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Richard Bochnovich/Seth Gadinskym MIAMBEACH 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 rity 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, derision 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 team "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435. Bochnovich _ Richard B. NAME OF LOBBYIST: (Last) (First) (M.I) Consulting Engineering and Science Inc. 8925 SW 148°i Street, Suite 100 Village of Palmetto Bay Florida 33176 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 378-5555 (305) 378-9304 richb@cesmiami.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LQBBYIST RETAINED BY: Seth Gadinsky NAME OF PRINCIPAUCLIENT: 1680 Michioan Avenue Suite 1001 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (7$6) 276-2387 (305) 675-7759 Seth@Gadinskvrealestate.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this sedaon if prindpal 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: SPECIFIC LOBBY ISSUE: A) Full Name of Individual/T'itle ~ B) Arty Finandal, Familial or Professional Relationship Planning and Zoning Department Staff , HPB, BOA, City I None Commission III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: IV. DISCLOSURE OF TERM5 AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY FLAT RATE OR OTHERx A) LOBBYIST DISCLOSURE: (Required) ~ 150 00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 150 00 cer hour 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°: present or vending award for goods, uivment or service 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes X No Are YQu lobbying on a vending avvlication for a Development Agreement with the Ciri or avvlication for change of zoning maD designation or chance to the Ciri's Future Land Use May? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "IobbyisY' as set forth in Section 2-481 above) who only appears as a representative of anot-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, shalt register with the clerk as inquired by this section but, shall not be required to pay any registration fees.. ^ Yes X No Ar~you representing a not for-profit corvoration or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1~ 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 M NSATION DURING THE REPORTING PERIOD. .~ ~~~ ~ Signa Lobbyist P 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 contain~l in Section, 2' X62 of the Miami Beach City Code and all reporting requirements. ,r/ ~j ,, ~~ Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identifiption Personally known (Lobbyist) SIGNATURE AND STAMP OF NOTARY: ~!f Eta of Florida, County of Miami-Dade i to ar~d subscr' b re me 9? nc .day of 20~ ~ ~blic Notary~State of Florida of Lobbyi s signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ^ Personally known (Principal) State of Florida, County of Miami-Dade Swom and subscribed before me This day of , 20_ Signature of Public Notary -State of Florida Notarization of Principal's signature FOR CLERK'S USE ONLY (~ ~1 Registration fee [ ]Yes [ ] No Amount Paid ,~_ MCR # ° '~ -.L Date Paid /Q. aac~n av~'ch IV, DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) $LS~00 cer hour -- B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ /SU00 u r hour - 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": 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": V. SIGNATURE UNDER OATH: ON OCTOBER 1~ 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 FILEp EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature 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 Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID ^ Produced ID Form of Identification ^ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of . 20^, Signature of Public Notary -State of Florida Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: Form of Identification 5onally known (Princi~ll arc Halpern y, My Commission OD301094 '~iaf~d~ Expires March 29, 2008 State of Florida, County of Miami-Dade Sworn and subscribed before me This ~~.,day of 20 v~ Signature o Pu iic tary -State of Fbrida Notarizatiat of Principal's signature FOR CLERK'S,~SE ONLY Annual Registration fee ]Yes [ ] No Amount Paid _ ` `~ MCR # ~ ~~~~ Date Paid ~ ~ _ 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forlfi in Section 2-481 above) who only appears as a representative of anot-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..