Ali A. Arbab/Longkey LLCm MIAMIBEACH
~~~~~~~~
City of Miami Beach Office of the Ci~131~~ ~ ~ AM 10= 33
1700 Convention Center Drive, Miami Beach, FL ;~'~
Cf7Y CLc:r~;'S OF"FICE
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.
>Rt~ Ag A ti i ~
NAME OF LOBBYIST: (Last) r~ (First) (M.I)
AR~A~BF~4~N~~I~NC,~ac. 3363 lu~f. IGs sT N •/~u~s~BfacH.F~ • 33/ G o
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(3o5)Q4a-3o8 8 C3~~5~g4oS32?3 J~&~6~i~Gt•-~BEu.soyil+•af.)
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
~...oh o, Ic.e.y ~...t.C .
NAME OF PRINC AL/CLI
~t32 Po~c~ ~l~e.~,,~ So~~~ New~o~~ ~~ . l00~6
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
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:
• IDENTIFY A ERSONS HOLDING, DIRECTLY OR IN IRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
~~ ~ h ~Qv1 ~__ - ~Q`M ~
Issue to be lobbied (Describe in detail): ~~~~ L) ~~~ ~~~ L j < j
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: Q ~ D~ ~ ~ J
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
~ ~s~ o~c ~ c. ~ c e-S~et v try ; on ~fxa~c~.
µ~ p~~~Y\~ ~ ~ ~~-~~ .
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERt ~
A) LOBBYIST DISCLOSURE: (Required) ~ `~ ~~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
The following information must be answered:
E°f°
Imo,
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yes'Si(No: Are you lobbying on a present or uendina bid for goods, eauioment or services, or on a
present or vending award for floods, eauiument or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
OYes `~ No: Are you lobbvina on a uendina auulication for a Development Agreement with the City or
~~ application for change of zoning map designation or chan4e to the City'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..
D Yes ~ No: Are you representing anot-for-profit corporation or entity without suecial 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 IDENTIFICAnTION:
Produced IDFLDL A6[~-6DI~yS ~~-~
Form of Identification
PRINCIPAL IDENTIFICATION:
~ Produced ID1=UC..~d V2Q0-526.6-3'8$-O
Form of Identification
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
^ Personally known (Principal)
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sworn and subscribe before me
This 0 day of >F'~ . , 20~ This 7 day ofj~/v }r Notary Public State of Florida
NOTARY PUBLIC-STATE C" ''?.!~RIDA Maria M Goicouria
.. Connie L. ,Sayer M Commission DD523057
- #DD682658 02127~20t0
Signature of Pu is Notary ~ es: JUNE 06 2011 Signature of Public Nota - f FFdPPff~
Notarization of Lobbyisi~~` CBONDINGCO.,INC. Notarization of Principal's signature
FOR CLER_~NLY /
Annual Registration fee: [J ]Yes [ ] No Amount Pai MCR # ~ Date Paid t
Lobbyist Registration Form received and verified by: ,
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04
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FEB-11-20@8 1~•.id l.t1Y
~~ _ .. ~ ~~ Clry o! iYlio~ni ~ee~el~, 17A0 Con.~nlion Cenlu Drire, Mlom~ Beoch, Fbride 33139, •~nvw,mlomibsachfi.gav
GTY CIERK Office Ci1yClark®mlomifxachfl.gov
• Tet: 305.673.7411 , imc 305.473.7254
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' .ta0$aY15T N~1NAE: A L t A ~ F~~
I . understood that no later thon QesFa6er l,~t Qf each ~, I must file the following
fiorms, pursuant i+o Section 2-465 of the Mivmi Beach City Code, with the City Clerk's
' Office for alt active lobbying issues.
' , '. ~ ,` 1) lobbyist ~xpen~liture Form
, 2) Disclosure Form
h
' ; :, ~ •`Fcilure to File these forms an a timely basis will result in my name being #ransmitled ro the
' ~ Miami-0ode County, Gommis5ion on Ethics and For code violetivn evoluation.
'; In addition, .once on issue I have registered to lobby on .has been resolved, (om required
to immediately notify the City Clerk's Office of lobbyist withdrQwal in writing.
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5~i8nature: Date:
Revisetd 0?JQ4/2Q08
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