2010- if_2011-tAdlerPublicAffairs i..GLIVt^�)
ity f Ln Beach CH
CLERK
;~AG1-1, CA1, 1i
LOBBYIST REGISTRATION REPORT I
10 AL IM i I` 30
1. Fill out fora
2. Sign and date
3. File with payment at the:
Long Beach City Clerk's Office
333 W. Ocean Blvd.
Long Beach, CA 90302
Tel. 562 5706101
This is the initial registration report
This is the quarterly report due on: (❑April 15 ❑ July 15 ❑ October 15 ❑January 15)
❑ This is an amendment of the report filed on
❑ This is a termination report covering up to date:
F
Section I- Information About All Filers
(ALL L09BYISTS MUST COMPLETE SECTION ONE)
PART I. Type of Lobbyist:
Contract lobbyist: 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. (Complete Sections 1 and 2
and,if applicable,Section 5.)
❑ business or organization lobbyist: 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. (Complete Sections 1 and 3 and,if applicable,Section 5.)
❑ Lxpenditua'e 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. (Complete Sections 1 and 4 and,if applicable,Section 5.)
X
City of Long Beach Lobbyist Registration Report Foran—3/3/2010 Page 1 of 5
City of Long Beach
LOBBYIST REGISTRATION REPORT
PART II. Filer Information:
Name of Filer:Jeffrey Adler/Adler Public Affairs
Business Address:
Business E-mail Address:
Business Phone Number:
Business Fax Number:
Description of the Nature of your Business or Organization:
public affairs/public relations/political consulting
PARI'III. Fees Due:
Annual Registration Fee is $100.00 ($50.00 if registered on or after June 30`h)
Each registrant shall also pay $25,00 per client for whom lobbying is undertaken for compensation in excess of$500.00.
Total Registration Fee (due at time of registration or renewal) $75
Make checks payable to"City of Long Beach".
PART IV. Verification of Person Responsible for Report Preparation:
Print Name: Jeffrey Adler
Title: President/CEO
Address:
Daytime Telephone Number:
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.
Date: July 11 2010 Signature: ' '''
City of Long Beach Lobbyist Registration Report Form—3/3/2010 �,...-,/
I 41;�-DA
City of Long Beach
LOBBYIST REGISTRATION REPORT
Section 2- Contract Lobbyist Client Information
Ownership Information: a
If the filer:
❑ is an entity,name each individual who is an o`vner,partner or officer of the filer.
❑ is a sole proprietorship,name the sole proprietor.
is a corporation,name each officer(president,secretary,chief financial officer,agent for service of process)
❑ is a partnership with fewer than 10(ten)partners,name each partner.
Client Name Client Address 'Telephone Nature of Contacted Item(s)of legislative or Name(s)of each person
Number Business Individual administrative action the employed or retained by
lobbyist is seeldng to the lobbyist to lobby on
influence on behalf of the behalf of client:
client:
Wmton.G-,Wafters BM=oy legal partnership John H.Weston entertainment permit Jeffrey Adler
City of Long Beach Lobbyist Registration Report Form—3/3/2010 Page 3 of 5
wit
4; City of Long Beach
LOBBYIST REGISTRATION REPORT
Section 3- Business or Organization Lobbyists
Names of owners, officers, or employees conducting lobbying activities:
Items of municipal, legislative, or administrative action the lobbyist is seeking to influence:
Names of contacted individuals:
Section 4- Expenditure Lobbyists
Items of municipal, legislative, or administrative action the lobbyist is seeking to influence:
Section 5- Consultant Payments Received by Lobbyist
Describe payments received by a lobbyist for services as a consultant or in any other capacity for services
rendered to a City agency, any City official, or any City Official-elect, or their controlled committees, any
officeholder committee, or any ballot measure committee.
Lobbyist receiving payment: 1 . � Y,, -� 'VKW Agency/Committee making payment:Uva � i�2� tlK-x--�LA5 k00y1_y
Payers Name:
Payment Amount: $ `—')QQ Payment Date:
............................................................................................................................
