Todd Tragash/Greater Miami Jewish Federation~ 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.
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NAME OF LOBBYIST: (Last) (First) (M.I)
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-51-1 gll 3o5-S-~l-Iga I TodC~~sta4rC'hitecturalgrduP.Co~
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
6r~affr l`'rialni 3P~vilJ~ ~d~r~ior~
NAME OF PRINCIPAL/CLIENT:
n%~miQ~ach ~~ 9a~~- ~~.~~ ~~n~fi~ Dr•, l7,'~~ti 8ra~h~ ~L 33/4v
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
3oS. s39. 3ao6
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
out this section 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:
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 RATEOR OTHER
A) LOBBYIST DISCLOSURE: (Required)
8) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
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":
Y r 1 in nt n i i f ui n or i
• present or pending award for goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entided "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
CYes i~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 Citv's Future Land Use
Mau?
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 snot-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 deck as required by this
section but, shall not be required to pay any registration fees..
^ Yes ,ono: are you repres~nttng a not-,fir-pror~t corporanon or entity wrcnour spec~a~ comcensatwn
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 YEAiL A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COM~NSATION DURING THE
REPORTING PERIOD. ~1 n .~) / I /I
X '
f L yi
I do solemnly swear that all of the foregoing facts re rue and cor and at I have read or am
familiar with the provisions/ c~Ined in Sectio -482 of the Miami Beach Ci Code and all reporting
requirements. ~~ ~~ / ~ ~
Signature of Lobbyist: X
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
~Y Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to a subscribed before me
This Z day of 2/Ery
Signature of Public Notary - ~
Notarization of Lobbyist's
Notary Public State of Florida
William Pinkus
My Commission DD) 1650
Expires 10!03/2011 S~Ignature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
~M§~~` ay of , 20_
Public Notary -State of Florida
n of Principal's signature
FOR CLE K.: S ONLY ~
Annual Registration fee: [ ] Y ] No Amount MCR # to Paid
Lobbyist Registration For rec and verified by:
F:\CLER\$ALL\MARIA-M\Lob vist\LOBBYIST fORM 05. Revi 1 /08/04