Todd Martin/Harding Avenue Investments, LLCMIAMI BEACH
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 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: (Last) (Fast) (M.I.)
Todd Martin
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
Itec Design 1825 West Avenue, #7, Miami Beach, Florida 33139
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
(305) 673-2121 (305) 673-4640 tmartin„~a,itec.net
1. LOBBYIST RETAINED BY:
Harding Avenue Investments, LLC
NAME OF PRINCIPALCLIENT:
Harding Avenue Investments, LLC 6340 Sunset Drive Miami Florida 33143
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 275-0108 (305) 779-8346
TELEPHONE NUMBER: 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: TOm Cabreriz0
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Tom Cabrerizo (50%); Yorem Izhak (50%)
II. SPECIFIC LOBBY ISSUE:
Planning Board Application .~
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of IndividuallTitle I B) Any Financial, Familial or Professional Relationship
Mercy Lamazares, Principal Planner None
Jorge Gomez, Director ~ None
iV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
B) PRINCIPAL'S DISCLOSURE (OFLOHBYISTCOMPENSATION):
The following information moat be answered:
1} Pursuant to Miami Beach City Coda Section 2488 I'sntitled "Prohibited Campaign Contributions By Lobbyists On Procurement
issues":
Yes Cf N Are u l0 1 on a res or a in bld for s e ent sorvi or on a resent r en a r r
taoods. equlament or servige?
Pursuant to Miami City Code 2-490 Entitled "Prohibited Campaign Gontributions By Lobbyists On Real Estate Dovelopment Issues":.
man dests:nation or chantre to the Citv's Future L,nnd Use Magi,
Pursuant to Miami Beach City Coda 2-484 {h) Any person (except those exempt from the definition of "lobbyisC' as set forth in
Section 2-481 above) who only appears as a represen4ltive of snot-for-profit corporation or entity without special compensation or
reimbursem~tt for the appearance, whether direct, or utdirect, to express support of or opposition to any itran, shall register with the
erk as required by this section but, shall not be required to pay any registration fees..
IV. SIGNATURE UNDER OATH:
ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LQBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL B EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. •
Signature of Lobbyist
1 do solemnly swear that all oft got acts are true and con•N~ct that I have read or am familiar with the provisions contained in Section
2-482 of the Miami Beach C' ode and all ortine reauirern~~ _
Signature of
Signature of PrincipaVClient:
V. LOBBYIST IDENTIFICATION: N o E
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^ Produced [D ~ - :T.Y 7v~~F~j ~^" N
Form of Identification "O G ~ ~
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^ Personally known (Lobbyist) ~ c '~ o
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VI. SIGNATURE AND STAMP OF NOTARY ~ -~ ~ Q
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Stato of Florida, County of Miami-Dade x
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Sworn to and su b re ~~7
This ~ day O~ .
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Lo byist s signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
D Personally known (Prlnclpal)
State of Florida, County ofMiami-Dade
Swom and subscribed before me
This day of , 2p
Signature of Public Notary - State of Florida
FOR CL ~ y ~ ~
Annual Registration fee: [ j Yes [ ~o Amount id- ~ + MCR~t~~#`~~Datc Paid ~ U
Lobbyist' Registration Fonn received and verified by:
F:ICI,ER\SALLUVIARIA-M\LobbyistlLOBBYIST FORM O5, d c Revised 12!08/04
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTN'ER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION}: (Required)
The following information must be answered:
1) Pursuant to Miami Beach City Code Sectiop 2488 Entitled "Prohibited Campaign Contribtttions By Lobbyists On Prncuremant
/issues":
j~„Yes [~l No: Ara you lobbvina on a present or aendfas bid [or Goode, eguinment or services. or on a present or vending award_tor
eaods. epuipmeat or service?
IV. SIGNATURE UNDER OATH:
ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO TAE 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 9HALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that alI of a for omg cts re true and corroct and that I havo read or am familiar with the provisions contained in Section
2-482 of the Miami Beach Ci Code a dal repo ing requirements.
Signature of
Signature of PrincipaVC
V. LOBBYIST
O ProducedlD
PRINCIPAL IDENTIFICATION:
Form of Identification
^ Personally known (Lobbyist)
VI. SIGNATURE AND STAMP OF NOTARY
State of Florida, County of Miami-Dade
Swom to and subscribed before me
This _ day of , 20
^ Produced ID
Form of Identification
[rJ Personally known {Principal)
State pf Floridan County of Miami-Dade
of _
~_ ROBERT CEBALLO$
Si store of Public Nota ~~ ~ ,: MY COMMISSION # DD6448a
gn ry-State of Florida Signs re of Public Notary - Sta 6
Notarization of Lobbyist's signature NoGtrization of PrincipaPs sie a{~~~ ~,• , EXPIRES
Aptil 07, 2011
ry8nvla.COm
FOR CLERK'S USE ONLY
Annual Registration fee: [ )Yes [ ] No Amount Paid MCR # Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\SALLIMARIA-M\Lobbyist\LABBYLST FORM O5. doe Revised t2J06/04
3) Pursuant to Miami Beach Ciry Code 2-464 (h) Any person (except those cxompt from the dcfmition of "lobbyist" as set forth in
Section 2-481 above) who only appears as a representative of snot-for-profit corporetion or entity without special compensation or
roimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall rogister widr the
clerk as required by this section but, shall not be required to pay any registration fces..