Barry Brodsky/Joseph W. Blountm 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.
Brodsky Barry
NAME OF LOBBYIST: (Last) (First) (M.I)
Brodson Construction 167 NE 39`" Street Miami, Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 576-9909 (305) 579-9902 bang@brodsonconstrudion.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Joseph W. Blount
NAME OF PRINCIPAL/CLIENT:
2535 Lake Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
_. _ __
out this section if principal is a Corporation, Partnership or Trust [Section 2-452 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 2535 Lake Avenue
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title ~ B) Any Financial, Familial or Professional Relationship
Planning Dept., HPB, BOA, Planning Board, City Commission ~ None
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
SLAT RATE OR OTHERt
A) LOBBYIST DISCLOSURE: (Required) ~0 er hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ ~~ .00 oer hour
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 uending bid for goods, equipment or services, or on a
present 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 X No: Are you lobbying on a pending application for a Development Agreement with the City or
aaiglication for change of zoning map designation or change to the City's Future Land Use
Mau? .
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 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 a; required by this
section but, shall not be required to pay any registration fees_
^ Yes X No: Are you reuresenting anot-for-profit corooration 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 Y
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 X~ ~cv
REPORTING PERIOD. ~ 2~ c
Signature of Lobbyist Z W N Y ~
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am ~~a"p ~
~~Y~~^
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting va_~'
requirements. ~_+ c m e
Signature of Lobbyist: ~ a ~ ~ .
w ~ d
Signature of Principal/Client: ~ ~
vI. LoBBYISr
^ 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 Lobbyists signature
PRINCIPAL IDENTIFICATION:
(
~7 Produced ID CI.Q-~-~- ~.
Form of Identification ~
^ Personally known (Principal) ?~
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Sworn and subscribed fore me a
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Signature of Public Notary -State of Florida F
Notarization of Principal's signature ~ v
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # to P id ~ ~
Lobbyist Registration Form received and verified by: Entered By: ,
F:\CLER\$ALL\MARIA-M\Lobbyi5t\LOBBYI57 fORM OS.doc i5ed 12/08/04
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