Allan Shulman/304-312 Ocean Drive, LLC!'~ 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, 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 Ordnance 2004-3435.
Shulman Allan T.
NAME OF LOBBYIST: (Last) (First) (M.I)
Allan T. Shulman Architect, P.A. 100 NE 36 Street Miami, Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 438-0609 (305) 438-0170 allan@shulmanarchitect.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
304-312 Ocean Drive, LLC
NAME OF PRINCIPAL/CLIENT:
600 North 3rd Street 2nd Floor Philadelphia PA 19123
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(215) 625-9722 (215) 625-0167 IouisjorocofskvlC~earthlink.net
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: Phillip McFillin, Louis Orocofsky
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Phillip McFillin
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 304-312 Ocean Drive - COA, Variance Approvals, and Conditional Use Permit
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title I B) Any Financial, Familial or Professional Relationship
Planning Dept., HPB, BOA, Planning Board, City Commission * None
* Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a public hearing setting.
~~
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FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ • D v '
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 X No• Are you lobbying on a present or pending bid for goods eguinment or services or on a
nrpspnt or Wending award for goods eauinment or service
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No• Are you lobbying on a Wending agnlication for a Development Agreement with the Citv or
aWWlication for change of zoning man designation or change to the City's Future Land Use
MaW?
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..
^ Yes X No• Are you reWresenting anot-for-Wrofit corporation or entity without special 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 IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn tgyand__~~ssubscribe be ore me G
This 2 L1'~Gtdav of , 20 ~~
Signature of Public Notary(- State of Florida
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY ~ ,J7
Annual Registration fee: [ ]Yes [ ] No Amount Paid ~ t ~ MCR 3~ ate Paid ~~
Lobbyist Registration Form received and verified by: Entered By: ~K
F:\CLER\~ALL\MARIA-M\Lobbyist\LOBBYIST FORM OS.doc Revised 12/08/04
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' FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) $
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 X No Are you lobbying on a present or en nding bid for goods eauiument or services or on a
Qresent or ep nding award for goods, eguir~ment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
oyes X No Are you lobbying on a Wending aunlication for a Development Agreement with the Citv or
aRWlica~ion for change of zoning maW designation or chance to the City's Future Land Use
MaW?
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 anot-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 X No• Are you representing anot-for-profit corporation or entity without special 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 IDENTIFICATION:
PRINCIPAL IDENTIFICATION: ~~
g
^ Produced ID ~b,,.,,c~
Form of Identification
Personally known (Principal)
:~
s. y
State of FlorJ'da, f Mia i-D
Swo~ a?rbsc o e
Thi ~/ day
^ Produced ID
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 . 20_
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
of Public Notary -State of Flori
lion of Principal's signature
FOR CLERK'S E ONLY ~ ~J~~~t'J
Annual Registration fee: [f ]Yes [ ] No Amount Paid MCR #
Paid
Lobbyist Registration Form received and verified by: Entered By: ^_.d•~L~''+-~ c~'Lt.t..e~
F:\CLER\SALL\MARIA-M\LObbyist\LOBBYIST fORM OS.da ReWSed 12/08/04