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Alex Tachmes/Ocean Drive Improvement Assoc. Inc.~ ~NAMIBEACH Rec,=rvFo City of Miami Beach Office of the City Clerk ZQ~~ ~E~ ! 2 ~~ !O; ' 8 1700 Convention Center Drive, Miami Beach, FL 33139 ciT~ c«~~~~s o~~F icf 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) (First) (M.I.) Tachmes Alexander I. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) Shutts & Bowen LLP; 201 S. Biscayne Blvd., Suite 1500, Miami, FL 33131 TELEPHONE NUMBER: FAX NUMBER: EMAIL (305) 347-7341 (305) 347-7754 atachmes@shutts.com I. LOBBYIST RETAINED BY: NAME OF PRINCIPAL/CLIENT: Ocean Drive Improvement Association, Inc. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) c/o Marlo Courtney 804 Ocean Drive, 2nd Floor, Miami Beach, FL 33139 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) (305) 531 - 4411 marlo@goldmanproperties.com Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: R. Anthony Goldman, President • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP oR TRUST: Not applicable -Principal is aNot-for-Profit Corporation II. sPECIFIC LOBBY IssuE: Proposed amendment to street performers and artist vendors ordinance. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Mayor None Commissioners City Administration None Cit Attorne 's Office City Boards None City Committees IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): MIADOCS 2459109 1 A) LOBBYIST DISCLOSURE: (Required) $400 00 p@C hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) $400.00 p@f hoUt- The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes 0 No• Are you lobbvinq on a present or pending bid for goods equipment or services or on a present or pending award for goods. eauipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^ Yes 0 No: Are you lobbvinq on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees.. ~~ Yes C~No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1$` 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. `' 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 2-482 of the Miami Beach C'~'iy~ode and all reporting requirements. Signature of Lobbyist: v Signature of Principal/Client:: VI . LOBBYIST IDENTIFICATION: x PRINCIPAL IDENTIFICATION: Produced ID Produced ID ~-- ~~'/~~ ~ ~ N4:~J Form of Identification Form of Identification Personally known (Lobbyist) _-.._ d zPersonally known (Principal) VII SIGNATURE AND STAMP OF NOTARY: ~ O ~, State of Florida, County of Miami-Dade ~-~ ~ ~ State of Florida, County of Miami-Dade Sworn to and subscribed before me This /I ~ day of l~c~'c ~m b>/r , 20 D'7 c ~ ;:~ :~ '.:...Sworn to and subscrib d before me ~-'~ y;`,,,~ ~;; This L1! day of ~r ~~no ~/ 1 -~ - •Yy o ~ ~. ou Notary Public State of Florida a ~ "~ ~ ~ ;e ~; Rodolfo Perez ~ ~ '~"~j ~`' c ~,>cG / ~G,~ ~ °` t~ n~ U c My Commission DD554416 ~' Signature o ublic Nota -State of Florida ' ~ ~ ~ ~ ~ r Signature of Pu ~ ' Notarization of Lobbyist s signature ®N ~ n o Notarization of i cipal s signature ~o~ ~ ~? 0 FOR CLERK'S USE ONLY Annual Registration fee: [ ]Yes (~o Amount Paid ~~ ~ U ~ MCR # ~ ~ ( / ~ ~ Date Paid ~ ~~ _ Lobbyist Registration Form received and verified by: 3-gi I p . F-~ ~= t~~_~ ` /'~ 1 / ~ ~~ ~ L ~ 1 ~ ( Revised 12/08/04 ,-, `l ~ ~ .- ~°°~:r--~; ' ~ .,_~~ ~ ~Z~~z~ ~~ MIADOCS 2459109 1