDDlication for a DeveloDment Agreement with the City or
aDDlication for change of zoning maD designation or chanae to the City's Future Land Use
M!lD1
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..
DYes IXNo: Are YOU nmresenting a not-for-DrOfit comoration or entity without sDeCial comoensation
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, U5nNG LOBBYING EXPENDITURES, AS WELL AS COMPENSAnON
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 COMPENSAnON DURING THE
IlIPOImNG PERIOD. ~ .
. ature of Lobbyist
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. ~
Signature of lObb~~
Signature of PrlncipaVCHenI: ~
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
U Produced ID
U Produced ID
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Form of Identification
~rsonallY known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of Identification
~I/Y known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This ~day of J 2006
~ Pakll/ ~I iJ'1
Revised 12/08/04