Donald J. Washburn/Margules Properties, Inc.m 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 enwurage the passage, defeat
or modification of any ordinance, resolution, adion or decision of any commissioner; any adaon, decision, recommendation of the
City Manager or any dty board or committee; or any adion, decision or recommendation of any city personnel during the time
period of the entire decision-making process on such action, derision or recommendation that foreseeably will be heard or reviewed
by the dty commission, or a dty board or committee. The term spedfically indudes the principal as well as any employee engaged
in lobbying adivities. The term "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435.
Washburn Donakt J.
NAME OF LOBBYIST: (Last) (First) (M.I)
The Audio Bug, Inc. 38~ Hitkrest Drive, #102 Hollywood Florida 33021
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(954) 983-2788 (954) 983-2789 audigbugl@aol.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Margules Properties, Inc.
NAME OF PRINCIPAL/CLIENT:
~g~ .r w..a....e c.,.aa, c..:b ~d~~ New York NY 10016
BUSINESS NAME AND ADDRESS (Number and Street) (C~ty) (Static) (gyp Code)
(212) 684-7079 cut 19
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
RII out tfas section if prindpal is a Corporatist, Partrtership or Trust
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Eric Margules
c'7
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN~1CH ~
CORPORATION, PARTNERSHIP OR TRUST: Eric Margutes -~ ~
C'7
II. SPECIFIC LOBBY ISSUE:
~`r,
Redevelopment of 1155 Collins Avenue ~_~~.
Issue to be lobbied (Describe in detail): -r, '"`~
-,~~ ~V
,~
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: t`% O `"'"'`
~~~ ..,,,
A) Fuif Name of Irxlividual/Tltie ~ B) Arty Rnanciai, Familial or Professional Relationship
HPB, BOA, Planning Board, City Commission * (Nate
* Unless an iswe is legislative in nature, HW3, BOA, Warming Board, and City Commission members are not bbbied outside of a public hearing setting.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER M01/RLY,
FL4T RATE OR OTHERx
A) LOBBYIST DISCLOSURE: (Required) S 4500.00
B) PRIAK:IPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 4.500.00
'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 X No• Are you lobbying on a present or ;+pndina bid for goods. equipment or services, or on a
present or pending ayrard for goods equipment or service?
2} Pursuant to Miami Bead City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No• Are you Iobbvina on a pendtna application for a Development Aar_eement with the Citv or
application for ~,janae of zoning map designation or chance to the City's Future Land Use
Ma°7
3) Pursuant to Miami Beach Cdy Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Sectbn 2-481 above) who only appears as a representative of anot-for-profit
corporation or entity wt~hout speaal compensation or rercnbursement for the appearance, whether direct, or
irxlirect, th express support of or oppositbn tD any item, shall regLSter with the cork as required by this
section but, shall not be required th pay any registration fees..
^ Yes X No• Are you re~+~nting a not-for-profit corporation or entity without special compensation
gr 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 DITURES PENSATION DURD~IG THE
REPORTING PERIOD. _ /
re 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 twined in Section 2-482 gf the Miami Beach Gty Code and all reporting
Signature ~ Lobbyist:
Signature of Prinapal/(dent:
VI. L.OBBYMT IDENi'IFTCATI[ON:
PRINCIPAL IDENTIFICATION:
A ~~~i~
~ o $ ••
^ Produced ID
Q ~ c i o
w
- d'
~ Form of Identification
~
N
o ~ ~ w o ~ Personally known (Lobbyist)
~~ o~~°
~ '~ ~ VII. SIGNATURE AND STAMP OF NOTARY:
~
(j,iA ~ v eGa
~ ~ ~ e
~ ~ v ~ State of Florida, County of Miami-Dade
~ Swan to and subsribed me
'
"'
'
,~
H [ 1b 20 d
This ~ 3
day of ~ t
z `~ furs ~ Pubik otary -State bride
rization of Lobbyist's si
^ 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 Pubik Notary -State of Florida
Notarization of Prinapal's signature
FOR CLERK'S` ~-ONLY /~ Z p
Annual Registration fee: [ ]Yes [ ] No Amount Paid ~~s~~ - MCR # Paid l
Lobbyist Relation Form received and verified by: Entered By:
F\QHt~At1\MARU1 MN~T [ORM ~.doc RevLed Wa6/~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) $
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
The following information must be answered:
i) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yes X No' Areyou lobbying on a uresent or pending bid for goods eguipment or services or on a
uresent 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 auulication for a Develoument Agreement with the Citv or
ag,2lication for chance of zoning mau 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 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 X No: Are you representing coot-for-urofit coruoration 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. 'PIitNGtpA1- IDENTIFICATION:
~f- Produced ID /y`f ~ l~ L-
Form of Identification
~~ Personally known (PRINct~)
VII. SIGNATURE AND STAMP OF NOTARY:
State o~ County of.miaa~Dade_
Sworn to and subscribed before me ~--'
This _~day of ~~ 0 c% ~
Signature of P lic Ngi~aryJ- State of,F-ler
Notarizati ~R I(~ALsignature
F
Annual Registration fee: [ ~ ]Yes [ ] No
LO~P~ItST ,IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (LA-3raY~5rt)
~'~" ~L~~ L.~'J~
[~'o~~;~ i~u lip tae f NeW rk.
e~f~ ~~,PPof iami-Dade
Qual~~r~ ~C1iJ me
Gor~iTSission re °-
t°~`~
Signature of Public Notary -State of Florida
Notarization of (,ol~-~ts?' signature
FOR CLERK'SiUSE ONLY g~26
Amount Paid ~~ MCR #
Paid ~ o'Z v
Lobbyist Registration Form received and verified by: Entered By:. ~='~1/"'~~ze
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYI57 foRM OS.doc v Revised 12/08/04
m MIAMIBEACH
City of Miami Beach, 1700 Conver-tion Center Drive, Miami Beach, Florida 33139, www miamibeachfl.gov
CITY CLERK office CityClerk(c~miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
Don Washburn
1 understand that no later than OctAber 1" of each veer t must file the fottaNring forms, Pursuant to Section 2-485 of
the Miami City Code, vritit the City Cleric's Office for all acxive lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Farm
Failure to file these forms on a timely basis wiN result in my name being transmitter to the Miami-Dade County
Commission on Ethics and for cxrde vitiation evaluation•
In add'fion, once ~ issue i have to bbby ~ has been resolved, I am required do immediacy notify ~
City Cleric's Office for tobbyrst w in writing.
~~ QCtober 23, 2008
~~_ ~ Date:
MIADOCS 31137071