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Palmer, Ali o�PARS Date 01/12/16 CITY OF PARKLAND 6600 UNIVERSITY DRIVE PARKLAND, FL 33067 NTAL�1 (954) 753-5040 FAX (954) 341-5161 LOBBYIST REGISTRATION STATEMENT Lobbyist Information Lobbyist Name PALMER ALESSANDRIA("Ali") (Please print) Last First Middle Lobbyist Address (Residence)2223 Arterra Court Royal Palm Beach FL 33411 City State Zip Code Business Name(Company/Firm) URBAN DESIGN KILDAY STUDIOS Business Address 610 Clematis Street,Suite CU-02 City: W. Palm Beach State:FL Zip Code 33401 Telephone 561-366-1100 Fax 561-366-1111 Nature of Lobbyist Business, Occupation or Profession:LAND PLANNING/LANDSCAPE ARCHITECTURE Name of Principal FENECH(SE FL Div.Pres.) DEREK Last First Middle Business Name K. HOVNANIAN HOMES Business Address 3601 Quantum Boulevard,Boynton Beach,FL 33426 City State Zip Code Subject matter that Lobbyist seeks to influence (Ordinance/Resolution etc. describe in detail) FOUR SEASONS AT PARKLAND(f/k/a Parkland Royale Phase 1) Please state the extent of any business association by the lobbyist with any current elected or appointed official or employee of the City of Parkland. For the purposes of this article, the term "direct business association" shall mean any mutual endeavor undertaken for profit or compensation. NONE Note: Appropriate authorization from the group, association, or organization that the lobbyist is representing must be attached. (Applicable minutes, motion, or other documentation of action) Page I 1 I understand that I am required to file, on an annual basis, a registration statement for each employer on whose behalf he or she lobbies before the city commission, board or city employee or official and to notify the City of any changes to the information contained herein. Further, I understand that each person who withdraws as a lobbyist for a particular person shall file a notice of withdrawal as a lobbyist with the city clerk. Annual Registration Fee of$150.00 to be included CERTIFICATION I do solemnly swear or affirm that all the foregoing facts are true and correct and that I have read the City of Parkland Code, Chapter 2.5 or Ordinance No. 2011-02, and that I am aware of the requirements for periodic filing and submission of other statements !� , Signature STATE OF FLORIDA COUNTY OF 13AAM ��— On this (2- day of L)4- , 201�before me,the undersigned Notary Public of the State of Florida, personally appeared ALE sANDRIA PALMER whose name(s�re subscribed and acknowledged that he/�xecuted it. o ary ubhc Notary Seal: : PYA, COiTiE E.RANKIN xxx Personally known to me :.. Commission#EE 849910 Expires November 20,2016 Produced Identification -•„R� ��`'•, B nded Th.Troy Fain Insurance 800-3857019 Page 12