Neisen Kasdin/Akerman Senterfitt, P.A.'~
City of Miami 8eac~i OFfioe of the City Clerk
17Q0 Conn Ce7tter Drive, Mianrd Beach, FL 33139
40BBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or rmt, 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 aay 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 activlties. The term "Lobbyists"
has specfic exclusions. Please refer tv Ordiasnce 20114-3435.
ICasdin Nelsen O.
NAME OF LOBBYIST: (Last} (First} (M.n
Akerman SenterFit, P.A. One SE and Ave., Ste. 250f? Mianu FL 33131
BUSINESS NAME AND ADDRESS (Number and Street} (City) (State) (Zip Code}
(305) 374-5b00 (305) 374-5095 neisen.kasdinQakerman.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
i. LOBBYIST RETAINED BY:
doldsmith William
NAME OF PRINCIPAL/CLIENT: (Last) (First) (lvi.i)
1820 W. 25`~ Street Miami Beach FL 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State} (Zip Code)
{30S) 205-7440
TELEPHONE NUMBER: FAX NUMBER: (optional) EMAIL.: (optional)
Fill ont this section if principal is a Corporation, Partnership or Trnst [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR
MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSH]P
OR TRUST:
II. SPECIFIC LOBBY ISSUE:
2500 Bay Avenue, LLC lot split
Issue to be labhied (Describe in detail):
{M2t~a92r~ }
III. CITY AGENCII;SJINDIVIDUALS TO BE LOBBIED:
A. Full Name of
IndividusllTitk B. Any Financial, Familial or
Professional Relationship
Planning Department and Planning Board None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION
(DISCLOSE WHETHERHOURLY, FLriTRATE 4R OTHERj:
A. LOBBYIST DISCLOSURE: (Required) $SOO.t?0 hourly
B. PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION}: {Required)
same
The following informat7ion must be answered:
{1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited
Campaign Contributions By Lobbyists on Procurement Issues":
^Yes ®No: Are you Lobbying on a present or peodiag bid far goods,
equipment or services, or on a present or pending sward 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 ®No: Are you lobbying on a pending application for a Development
Agreement with the City or appligtion for chance of zoning
map designation or chance to the City'a Future Land Use
spy
(3} Pursuant to Miami Beach City Code 2-484 (h) Any person (except those
exempt from tL-e definition of "lobbyist" as sat forth in Section 2-48] 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 ®No: Are you representing a not for-profit corporation or entity
without special compensation or reimbursement.
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V. SIGNATURE UNDER OATH:
ON OCTOBER l~ 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 BL FILED EVEN IF THERE
HAVE BEEN NO EXPENDITURES OR COMPENSATIO /~URII~IG THE REPORTING
PERIOD. i/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
familiaz with the provisions contain Section 2-482 of the Miami Beach City Code and all
reporting requirements.
Signature of Lobbyist:
Signature of Principa}/CHent:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF
NOTARY:
PRINCll'AL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known {Prilocipal}
State of Florida, County of Miami-Dade
Swom subscribed before me
Thi~ay of /'1^~Q.,1r1 iL~1. . 20~
Signature of Public N - State of Florida
Notarrcation of Lob g"s ,pCA E. FE1tNANDEZ
MY COMMISSION # DD312914
'~. EXPIRES: June 25, 2008
1-600-3-NOTARY FI. Notary Discount Aesoa Co.
State of Florida, County of Miami-Dade
Sworn bscrt bef
y of ~"""~ MIRIAM MILLER
c ,,, ';. MY COMMISSION # DD 508216
1~` _ '~: , ~= EXPIRES: February 9, 2010
'~••••~ BorldedihuNderyPubBcUlrs
Signature of Public Notary -
`~Notarization oP Principal's slguature
TOR CLERK'S USE ONLY _
~ zS ~~
Annual Registration fco: ^Yos ^No Amount Paid ~ S ~ MCR 939/ Date Paid 3
Lobbyist Registration Form received and verified by:
R~evited 1Z/U811J4
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