City of Long Beach Lobbyist Registration Report Form—3/3/2010 Page 4 of 5
r City ®f Long Beach (�kM 1v L �
CfTYC Ear
LOBBYIST QUARTERLY REGISTRATION RERG'r0 �-
eltarr
1. dill out form
2. Sign and date
3. File with payment at the:
Long Beach City Clerk's Office
333 W. Ocean Blvd.
Long Beach, CA 90602
Tel. (562) 570®6101
❑ This is the quarterly report f®r e -r y Ly �� t�� y I Loa
(Lobbyists ame) I® number
due on: (❑ April 15 ❑ July 15 K October 15 ❑ January 15)
❑ This is an amendment of the report filed on
Section I® Information About All Filers
(ALL LOBBYISTS MUST COMPLETE SECTION ONE)
PART 1. Type of Lobbyist:
Contract lobbyist: 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. (Complete Sections 1 and 2B.)
❑ Business or organization lobbyist ,- -' organization,whose owner(s), officers(s) or employee(s) cavy out
lobbying on its behalf,in an aggregate amount of fifty(SO)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 then reasonable,travel;meals or
incidental expenses. (Complete Sections 1 and 3.)
❑ 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. (Complete Sections 1
and 4.)
City of Long Beach Lobbyist Registration Report Form—10/4/2010 Page 1 of 5
-410)
City n
LOBBYIST QUARTERLY REGISTRATION REPORT
PART M. Fees Due:
Each registrant shall also pay$25,00 per client for whom lobbying is undertaken for compensation in excess of$500.00.
List new clients (clients that have not been previously reported):
Number of new clients registered: _
Client Registration total: $
Make checks payable to"City of Long Beach".
PART IV. Verification of Person Responsible for Report Preparation:
rt�I�T om`1�LCIZ___
Print Name:
Title: 0"" i_a-
Address: ' _ �")
Daytime Telephone Number: �
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 snider penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
ZO 10 Signature:1(4 1
City of Long Beach Lobbyist Registration Report Form—10/4/2010 Page 2 of 5
City c
LOBBYIST QUARTERLY REGISTRATION REPORT
Section 2 - Client Information
Client Name Client Address 'Telephone Nature of City Official or Item(s)of legislative or Name(s)of each person
Number Business Employee administrative action the employed or retained by
Contacted lobbyist is seeking to the lobbyist to lobby on
influence on behalf of the behalf of client:
client:
- '` ` - °9'x"3'1:
Filer n e: �� Date gy 0,) 4
f.c,-)
City of Long Beach Lobbyist Registration Report Form—10/4/2010 Page 3 of 5
-
6W1
City of Long Beach (q
10 DECLARATION OF TERMINATION
INSTRUCTIONS
1. Fill out form
2. Sign and date
Long Beach City Clerk's Office
333 W. Ocean Blvd.
Long Beach, CA 90802
Tel. 562 570-6101
l� i
This is a lobbyist termination declaration for: t`,y1t:tz - t-4,>wc- t f.rlw. /
(Lobbyist Name) Filer ID number
Covering up to date: 11i %'C7J
Section I- Information About All Filers
(ALL LOBBYISTS MUST COMPLETE SECTION ONE)
PART A. Filer Inforftmation:
Name of Filer: / c(�L X12 ( ut t-i�-- 1q`i^4/Z-'-'
Business Address:
�
Description of the Nature of your Business or Organization:
PART B. Verification of Per/soman Responsible for Report Preparation:
Print11i�
Title: 11,St?44
Address:
Daytime Telephone Number:
I have used all reasonable diligence in preparing this report, I have reviewed all the sections and to the best of illy
knowledge the information contained herein is true and complete.I certify under penalty of perjury under the laws of the
State of Cali�fyornia that the foregoing is true and correct.
Date: l t Zol Signature: ���. Filer ID number
City of Long Beach Lobbyist Registration Report Form—clb.cc.lbyterm Revised 12/23/2010 Page ] or 2
,.; City of Long Beach
DECLARATION OF TERMINATION
Section 2 - Client Temination Infomiation
(All declarations of termination must list all client lobbying activity that occurred since the end of the last quarterly reporting period and the date ofthe termination.)
Client Name Client Address Telephone Number Nature of City Official or
Business Employee Contacted
-
Filer name: k-p 2- ?0 Cr �' r- -�I Ze, Filer ID number Date ?tel)
City of Long Beach Lobbyist Registration Report Form—clb.ec.lbvterm Revised 12/23/2010 Page 2 of 2