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Robert Brown/Seth Gadinskym 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 decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any actlon, 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 aty board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The berm "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435. Brown Robert NAME OF LOBBYIST: (Last) (First) (M.I) Robert Brown Architect 6710 SW 80°i Street, Suite 101 Miami Florida 33143 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 662-1940 o4dare@aol.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Seth Gadinsky NAME OF PRINCIPAL/CLIENT: 1680 Michigan Avenue, Suite 1001 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 276-2387 (305) 675-7759 SethC~Gadinskyrealestate.corri TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this sedaon 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: Certificate of Appropriateness/Variances ~ ; ; a ', r ~, ~ Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title ~ B) Any Financial, Familial or Professional Relationship Planning and Zoning Department Staff, HPB, BOA, City None Commission IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HO[1RLY FLAT RATE OR OTHERj. A) LOBBYIST DISCLOSURE: (Required) $ 100 00 Der hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 100.00 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": ^ Yes X No• Are you lobbying on a present or pending bid for goods equipment or services or on a present or cending award for goods, equipment 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 you lobbying on a cending application for a Development Agreement with the Citv or application for chance of zoning map designation or chance to the City's Future Land Use Ma°? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Sed9on 2-481 above) who only appears as a representative of anot-for-profit corporation or entity without spedal compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the derk as required by this section but, shall not be required to pay any registration fees.. ^ Yes X No: Are you representing coot-for-profit corporation 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 PRECED NG CALEND R YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEND C ENSATION 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 contaiyfe~ in 2-482 of the Miami Beach City Code and all reporting requirements. ~ // Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ~_.a. --° ~t~0.Y (~,QdUC~{~~i' MAY DUFhY r coM,~issior~ ~° ,;~` ` F~f~~ entification ~' '~`~4 " ~>~p,r r,~ nor Q6.2QQ7 ~ Personally knoww (Lebbyisil) PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ^ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed~efQre me This coq IL day of LQ. w7 lE , 20~. Signature of Public Notary `state of Florida Notarization of Lobbyist's signature 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 Annual Registration fee ]Yes [ ] No Amount Paid Sv MCR # ~~~~~n Date Paid ~ 0 Lobbyist Registration Form received and verified by: Entered By: F:\CLER\;ALL\MARIA-M\Lobbyist\LOBBYISi fORM OS.doc Revised 12/08/04 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYISt COMPENSATION (DISCLOSE WHETHER NOl1RLY, ~' 8~ FLAT RATE OR OTHER). A) LOBBYIST DISCLOSURE: (Required) $~Od00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $J~~00 ner 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": ^ Yes X No: Are Vou lob vino on ~ ,present or pending bid for goods. eauipmerLt or services, or on a present or pending avy~rd fora s, eauiament Qr' service? 2) Pursuant to Miami Beath City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Devebpment Issues": 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 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.. ^ Yes X,No: Are you re~~:~:sentina a not-for-profit corooration or entiiv without special comuensation or reimbursernent. . 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 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 PrincipalJGient: YI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ 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 ^ Produced ID Form of Identification ~-Personally known (Principal~,r Mara Ha~pem '~~ ~ My Commission DD301094 ~o*F,,d~ Expires March 29, 2008 State of Florida, County of Miami-Dade Sworn and subscribed re me This ~ day of 0' <. Signature of ublic Nota -State of Florida Notarization of Prind 1's signabir+e FOR CLERK'S USE ONLY ~ ~~~ .~-~9, Annual Registration fee: ~'`~ ]Yes [ ] No Amount Paid ~ ~'7 MCR # Date Paid vJ Lobbyist Registration Form received and verified by: _ Entered By: