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Michel F. Sauers/Todd Glickman ' 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 rrrodification of any ordinance, resolution, action or decision of any commissioner; any action, decision, rewmmendation 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 nfe-to Ordinance 2004-3435. NAME OF LO YIST: (Last) (First) (M.I) BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Codej TELE ONE NUMBER: FAX NUMBER: EMAIL: ~ t ~~ LOBBYIST RETAINED HY: ~~' NAME OF PR~JI/NCIPAUCL,IE~NT: ~J ~/(~ B ES A~ D D~~T ~, (Num~Gd,Str e sa ~ _ Sta G /~~ TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) out this section if principal is a Corporation, Partnership or Trust Section 2-462 (c)] • NAME OF CHIEF OFFICER, PARTNER, QR BENE CIARY: ~~~~ . • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Ii.SPECIFIC LOBBY ISSUE: _~ i~_ / ^ l~ iii. CI GENCIES/INDI (DUALS TO BE LOBBIED: (Pursuant to city code section 2.4BZ(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 sough to be lobbied; further, pursuant to City Code Section 2- 4s2(aK4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the commencement of service of Clty personnel to be lobbied.) _ A Fup Name of Individual Title 8) An Financial, Familial or Professional Relationshi ~~~~ ®C~%~1-CGl /yb~ ~J1 ~.r! ~~ ~~~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBB T D SC SURE: (Re uired) ~ B) PRINCIPf~a'S~ DISC SURE (OF ~QBBY~~OMPEQN~ATION): 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 aoods equipment or services or on a present or pendina award for aoods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes~~7id'o• Are you lobbvina on a pendina application for a Development Agreement with the Citv or application for change of zoning map designation or change 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 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. ^l`es-~ No• Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1sT 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 DURI G THE REPORTIN PERIOD. i Signature o yist I do solemnly swear that all of the foregoing facts are true and correct and that 1 have read or am familiar with the provisions contained in S~;c~iyy~-482,pf the Miami Bitch City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: (/ / / ~ U ~~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: [~ Produced ID D+%~ ~0?0 ~y~ ~llo(L(°~ v Produced ID dl~~ 0¢ `~6~ S 3 N Form of Identification Form of Identification ^ Personally known (Lobbyist) ^ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn tq and subscribe bef re me ~ Sworn and subscrib bef re me This / day of , 206 ~ This ~~day of , 2Q~~ • Signature of Public Notary -State Florida Si nature of Public Notary -State Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid $ 1 ~~ MCR # ~ Date Paid Lobbyist Registration Form received and verified by: Revised 02/04/2008 City of Miomi Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachfl.gov CITY CLERK Office 7e1: 305.673.741 1 ,Fax: 305.673.7254 CiyClerk@miami beachfl.gov LOBBYIST NAME. 1 understand that no later than October 1st of each year, I must file the folbwing forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1 ~ Lobbyist Expenditure Form 2) Disclosure Form Failure to file these forms on a timely basis will result in my name being tronsmitted to the Miami-Dade County Commission on Ethics and For code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. - 1G ~~~ Signature: ate: r~s~visacl 02IQa r2OOS ~'~ .L,1. ,~ ~ ~.. i. i~•~' ~, ,: '.r.! rSSti,.. i ~ I alit. Global Spectrum, LP Partnership Disclosure Statement Global Spectrum, LP is a limited partnership and its partners are as follows: 1. Global Spectrum, Inc. (General Partner), 3601 South Broad Street, Philadelphia, PA 19148 2. Comcast-Spectacor Ventures, LLC, 3601 South Broad Street, Philadelphia, PA 19148 3. Globe Facility Services, Inc., 111 Second Avenue NE, Suite 517, St. Petersburg, FL 33716