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Alfredo J. Gonzalez/Dr. Kabakibii ~~~~' ~,a} m 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 aty 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 specifwlly includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Gonzalez Alfredo NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0588 305-961-5588 gonzalezaj a gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED 8Y: Dr. Riad A. Kabakibi and Mrs. Lama Kabakibi NAME OF PRINCIPAL/CLIENT: 280 South Hibiscus Dr. Miami Beach FL 33139 p BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Lp Code) 201-867-6677 201-405-1094 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: Dc Riad A. Kabakibi and Mrs. Lama Kabakibi • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: DRB Single Family Appro~ Issue to be lobbied (Describe in III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title Building Department /Planning Department Design Review Board B) Any Financial, Familial or Professional Relationship City Commission N. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER). A) L088YI8T DISCLOSURE: (Required) $355.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Yi355 00 Hourly a $ N a a'~ z°2N~~ ~~a s I~~r.~ 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 La No Are you lobbvina on a present or Dendina bid for goods eauioment or services or on a of or Dendina av~ard for goods eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes d No• Are you lobbvina on a Dendina application for a Development ADreement with the Ciri or apDlic-tion for chance of zoning map designation or chance to the Ciri'~ Future Land Use Mau? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the deFlnition 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 representing anot-for-profit corporation or entiri without special compensa±ion 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 PRECE NG CAL~~jjNDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDIT ~~OR~QM~E^ SATION DURI~THE REPORTING PERIOD. ~~ ,. / II ~~ //'' I do solemnly swear that all f the foregoing fame true and corr~Ect and that I have read or am familiar with the provision ntaine in Section 2-482 of the Miami Beach City Code and all reporting requirements. ~~ Signature of Signature of Prit`Te VI. LOBBYIST c Produced ID Form of Identifcation ^ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This a`~ day of .-+. 20 08 ry -State of Florida NcH'arization Lob isYs signature IDENTIFICATION: c Produced ID Form of Identification Personally known (Principal) State of Sworn a This Signature of Public Notary -State of Florida Notarization of Principal's signature FOR CLERK'S SE ONLY ~J Annual Registration fee: [ ]Yes [ ] No Amount Paid ~ ob MCR k~ 9a6 7SDate Paid ~ I S D~ Lobbyist Registration Form received and verifed by: F:\CLER\$ALL\MARIA-M\LObbyist\LOBBYIST fORM OS.doc Revised 12/08/04 Florida, County of M BEH1}IAIIUNDEUADT nd subscribed befor '••`- Ml'CDUL9SSION f!DD 71582p S day of ~~ ~ s XPIRE • r22, 2011 ^ __ u~erntinars