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Bob De la Fuente/Project Madison LLC .-- " e 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 rClllined, whether paid or not, by a principal who seeks to encourage the passage, defcat or modification of any ordinance, resolution, action or decision of any commissioner; any action, d~'Cisian. recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel during Ihe lime period of the enlire decision-making process on such aClion. decision or recommendation Ihat fareseeably will bc heard or reviewed by Ihe cily commission. or a city board or committee. The term specifically includes the principal as well liS any employee engaged ;11 lobbying activities. The term "Lobbyists" hus specll1c exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: (Last) De la Fuente (First) (M.!.) Bob BUSINESS NAME AND ADDRESS T ewCardenas, UP (Numbec and Street) (City) (State) 1441 Brickell Avenue, 15th Floor, Miami, FLorida (Zip Code) 33131 TELEPHONE NUMBER: (305) 536-8460 FAX NUMBER: (305) 536-1116 EMAIL: BDF@tewLaw.com I. LOBBYIST RETAINED BY: Project Madison, LLC NAME OF PRINCIPALJCLlENT: c/o TewCardenas BUSINESS NAME AND ADDRESS 1441 Brickell Avenue (Number and Street) (City) (State) 33131 (Zip Code) 1. '30 5J " '3 h ",? TELE~HONE NUMBER: (305) 536-1116 FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this seclion If principal is a Corporation, Partnership or Trust (Seclloll 2-482(c)1 NAME OF Cl-llEFOFFICER, PARTNER, OR BENEFICIARY: John Baldw i n IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Historic Preservation Board Application Issue to be lobbied (Describe in detail): III, CITY AGENCIEs/INDIVIDUALS TO BE LOBRIEI}: ^) Full Name of Indlvldualrrllle B} Any Financial, FamIlIal or Professional Relatiollship William H. Cary, Director Design Michael Belush, Senior Planner Thomas R. Mooney, AICP, Design and Preservation Manager ~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $335 hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) $335.00 hourly The following information must be answered: I) Pursuant to Miami Beach City Code Section 2488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Is es": r ser Ice or on r D Yel 2) Pursuant to Miami City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues"; DYe 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except Illose Cllempt Ii-om the definition of "lobbyist" as set Ibrth 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.. n r relmbursemen ., IV. SIGNATURE 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 FIL EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERI~. LOBBYIST ID PRINCIPAL IDENTIFICATION: Signature of Lobbyist: Signature of Principal/Client: V. VI. 1 Personally known (Lobbyist) SIGNATURE AND STAMP OF NOTARY C!.,NM I - Is l/liAd b/-StlIfr,z11. ~' ., Sworn and subscribed before me This .2rd.. da of , 20 o Produced 10 D Produced 10 Form of Identification C R~S "'~Y Annual Registration fee: Paid . 7~ MCR Lobbyist Registration Fonn received and vcrifie b . F:\CLERISALL\MARIA-M\Lobbyist\LOBBYIST FORM 5. doc Revised 12/08/04 """" V G d "~~Vfl~", Janet 0 oy ~o.&'C-~ =~:' ':~:Commission #00517622 -~. ....- \~~.'''.'o~gExpires: FEB. 13,2010 '" OFf\.:,,~ A N ",,,,,,,, WWW.ARONOTARY.com JOHN W. STONE Notary Public - Reg. No. S2DA Commonwealth of the North~n MarillJla Islands My Commission Expires: 6-1 r-171 P.O. Box 10001 PMB 1020 Saipan, MP 96950