Allan Shulman/Margules Properties, Inc.?~ MIAMIBEACH
City of Miami Beach Office of the City Clerk
17Q(} Coon 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 Ordnance 2004-3435.
Shulman Allan T•
NAME OF LOBBYIST: (Last) (First) (M.I)
Allan T. Shulman Architect, P.A. 100 NE 36 Street Miami, Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 438-0609 (305) 438-0170 allan@shufmanarchitect.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Margules Properties, Inc.
NAME OF PRINCIPAL/CLIENT:
381 Park Avenue South Suite 1420 New York NY 10016
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212) 684-7079 ext 19
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
if principal is a
or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Eric Margules
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Eric Margules
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 1155 Collins Avenue
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
~°
A) Futl_me of Individual/Title B) Any Financial, Familial or Professional Relationship
Planning,-Dept., HPB, BOA, Planning Board, City Commission None
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
rLAT RATE OR OTHERj.
A) LOBBYIST DISCLOSURE: (Required) ~ 3 3
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)._~ ~ ~ ~ 6 ~ 6
The foNowing information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
Yes X No Are you lobbying on a present or sending bid for goods eguiament or services. or on a
present or pending award for goods eguioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No Are you lobbying on a pending application for a Development Agreement with the City or
ap IiWtion for change of zoning map designation or change to the C~tv's Future Land Use
Ma°?
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 a not 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_
C] Yes X No Are you representing anot-for-profit corporation or entity without special compensation
or rcimbursement. .
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
RECENED, 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 City Code and all reporting
requirements. ~//
ignature of Lobbyist: ~ / < < ~°~"J ~~/ ~~1~~
Signature of Principal/Client:
Q `.:'~. ~ LOBBYIST IDENTIFICATION:
p ,~ ~ o ~:
~' ~ j ~ N ~ ~~ Produced ID
N = Form of Identification
O ,.. ~ q :~
r;~ ~ ~ ~ C
~'° ~ `~ x' ^ Personally known (Lobbyist)
y-°~.~
c ~ ~ ~ ~ SIGNAT'!!RE AND STAMP OF NOTARY:
8 ~1/.~I.
~, ' ~,, date of Florida, County of Miami-Dade
~" ~ ~anrorn to and subscri{~~be ~
~ off,; ~~is day of M~ 20~-%
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Signature of Pu lic otary State of Florida
Notarization of Lobbyists signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
~ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Principal's signature
/ FOR CLERK'S USE ONLY ~ ~ 1 ~ r3
Annual Registration fee: ( ]Yes [ ] No Amount Paid I~~ s.- MCR # ~ 9~ ~ Date Paid ~ /
Lobbyist Registration Form received and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12108/04
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) ~ ~ 3 ~~~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).~_/~ w~
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 X No Are you lobbying on a present or igendina bid for aoods eauipment or services, or on a
,present or igendina award for aoods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled °Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No Are you lobbvina on a pending application for a Development Agreement with the City or
lication for chance of zoning map designation or chance 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 clerk as required by this
section but, shall not be required to pay any registration fees..
^ Yes X No Are you reipresentina a not for-profit coraoration 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 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 City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Produced ID
PRINCIPAL IDENTIFICATION: I ~~
~~A
^ Produced ID
Form of Identification
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
FOR CLE
Annual Registration fee: [ ]Yes [ ] No Amount Paid
Form of Identification x ~ ~ o
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Personally known (Principal) ; 3 0
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State of Florida, u of Miami-Dade ~ T
Swore} d su of re e g
This /~ da of y
Iblic Notary -State cif Flor
of Principal's signature
ONLY ~~~ ~~ ~ ^7 ~
MCR #,.r [ Date Paid
Lobbyist Registration Form received and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\LObbyist\LOBBYIST fORM OS.doc Revised 12/08/04