William Riley/Morton's of Chicago 4041 Collins AvenueCHy of Mlaml Beach Office of the City Clerk
17dd Convention Canter Drive, Mlaml Beach, FL 33139
LOBBYIST RE(31STRATION FORM
Lobbyist mama aN parsons arrrpbyed or retained, whNher pMd or not, by a prkroipal who seeks 1n enoourtps the passage, detest or
moditiaMon of any ordiranoe, roadu5on, adios a deoWon of eny aorr>rr~tsiorua; aft)r acaon. deobion, reoormrsndatbn of the City
Manager or any ~ board or oommlll6aae; or arry aeon, decision or raoorm»ndNlon of any dry persaxtel during th• tknt psNod of the
sntlro dscision~ddng process on such adios, dedaion or neoonunendation that foresoaabyr will be heard or reviewed by the city
conxrdpton, or a ally board or rArrNnttoss. The term spoor irx4odee the prlru4pal as wail as am employee engaged in lobbying
soWitlas. The tsera "LobbyNts° lee apedfie arrdtestons. Please elver>n Ordknrew ?004.;436.
RI1~EY 1MII~LIA!<A W,. JR. _
NAME OF LOBBYIST: {Lath (First} (M.q
B~}n Sitrrbera Bsens Prior a A~'ad LLP. 200 So. Biecaivna Blvd.. Miami. Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State} (Zip Code) .
3Q5~7S-61 ~ ' 305 351,2285 Wrilev~6~zin. com
TELEPI,~t.~ NUMBER: FAX NiiM6ER: rhiAtfi.:
L08BYIST RETAINED BY:
lyorton'a ~ ClticaseolMi•mi Beach. LLC
NAIAE OF PRINCIPAUCUENT:
325 North LaSaNe Street. 4. IL 80810
B1131NE6S NAME AND ADDRESS (Number and Skeet) (City) (State} ~ {Zlp Code)
404-783 2383 312-BBD-1155 I .Dorn
TELEPHONE NUMBER: FAX NUMBER: (Optional} '- EIAAIL: {Optional}
FIII out this section If prMclpal is a Corporatlon, Partnership or Trust ]section 2,482 (c}]
• NAME OF CHEF OFFICER, PARTNER, OR BENEFICWRY:Morton's of Chicago Florida Holding, Inc.
~ IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 596 OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST.
AoaliaaUon b the Board of AeMusUr»nt for Prooarbr located at 4041 Cobra Aveeare
Issue to be bbbbd (Dssaiba ~- delail}:
IIL CITY A~IGIEi11NDlMDUAL8 TO BE IABBI~:
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•(V. DISCLOSURE ~ TERMS AND AMOUNTS OF LOBBYIST COi~ENSATION (DISCLASE WHETHER HOURLY, FLAT
RAYtE OR O]7~ILrl!)
A) LOBBYIST DISCLOSURE: (Rs~irad) 532b oet hour
'B) PRINCIPAL"8 DISCLOSURE (OF LOBBYIST COMPENSATION): (Raqubvd). 5325 oar hour
The followkrQ Mloraaltforf must ba answered:
1) Purstrark~ Miami Beach City Code Seclbn 2ataa ErriMed "Prohibited Campalpn CoMrlbullora By Lobbyfts On Procurwnarrt
Issues':
,Q Yaa la No• Ant you letd:vim t~ a araaarrt or oaadlno bid .{~ goods. aaulomsnt a' saivkas. or on a onaer~t or oandtna
award for amriorrtiarrt or sarvica4
2) Pursuant to Miami Beach City Code 2.4b0 Entttbd "Prohibiisd Campaign Contributbna By Lobbyists On Re4 Estate
l>ovaloprnerrt issues".
^„ Yas ®No• ra var lobbvlnn on a oandtna aaotiatlon for L DavNooarsnt Aanamat wNh fM Ctbr or seaaNeatlon for
a or chanaa ~ the Ctbv'a Future Land tJaa Maa7
$) Pursuant to Mlsmi Beach C>!,r Cade 2-484 (h) Any parson (except 1t>ose from the deA~ion of "bbbykt" M sat forth nt
Section 2-481 abo+-e) who .oNy apparo as a ropras~katlw of a not-b~prolR oorporaiion or orally wllhout spaoW
compensation or ant far the sppaararas, wtrsthlr dkact, or to e~reas support of or opposition tD arty
Item, aha9 raplater wMh rite clerk as roq~dred try this aactlon tx~ shalt rat be recxrieed to pay any ropistrstlon flea..
,~I Ya ®No: An you »tansarrtlna a sot~4orar~ corworalion ar snlllrr wtt5wut soeatai or+ or nMnburaarneM?~,
V. SGNATURE UNDER OATH:
ON OCTODER 1'r OF EACH YEAR, EACH LOt3BY18T 8HALL t3Ut3MIT TO THE CITY CLERK A SIGHED STATE1iENT UNDER
DATH, LtaTMiG L08BYIlIG E)(PtIBIDITURE,S, AS WELL A8 COMPEt~AT~I RECENED, MI Tim CITY OF MIAAE BEACH FOR
THE PRECEDING CALEMDAR YEAR A STATPiENT SHALL BE FILED EVEN F THERE HAVE BEtI~Ji NO EXPENDS OR
COMPl1t8ATid~t DURfN<i THE REPORTING PERIOD. ' _ / ~
8lpnat Lobbyist - . Riley, Jr.
I do solarrrdy swear that aG of ~ tonapoirtp 1letds are true and corral end thot I have read or em fam9iar with the provisions contained
in Saotlon 2182 otMe Miami Bach ~///Coda and all roquiromsnte.
ILI7~,t3F-ti ~RTI;'
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PRINCIPAL IDENTIFICATION:
{a' ProducedlD c'~i7vL' T'URNEF~
F~ ~ 1`1bTARY PUBUC
^ PeraormHy !mown (Prin
Vobb County,
Expires ~
~ Produced lD
Forth of Identltkatbn
PensonaNy brown I~bYM~
VII. SIGNATURE AND STAMP OF NOTARY:
Stale of Flort~, County of Mbmi-Dade State of Fbrida, C~My of Miami-Dade
n to and before me Sworn subs me
Th' 1~ day of 20 Ct~ This ZO ~0
f i .,,,/'- ~...
of PutRc Notary - FlorlrM S ry -Stale of Florida
NetsN~fan of Lobbytat'a a of Prlnelpal's sigrarbun
Annwl RapNtretlon fee: [ ] Yes j ] No Amount Psld ~ ~ MCR g Data Paid a ~ o K
Lobbyist RspiNration Form rsoet+red and verNbd by
F:ICLERtBALJ_WL4RU~rMLobbylatlLOBBYiST FORM OS.doc Revised
MIAMI 1356925.17319817141
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