Robert Fornataro/Margules Properties, Inc.~ 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 teen "Lobbyists" has specific exclusions. Please refer to Ordnance 2004-3435.
Fornataro Robert
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 robert@shulmanarchitect.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)
Fill out this section if principal is a Corporation, Partnership 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) Full Name of Individual/Title I B) Any Financial, Familial or Professional Relationship
Dept., HPB, BOA, Planning Board, City Commission ~ None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOSBYI5T COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERf
:,) LOBBYIST DISCLOSURE: (Required) $ 3 3 6 0 6 ^^~~ TT
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ ~ 3 ~ V ~ V
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 pending bid for Hoods, equipment or services, or on a
present or pending award for goods, 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 lobbying on a Qending 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
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 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_
^ Yes X No: Are you representing anot-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 ,E~(PENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD. ...
Signature of Lobbyist
I do solemnly swear that
familiar with the provision
requirements.
Signature of Lobbyist: ~-
Signature of Principal/Client:
II of the foregoing facts are true and correct and that I have read or am
contained in Section 2-482 of the Miami Beach City Code and all reporting
VI. LOBBYIST IDENTIFICATION:
^ Produced Ifl
Form of Identification
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
personally known (Lobbyist)
q ~ ~ [VII. SIGNATURE AND STAMP OF NOTARY:
~ ~~o.~
° V n N `State of Florida, County of Miami-Dade
~. Q N 5°~worn to and subscribed befor me
~ ~ ~ ~ his day of U N1~ ~ 20~
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H ~.o~-M
~ N ~
W ~ .~s5ignature of Public P otary -State of Florida
~, o >e rlVotarization of Lobbyist's signature
n. ca w ~
H
0
i~ 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 L~
nnual Registration fee: ( ]Yes [ ] No Amount Paid~~ MCR # ~~ /~ 'Date Paid ~ ~ ~ ~ l
Lobbyist Registration Form received and verified by: ~ Entered By. 7'v`2 ~~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) $ 33 ~ ~~ ~ 2
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ '7~ ~ ®~
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 pending bid for goods equipment or services or on a
present or pending award for goods 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 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
Man?
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 X 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 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.
g o Signature of Lobbyist:
s ;°
g„ Signature of Principal/Client:
~ °
Y ~~ .s ~ VI. LOBBYIST IDENTIFICATION:
~ ~'.~ =
~ ~ ~ ~ roducedID
z° ~ ~ w For of Identification
(Lobbyist)
VII.
State of
Sworn G
AND STAMP OF NOTARY:
M
Signature of Public Notary - Sta-Ee of ~Idf
Notarization of Lobbyist's signature
[~
PRINCIPAL IDENTIFICATION: "' "
x~~~
Produced ID ~.
Form of Identification y ~ ~
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Personally known (Principal) ~ ~ ~
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i~
State of Florida. County of Miami-Datfe ~~11
This
of Public Notary -State of Ffdr
lion of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # 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