Alexander Tachmes/Ameresco
m 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, resdutbn, adbn or derision of any commissioner; any action, derision, recommendation of the City Manager or any city board or
commktee; or any action, derision or recommendation of any dty personnel during the time per(od of the enOre dedslon-making process on such
action, dedslon or recommendation that foreseeably will be heard or reviewed by the dty commission, or a city board or committee. The term
specifically indudes the prindpal as well as any employee engaged in lobbying adtvitles. The term "Lobbyists" has specific exclusions. Please
referto Ordinance 2004J436.
TACHMES ALEXANDER I.
NAME OF LOBBYIST: (Last) (First) (M.I)
Shutts & Bowen LLP 201 S Bisca~r; e Blvd G,,; tP ~ snn; M; am; FT- ~~t ~1_
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 347-7341 (~n51 X47-7754 a achme~(dGhnttc_r•nm__
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY: '
AMERESCO, INC.
NAME OF PRINCIPAUCLIENT:
5200 77 Center Drive Suite 300 Charlotte NC 28217
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip 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: •
George P. Sakellaris, President/CEO
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 3% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST: privately owned.
Geor P
n.SPECIFIC LOBBY ISSUE: ~~ p(~-v~~(2 y
_ City of Miami Beach ;Energy Services P
Issue to be lobbied (Describe in detail):
Iii. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to Clty Code section 2-as2(g)
include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to Clty Code Section 2-
482(a-(4) include a statement of any cohtractual relationship (paid or unpaid) from 12 months preceding the
commencement of service of C1ty personnel to be lobbied.)
A Full Name of Individual Title B An Financial, Familial or Professional Relatlonshi
Mayor and•City Commissioners, None
City Boards ~ Committees,
Cit Attorne ' 0 •
City Administration, to the extent
ermissible.
Project")
__
iV. DISCLOSURE 01= TERMS AND AMOUNTS OF LOBBYIST COMPENSATION DISCLOSE WHgTHER,HOURLY, FLAT
' RATE OR 01'HERJ:
~---~
• A) LOBeYISTDISC,LOSURE: (Requtred) SAC ~~^
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION);
(Required}.
The following information must be answered:
1) Pursuantto Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
• ~"Yes ^ No Are Jou lobbyina on a present or pending bid for Goods, eauipment or services, or on a
~r~j,],t or aendina award for goods eau[ament or service?
2) Pursuant to Miami Beach• City Code 2=490 EntiE(ed "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues": .
^ Yes ~CNo Are you Iohbvina on a aendin4 ano[ication for a DevelopmentAareement with the Ci or
~r,nra*;on for chanaa of zoning maa dgs:anatlon or change to the C:tV s Future Land Use
Mau? .
3) Pursuant to Miami Beach Clty 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 s representative o6 anot-for-profit
corporation or entity without special compensation or reimbursement for ttJe appearance, whether direct, or
indirect,.to express support of or opposition bo any item, shalt register with the clerk as required liy this
section but, shall not be regylred to pay any registration fees.
• I do solemnly swear that all of foregoing facts are tru d correct and that 1 have read or am familiar with the •
provisions contained in 5ectio 2-4 of the Mi ' B Ci a and all reporting requirements.
Signature of Lobbyist
nature of PrlnclpaUClient ~~~ ~~_~~~ ~~~
VI. LOBBYIST IDENTIFICATION: •• ~ z PRINCIPAL IDENTIFICATION: •
^ Produced iD ° ~ ~ Produced ID
• Form of Identiticatio~~ ~ ~ ~ Form of Identification .
0
ad
Personally known (Lobbyist) rc'~. ~. ~ ~. ~ ^ Personally known (Principal)
+~ rn t
• V[L SIGNATURE ANA STAMP OF NOT ®~ ~' O
State of Florida, County of Mlaml-Dade A. ~ ~'~`~ r~ State of Florida, County ofMiami-Dade
Swom to d subscribed befor me 5• ~-' CJ ~ '~ Sworn and subscribed before ma
This J~~ day of 2008 0 ~ ~ ~ ~ This day of : 2Q06
Signature of~1'ubllc Not4~-y -State of Florida n ~ a' sv a Signature of Public Notary -State of Florida
Notarization of ).obbyist's s[gnature Notarization of P 'n a' signature
• TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ 1 No AmountPald S; ~ MCR Date Paid
L•obbytst Registration Form received and vprJfied'by: •Revised• D3 7/2D08
F:\CLEA\LOaBYIST\LObbylst Registration Farm 32708.doc
V. SIGNATURE UNDER OATH:
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER,HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
hourly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).
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 ^ No• Are you lobbvina on a present or pending bid for Goods equipment or services or on a
~rpAent 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 ~ NO' Are you lobbvina on a pending application for a Development Agreement with the City or
application for change of zoning map deli nation or chance to the City's Future Land Use
Map?
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 speaal 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 )~lo• Are you representing anot-for-profit corporatlon or entity without special compensation or
reimbursement..
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 PrincipaUClient:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
IDENTIFICATION:
_ Produced ID t~~ a' ~ ~ Uri i!i/'r j ~L~r'U-'
Form of Identification .
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of , 2008
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
^ Personally known (Principal) N07'ARYFUBLIC•STATLOFFLORIDA
~-""...,+~ Lauren M. Marks
Cointiuaaioa ;f DD755S82
State of Florida, County of Miami-D~~'•'~~~p~' FEB. 05, 2012
Swom and subscribed before me m7ftxue'r't.+Hrrcaoxnnvcco.,urc
This ~Lday of //~^y~, 2008
S gnature of Public Notary -State of Florida
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Pald;: MCR # Date Paid
Lobbyist Registration Form received and verHied by:
F:\CLER\LOBBYIST\Lobbyist Registration Form 32708.doc ~ Revised 03/27/2008
V. SIGNATURE UNDER OATH:
~~~~~~
~~
City of Minmi Beach, 1700 Convention Center Drive, Miami Beoch, Fbrida 33139, www.miamlbeachfl.gov
' CITY CLERK Office CiryClerk@miamibeachfl.gov
Tel: 305,673.7411 ,Fax: 305.673,7254 '
LOBBYIST NAME: ~-exander I. Tachmes
I
I undersfiand that no later than October 7si~ of each year, I must file the following
forms, pursuant to Section 2 485 of the Miami Beach City Code, with the City Clerk's
Office for al( active lobbying tssues. •
,
• i J Lobbyist Expenditure Form•
~ 2} Disclosure Form ~ .
Failure to fife these forms on a timeEy basis will result in my name being transmitted to the
• Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby oh has been resvfved, I am required
' to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
' ~ .
• Sig afure: Date:
F:IGLER1LQ13gYISTILolibyist Registration Form 32708.doc