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Nikolay Nedev/Jay Schechterm 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 °Lot-byists° has specific exclusions. Please refer to Ordinance 2004-3435. NEDEV NIKOLAY I NAME OF LOBBYIST: (Last) (First) (M.I) NC-OFFICE, CORP. 14 NE FIRST AVENUE #1203 MIAMI FLORIDA 33132 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-3?~-0082 305-3~3-0082 nn~nc-office.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: JAY SCHECHTER NAME OF PRINCIPALJCLIENT: 4333 JEFFERSON AVENUE MIAMI BEACH FL 33140 BUSINESS NAME AND ADDRESS (Number and Street) (Gty) (State) (Ztp Code) 305-632-4548 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: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: SINGLE FAMILY RESIDENCE RENOVATION AND ADDITION IDESIGN REVIEW BOARD APPROVAL) Issue do be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Indivit~pal/Title I B) Any Financial, Familial or Professional Relationship DESIGN REVIEW BOARD CITY OF MIAMI BEACH `.. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERr /~ fi) LOBBYIST DISCLOSURE: (Required) SO ~Q B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). S~ I ~O ~ 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": n Vac tsd No• Are you lobbvina on a present or Dendina bid for goods eauiument or services or on a ar+esent or oendina award for goods, equipment or service? 2) Pursuant to Miami Beach Gty Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes ®No• Are you IobbYjna on a oendina aRnlication for a Development Agreement witl~ the City or aunlication for change of zoning moo designation or change to the Citv's Future Land Use Mao? 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 rearesentina anot-for-arofit cerporation or entity without sgecial compensation ar 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 OR COMPENSATION DURING THE REPORTING PERIOD. J/i~a of lobbyist I do solemnly swear that all familiar with the provisions c requirements. Signature of Lobbyist: of the foregoing facts are true ahd correct and that I have read or am ~ni;ained in Section 2-482 of the Miarni Beach City Code and all reporting Signature of Principal/Client%~ VI. LOBBYIST IDENTIFICATION: Produced ID -----•~--° Form of Identification ~k'1N~,. ELIZABE H CARDONA :-: •'_ MY COM s1~t~A~l7~~Ch n (Lobbyist) ~. • ~ ~. EXPIRE September 06, 2011. t407t~py015~ V11~aaN D STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribe before me This day of /1'l 20.7 Public Notary -State of Florida Notar zation of Lobbyist's signature PRINCIPAL IDENTIFICATION: i:_~ Produced ID Form of Identification Personally known (Prin ' , , ' • ~~;: ELIZABETH CARDONA =•: •'"r MY COMMIS310N # DD712113 EXPIRES September O6, 2011 State of Florida, County of ,,~ ~ ~ Fb,~aa~rysFNix.com Sworn d subscri bef re me This ~da o 207 Signature of Pu otary -State of Florida Notarization of Principal's signature FOR CLERK'S U E ONLY Annual Registration fee ]Yes [ ] No Amount Pa` _ MCR # ~ Date Paid Lobbyist Registration Form received and verified by: F:~CLER~$ALL\MARIA-M~LobbyistlLOBBYiST fORM 05. 5~ Revised 12/08/04