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Raul E. Mateu/Raul Mateu - Comedy Festival Productionsm 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 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. l~la~e. v Raul E NAME OF LOBBYIST: (Last) ~ Cow.edy Fes~~Val lroduc-kib~s, U.C. Il°I BUSINESS AME AND ADDRESS (Num er and Street) (City) 30~'-93g - 2,v 20 3oS-93g- aooa TELEPHONE NUMBER: FAX NUMBER: I. LOBBYIST RETAINED BY: ~4u ~ N1 afie v ~n4~o n RJ~.,S~-}~ x ww.q . EMAIL: (M.I).MIgIMI CT~it~-1 R o~ ~313`~ (Zip Code) NAME OF PRINCIPAL/CLIENT: ~ ~ ( (~QS~~ nQ~-0 A ~t~ S~- Q. ~ 0O Cbw~4dy FlS~-~AI Prtid ~c~b~S,L~~ M.ayr;~ ~iQ~ G~,~ FL 33135 BUSINESS-fGAME AND ADDRESS (Number and Street) (City) ~ (State) (Zp Code) ?cos- 938 -aoao 3~5-~t3g--aoo~a R, ww.g. cowti TELEPHONE NUMBER: FAX NUMBER: fODtional) FMATI • (nntinnan out this section if principal is a Corporation, Partnership or Trust [Section • 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: 5ou4~n ~3ec-c1n ComQd,~ FeS~'~yal 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 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): 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": Q Xes ~No: Are you lobbying on a oresent or oending bid for goods eauioment or services or on a aresent or oending award for goods eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": 3) Pursuant to Miami Beach City Code 2-484 (hj 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 seyti"on but, shall not be required to pay any registration fees.. 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 EXPEN UR AS WELL AS COMPENSATION SHALL BE~FILED EVEN FT HERE HAVEABEENONOTEXPEND URE ~ COMPENSATIONA SRING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the forE familiar with the provisions contained in requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification C~Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, Coun of Miami-Dade Sworn to and subscri ~•~•~-~~~-•°-°•----____ This day of ~`~, ~' ~~~ -_ 4r -_ , TAB-E OF FLORIDA / _ e / = C`0 11AIS;"sir~'+I'J ~t:~D2840S9 ~ cif Pubttc_i~t d 'P ~ ° S FFi3.25, 2008 Notarization of Lobbyist's signature ,...,.b..a,.~,,..,a,.,y, and correct and that I have read or am ' M•i~a' i_.Beac-I~ty-~orle and all reporting PRINCIPAL IDENTIFICATION: f ~ Produced ID Form of Identification ~~ Personally known (Principal) State of Florida, County of Miami-Dade worn and subscrib bef a me is ~~day of _~ 20~~ /~:~'' FOR ERK' S~~ONLY Annual Registration fee: [ ]Yes [ ] No Amou P i C MCR Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM .d c rblic `Mate of~Fk3t •' of i 1's si jrid'ture•'~~~F OF FLORIDA ~ ~~,a, :~.~., ~ r °~~DZSaoss Revised aioDlication for change of zoning mao designation or change to the City's Future Land Use Man?