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James Rauh/Komoko Corporation o J()f( \ .. ~...~ lD "WV ,MIAMIBEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRA nON 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: rz. C S l'..... ~"..> iT/i!, e-S BUSINESS NAME AND ADDRESS 2A(,.lH (Last) .:jA"'" ~~ (First) E. (MJ) ~ r"" T I AJ p.L. ' .Lf () 7 (Number and Street) {. IM{'; C.AJ (City) (loA-O PffSE /tAI,."."",,/ f3e-fff! h !.:?'s1 (State) (Zip Code) -ro~ ~3q t{757 TELEPHONE NUMBER: 36; :; 3~ ,; SoLI FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: \< 0 1"\0 ~D CO ~'o 6!-4jl iJt\J NAME OF PRINCIPAL/CLIENT: ~o.....olc,.c> c.oft.pofl.lrntr, BUSINESS NAME AND ADDRESS (3()~)67 3.. 37b7 TELEPHONE NUMBER: t..{ 00 Arfh"'f 00Jfre y IG-<t;) (Number and Street) (City) S l.l;k 'ZOO .MIa"",; (State) ;sqCtc!." FL (Zip Code) J1'~ FAX NUMBER: (Optional) 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: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: (ODI-rI...,''I'L lASE="' A-ff/(2.-oIffAv 10 L-oIIISTf1-l4lr S,..(l..~c."f1.-l~t'" LMZ-bFtl- TH-"r,v Issue to be lobbied (Describe in detail): ~ D,oOD SQ4AA-(Z.-E' fe1:?T AI ~'tof) (OLLI.-.JI A-vG"IIvle- III, CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship ?t.ANN IN <0 gO-"T(2..() NO IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WH,ETHER HOURLY, FLA T RATE OR OTHER). A) LOBBYIST DISCLOSURE: (Required) t$ 7 ~ t)O. c;! M ON TI-tt-'{ It' 7/0fJ. ~ B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ..u> _:> M ~ (>I rIft.- y The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": DYes ri No: Are you 10bbyinQ on a Dresent or DendinQ bid for Qoods, eauiDment or services, or on a present or oendina award for aoods, eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes ri No: Are YOU lobbvina on a pendinQ aDDlication for a Development Aareement with the City or aDDlication for chanae of zonina maD desianation or chanae 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.. V. SIGNATURE UNDER OATH: I do solemnly swear familiar with the pro requirements. Signature of Lobbyist: VI. PRINCIPAL IDENTIFICATION: o Produced ID o Produced ID Form of Identification Form of Identification ~ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Revised 12/08/04