Michael Abrams/Bear, Stearns & Co., Inc.m 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.
NAM OF LOBBYIST: (Last) (First)
BUSINESS NAME AND P
5~ ~ ~ ~~
TELEPHONE NUMBER:
(Number and Street) (City)
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(State) (Zip Code)
FAX NUMBER:
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAL/CLIENT:
~~~ ~~~ ~
BUSINESS NAME AND ADDRESS
TELEPHONE NUMBER:
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(Number and Street) (City)
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FAX NUMBER:
Fill out this section if principal is a Corporation, Partnership or Trust
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
(M.I)
N~~ilz~r6~ucl gocu ~1~~ y3
2-482
EMAIL: (Optional)
(Zp Code)
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: \ p
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II. SPECIFIC LOBBY ISSUE:I (~
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Issue to be lobbied (Descri a in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
PLAT RATE OR OTHERf f ~, ,, ,~ L f, n,~ ,,n,~e~1
A) LOBBYIST DISCLOSURE: (Required) U7-i 1~' - ~ (SC-f'~T! C~C~ I~ C ' M ~j, fi Qn ~SeLx L9Y1 I-~~~ ~r~° `~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ ~ (,~ ~~'~ ~~~~~
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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":
'Yes No• Are you lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation or change to the City's Future Land Use
MaD?
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~No• Are you representing snot-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 PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES R COMPENSATION DURING THE
REPORTING PERIOD.
/~~L~1 ~~a~~_~i
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 2~2 of the Miami Beach City Code and all reporting
requirements. ,~ „`~~Y.f / 1
Signature of Lobbyist:
Signature of Principal/Client:
Ann Cogtlpn LOBBYIST IDENTIFICATION:
f Ny Commission DD2903a7
'~`awdi' Expires March 20, iuced ID
~ ~~ Form of Identificat
`Personally kn n (Lobbyist)
VII. SIGNATURE AND STAMP OF NOT
State of Florida, County of Miami-Dade
Sworn to and subscrib~ bef e me
This'/ day of _L~~-~20 -%
Signature of Public Notary -State of Flonda
Notarization of Lobbyist's signature
ion
ARY:
Annual Reyistration fee: [ " ]Yes [ ] No Am
Lobbyist Registration Form received and verified by:
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PRINCIPAL IDENTIFICATION:
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Form of Identification „
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- Personally known (Principal) } c~N
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State of Florida, County of Miami-Dade a
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Sworn and subscrif~~d befpre me
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This i
day of ~Y~~ , 20` o ~ t''
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Signature of Public Notary -State of F orida ~ ~ --
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No rization of Principal's signature z° ~
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MCR #e~_ Date Paid ~ 2+7 ~~ c.