Carter N. McDowell/Miami Habitat, Inc. AmendedY
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AMENDED
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 Ordinance 2004-3435.
MCDOW ELL CARTER N
NAME OF LOBBYIST: (Last) (First) (M.I)
Bilzin Sumberp Baena Price & Axelrod LLP 200 So Biscayne Boulevard Miami Florida 33131
BUSINESS NAME AND ACDRESS (Number and Street) (City) (State) Zip Code)
(305)350 2355 305 351 2239 CMcDowell(c~bilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL.
LOBBYIST RETAINED BY:
MIAMI HABITAT INC.
NAME OF PRINCIPAL/CLIENT:
1329 ALTON ROAD MIAMI BEACH FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-673-3948 305-673-4348
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: Eric Harari
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IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWh}ERSFIAs ~"";~
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: '~'' rv '~"`{
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II. SPECIFIC LOBBY ISSUE:
Participation in City Commission proposed short-term Ordinance ~' h
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
City Commission & staff no
Planning Department & staffq no
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IV. ~ DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $535 00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $535.00
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 pendina 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 / No• Are you lobbvina on a pendina application for a Development Aareement with the Citv or application
for chanae of zonina map desianation or chanae 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 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..
^ Yes /No• Are you representina a not-for-profit corporation or entity without special compensation or
reimbursement?
V. SIGNATURE UNDER OATH:
ON OCTOBER 15~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CI CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENS !V' RECEIVED, IN THE CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SH ~,FfLED EV N tF THERE AVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING P OD.
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Signature of Lobbyist -=-? `~' ;,;~`I
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I do solemnly swear that all of the foregoing f re true and correct and that I have read or am familiar-with provisions
contained in Section 2-482 of the Miami Be ' y ode nd all repo 'n equirements. ~ r•,~
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Signature of Lobbyist: " ~~ °
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Signature of Principal/Client: _
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
~/' Form of Identification
E~ Personally known (Lobbyist)
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PRINCIPAL IDENTIFICATION: Eric Harry ~
^ Produced ID
Form of Identification
^ Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before m
This ay , 208.
Signature of Public Notary -State of
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of , 2008.
Signature of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY : y~ ~ r~
Annual Registration fee: [ ]Yes [ j No Amount Paid MCR # Date Paid d
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM 05.doc ~~~ Revised 12/08/04
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.~
LOBBYIST NAME: Carter N. McDowell
I understand that no later than October 1st 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 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 transmitted 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 f lobbyist withdrawal in writing.
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ignature: Date:
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IAMI 1641072.1 78176305 13
x/18/08