Lobbyist_2019_S1_Stefan Borst-Censullo (Formerly Grass Roots Government Services)_070919 rOFFICE OF THE
CITY CLERK
loco
SERVING LONG BEACH SINGE 17
For Official Use Only
LOBBYIST REGISTRATION & REPORTING FORM Page 1 of
Initial Registration Annual Renewal(filed annually by Jan. 15th) Elermination/Date of Termination:
(See Section Il)
Amendment To: Filed On;
Semi-Annual Period list Semi-Annual Period(January 1st-June 30th) 0 2nd Semi-Annual Period(July 1st-December 31st)
SECTION 1
CONTRACT LYIST:
A person who engages in lobbying on behalf of one or more clients (acting individually or through agents, associates,
employees or contractors) and who has received or has entered into an agreement for compensation of$3,200 or more
("threshold compensation")for engaging in lobbying during any consecutive three-month period.
BUSINESS OR ORGANIZATIONLOBBYIST:
Any business or organization, whose owner(s), officers(s) or employee(s) carry out lobbying on its behalf, in an aggregate
amount of fifty(50) hours or more within any three month period, whether or not such officers or employees are
specifically compensated to engage in lobbying; provided that the activities of officers shall be considered lobbying only
if those officers receive compensation by the business or organization beyond reimbursement for their reasonable,
travel, meals or incidental expenses.
EXPENDITURE LOBBYIST:
A person who makes payments or incurs expenditures of five thousand dollars ($5,000) or more during any calendar year
in connection with carrying out public relations, advertising or similar activities with the intent of soliciting or urging,
directly or indirectly, other persons to communicate directly with any City Official in order to attempt to influence
legislative or administrative action.The five thousand-dollar($5,000)threshold shall not include: (a) compensation paid
to contract lobbyists or employees of lobbying; or(b) dues payments, donations, or other economic consideration paid to
an organization, regardless of whether the dues payments, donations or other economic consideration are used in whole
or in part to lobby.
IN
Name of Primary Contact/Filer Stefan ors -Censullo
TitleAttorney
E-mail
Name of Business/Organization
Address
E-mail Phone Number
Description of the Nature of your Business or Organization:
Updated 1211212018 LOBBYIST REGISTRATION&REPORTING FOR
City Clerk of Long Beach
LOBBYIST REGISTRATION & REPORTING FORM
F—Page 2 of 3
SECTION 11
I certify that I have been authorized by the Lobbyist identified above to make this verification. I have reviewed the requirements of the
provision of the Long Beach Municipal Code I certify under penalty of perjury under the laws of the
State of California that I have reviewed this Termination and to the best of my knowledge the information contained herein is true and
complete.
Print Name Title
Signature: Date
IMMINNINE
SELECT ALL THAT ARE APPLICABLE
Registration Fee Registration
Reduced Fee Registration Fee for Additional Clients Registration Late Fee
$1101 Year $561 Year $271 Client $281 Day
E= -- —=—
TotalT
Lobbyists Fees are subject to change on a quarterly basis. Please see the Current Fee Schedule to apply the correct fees.
MAKE CHECKS PAYABLE TO:
CITY OF LONG BEACH
FORMS AND PAYMENT CAN BE SENT TO:
CITY OF LONG BEACH -C/O OFFICE OF THE CITY CLERK
333 WEST OCEAN BLVD. - LOBBY LEVEL- LONG BEACH, CA 90802
NOTE: Late fees will apply to any lobbying activity not reported after the 15 days of qualifying as a lobbyist
In
I have reviewed the lobbyist guidelines and I have nothing to report. I have indicated as such in SECTION III for this period-
0 Attached to this report is SECTION III, which lists the current activity for this period.
I have used all reasonable diligence in preparing this report. I have reviewed all the sections and to the best of my knowledge
the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of
California that the foregoing is true and correct.
Print Name:Stefan Borst-Censuillo Title:Attorney
Signature: Date 7/9/2019
Updated 12/1212018 LOBBYIST REGISTRATION&REPORTING FORM
City Clerk of Long Beach
LOBBYIST REGISTRATION & REPORTING FORM
Page 3 of 3
SECTION III I have reviewed the lobbyist guidelines and I have nothing to report,
✓
Client Name Client Address Client Phone Lobbyist(s) Item(s) Discussed City Contact(s)
Updated 12/12/2018 LOBBYIST REGISTRATION&REPORTING FORM