Carter N. McDowell/16th Street Partners, LLCCity of Miami Beach Office of the City Clerk ~ i /
1700 Convention Center Drive, Miami Beach, FL 3313 ~ ~' ~ ' ~" =-
LOBBYIST REGISTRATION FORM ZQ08 a~T 17 ~ i I ~ Q4
Lobbyist means all persons employed or retained, whether paid or not, by a principal who see~ks~to e~~`ouF~g~ ~~ Ip~~~ge,
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.
McDowell Carter N•
NAME OF LOBBYIST: (Last) (First) (M.I)
Bilzin Sumberg Baena Price & Axelrod LLP 200 S Biscayne Blvd. Suite 2500. Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code)
-305-350-2335 305-351-2239 cmcdowell anbilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
16"' Street Partners LLC
NAME OF PRINCIPAL/CLIENT:
1601 Washington Avenue 8`h FL Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-672-9602
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:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Property located at• 1601 Washington Avenue
Issue to be lobbied (Describe in detail):
I11. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Fernando Vasquez, Public Works
Jose Perez, Public Works
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $535 Hourly
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 Iobbvina on a present or pending 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 '~ No: Are you Iobbvina on a pending application for a Development Agreement with the City or application
for change of zoning map designation or change to the Citv'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 representing 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 CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSA RECEIVED, IN THE CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL ED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO
Signature of Lobbyist-Carter N. McDowell
I do solemnly swear that all of the foregoi acts are true and cor ect and that I have read or am familiar with the provisions
contained in Section 2-482 of the Miar~~1 City C9,le ancj aorting requirements.
Signature of Lobbyist: ~
Carter N. Mc owe
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
^ Produced 1D
/ Form of Identification
`d''" Personally known (Lobbyist)
Produced ID
Form of Identification
Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County
Sworn o and sub ib ~~ ~'•,~ne BISDUZ
This d of ,• 0~'~MISSION # OD X9254
° -EXPIRES: May 18,,2010
9aiaed Thm r~r~a ~y
Signatur Public Notary - S e of orida
Notarization of Lobbyist's signature
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
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM 05.doc Revised 12/08/04
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
PLAT" RATE OR OTHER)
A} LOBBYIST DISCLOSURE: (Required) 5535 Hourly
B} PRINCIPAL'S DISCLOSURE (OF LOBBYISTC COMPENSATION): (Required). 5535.00
The following Information must be answered:
1) Pursuant to Miami Beach City Code Section 2-48a Entitled "Prohibited Campaign. Contributions By Lobbyists On
Procurement issues":
^ Yes ~ No: Asa vrou tobbving on a present or pending bid for goods eaufoment 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 ~ No: Are tobbvinsi on a pending appitcatiortl for a Devela~ment Agreement with the City or applicatl~
for change of zoning mm desirinatlon or change to the Citv's Future Land Use Matz?
3) Pursuant to Miami Beach City Code 2-484 (h) Any pennon (except those exempt from the definition of "lobbyist" as set
forth in Section 2-481 above) who only appears as a represerdative of a not for=profd corporation or entity without
special compensation or reimbursement for the appearance, whether direct; or indirect, th express support of or
opposition to any item, shall register with the clerk as required by this sectbn but, shah not be required to pay any
registration fees..
^ Yes '~ No• Are you representtng snot-for-profit corooration or entity without special compensation or
~lmbursement?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1'~ OF EACH YEAR, EACM LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGHED 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-Carter N. McDowell
I do solemnly swear that all of the foregoing facts are true and correct $nd that I have read or am famil~r with the provisions
contained in Section 2-482 of the Miami Beach City Code and all reporting requln:ments.
Signature of Lobbyist: . .
Carter N. McDowell
Signature of PrincipaUCliertb
VL LOBBYIST IDENTII=ICATION:
^ Produced ID
Form of identification
^ Personally known (Lobbyist).
Vq. SIGNATURE AND STAMP OF NOTARY:
~~~~ VtC~ t~s~i~~
PRINCIPAL titT1E!
,~~~~~~.,,, ISAURA SCANDELIA
•~.S„aY Pl~~(
^ ProdU , ~. Notary Public -State of Fbrida
__ • . ~ Expires Sep 2009
p ~ - ~dnnission # DD 427603
~'"'~~~~~"~ Bonded By National No!3ryAssn.
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of . 20
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn and subscribed be re me
This ~~iay of 20~
S'~afure of Pubec Notary -State of Florida
Notarization ot'~rtncipaPs siEnature
R C RK'S U$E NLY /~~~/
Annual Registration fee: [ Yes ( ] No Amount Paid~= MCR ~~~f'G ~ Date Paid ~ ~ ~ n
Lobbyist Registration Fonn received and verified by:
F:\CLERISALL\MARIMM1LobbyistlLOBBYiST FORM 05.doc ~~ Revised 12/Oa3/04
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,
www.miamibeachfl.gov
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 notif e City Clerk's Office of lobbyist withdrawal in writing.
~ l~ v~
Signature: Dat
MIAMI 1639237.1 7310210993
9/16/08