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Marbet Mier/Regal Entertainment GroupLOBBYIST 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, adion 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 tfie 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 specificaly includes the principal as well as any empioyee engaged in lobbying activities. The term ~~Lobbyists" has specific exciusions. Please refer to Ordinance 2004-3435. Mier Marbet NAME OF LOBBYIST: (Last) (First) (M•I) Gray Robinson, P.A., 401 E. Las Olas Blvd., Suite 1850, Florida 33301 BUSINE55 NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 954.761.7472 954.761.8112 mmier@gray-rabinson.com TELEPHONE NUMBER: FAX NUMBER: EMAII: LOBBYIST RETAINED BY: Regal Entertainment Group NAME OF PRINCIPAUCUENT: 7132 Regal Lane Knoxville TN 37918 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code) 865.925.9414 865.925.3621 rob. delmoro@regalcinemas. com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnerahip or Truat [Section 2-482 (c)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Rob Del Maro, Chief Purchasing Officer • IDEfJfIFY ALL PERSONS HOLDING, DIRECl1Y OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Publicly traded company II. SPECIFIC LOBBY ISSUE; Seeking to madify city cade to per-mit sale of beer and wine at Regal Cinemas on Lincoln Rd. ---- Issue to be lobbied (Describe in detail): YII. CITY AGENCIES/INDNIDUALSTO BE LOBBIED: A) Full Name of Individual/Titfe B) Aoy Financiat, Familial or Professional Relationship iami eac ayor s ice No Miami Beach Commission Miami Beach Planning Board No Miami Beach City Attorney Miami Beach City Manager No ~1~ ~lli~ ~o :~ ~d z~ ~tir eao~ ~~~«:~~ . IV. DISCLOSURE OF'IfRMS AND AMOUNTS OF LOBBYIST COMPENSATION (DI5CLOSE WHETHER HOURLY, FLATRATE OR 0T)5/ERJ: A) LOBBYIST DISCLOSURE: (Requ[redj Flat I'at@, $25,OQ0 paid to Gray Robinson, P.A. B) PWNCIPAL'S DISCLOSURE (OF LOBBYISTCOMPENSATION): (Required). FIBt f8t@~$25,004 paid to Gray Robinson, P.A. The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entltled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": C Yes .~ No: Are vou lobbvina on a aresent or uendina bid for aoods, eauinment or services, or on a present or qendina award for aoods, eauiament or service? 2) Pursuant to Miami Beach Ciry Code 2-490 En4tled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": GYes D~1 No: Are vou lobbvin~on a nendina aaplication fo~ a Develoament Agreement with the Citv or aaalication for chanae of zonina map desiunation or char~ae to the Citv's Future Land Use Ma°? 3) Pursuant to Miami Beach Ciry 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 enbty without special compensation or r~imbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register witi~ the clerk as required by tt~is section but, shall not be required to pay any registration fees., •~Yes ^ No: Are vou representins~ a not-for-profit coraoration or entiri wid~out special compensation or reimbursement. . V. SIGNATURE UNOEROATH: ON OCTOBER lsT OF EACH YEAR, EACH LOBBYIST SHALt SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDTTURES, AS WELL AS COMPENSATION RECEYVED, YN 7HE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE N~ EXPEPlDITURES OR C PENSATION DURING THE REPORTING PERIOD. ~ /1 ~ • 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 o'' ns contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. ~ _ /J ~Q ,~ .. 5ignature of Lobbyist: _~__V_ ~~ `"~ 7--- ~ o ~ Signature of Principal/Client: < ~ $ ^ VI. IOBBYIST IDENTIFICATIOM ~ ~ ~~ ~ Produced ID __ ~ ~ ~ Form of Identification ~ ~ ~ ~ ~1 Personally known (Lobbyist) ~~~ VII. SIGNATURE AND STAMP OF NOTARY: ~ ~ State of Florida, County of ~D Sworn to and subscribed before me This ~'1'~'' day of ~nua~_, 20 ~$ ~ 4 _ ~-. , i ~ ~ Sig ture of ublic Notary - State of Florida N a' ' n of Lobbyist's signature PRINCIPAL IDENTIFICATION: ~ Produced ID Form ofIdentificadon ~'Personally known (Principal) 7~v~E'SSEE ki/o~c State offbriela, County of i~4ietrtfi=Datfe Swom and subscribed before me This ~'~.iay of 20~ ~ s Signature of Public Nota State of~Flerifla Notarization of Princip 's signature ~PNS q F c T~ ~FT ~ •N~p F~-~E "~~~c i FOR CLERK'S USE ONLY ~ Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # Date Paid Lobbyist Registretion Form received and verified by: ^ F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/O8/04