HomeMy Public PortalAboutgehl.pdfForm CFt3.OB(S)
Rev. 2020
Page Iof1
Lobbyist Supplemental Registration Application
Georgia Government Transparency and Campaign Finance Commission
200 Piedmont Ave. SE 1416 West Tower i Atlanta, GA 30334
404-463-1480 www.ethics.ga.gov
Lobbyists must pay a 5110 supplemental fee for each additional group.
Registration Year
aoa3
Name (Last) Ci C A \ L
Type of Registration
13 ORIGINAL In AMENDMENT
(IF AMENDSvilaa DESCtt1DE) - --
Lobbyist Identification
(First) -TO N.r
(NI die)
First Name for Badge: _To kiNs Email Address (Optional)
Mailing Address (Street)
32 a:\
(Suite)
City
�Ec TZ-
Contact Phone # l_ f ot4 _ Lf (/(/ _ Z CJ 0 6
State G A Zip
So 030
Are you an employee of a City or County: 0 Yes No
Name
Lobbying on Behalf of
c, -1- y ;fib a s k vv ci
Mailing Address (Street)
City
Phone
L/03 2triLf P AVf,
Ty TELApJ
(Suite)
State Ci A ',ip 3 r 3 Z E
%j2- g6-Lis73
Type of Lobbying (check all that apply): State 0 State Agency 0 Local (CityCounty) 0 Vendor
0 State Transportation Board
Has the above individual or entity agreed to pay the Lobbyist an amount exceeding 13 Yes 0 No
510,000.00 in a calendar year for lobbying activities'
General Business or Purpose of Party Lobbied for:
MIAN At- -0Je.(.n✓`-'e..4-4
Name of state agency or agencies which applicant will lobby:
If applicant represents a membership group other than an agency or Corporation,
state the approximate number of members:
Do you serve as a Lobbyist for more than one organisation? VI Yes 0 No
Authorrzntion
1 hereby authorize the applicant named above to lobby on behalf of the undersigned:
Person CI tying bbyisl and Title:
OA'
Signs Pe on Autho ' ing Lobbyist:
PLEASE EXECUTE THE APPLICABLE AFFIDAVIT BELOW FOR E -VERIFY COMPLIANCE. IF YOUR
BUSINESS HAS ONLY ONE EMPLOYEE THEN EXECUTE THE EXEMPTION AFFIDAVIT. PER O.C.G.A. §
36-60-6(d), ALL BUSINESSES WITH MORE THAN ONE EMPLOYEE MUST PROVIDE THEIR E -VERIFY
NUMBER IN ORDER TO DO BUSINESS WITH A GOVERNMENTAL ENTITY,
Private Employer Affidavit Of Compliance Pursuant To O.C.G.A. § 36-60-6(d)
By executing this affidavit, the undersigned private employer verifies its compliance with O.C. G.A. § 36-60-6, stating
affirmatively that the individual, firm or corporation has registered with and utilizes the federal work authorization program
commonly known as E -Verify, or any subsequent replacement program, in accordance with the applicable provisions and
deadlines established in O. C.G.A. §13-10-90. Furthermore, the undersigned private employer hereby attests that its
federal work authorization user identification number and date of authorization are as follows:
Federal Work Authorization User identification Number
Date of Authorization
Name of Private Employer
OR
Private Employer Exemption Affidavit Pursuant To O.C.G.A. § 36-60-6(d)
By executing this affidavit, the undersigned private employer verifies that it is
exempt from compliance with O. C. G.A. § 36-60-6, stating affirmatively that the
individual, firm or corporation has no more than one employee and therefore, is
not required to register with and/or utilize the federal work authorization program
commonly known as E -Verify, or any subsequent replacement program, in accordance
with the applicable viicuffs ajfd deadlines established in O.C.G.A. § 13-10-90.
Signature of Exempt P mate Employer
,. s ( I --
Printed Name of Exempt Private Employer
Any person who knowingly or willfully makes a false, fictitious, or fraudulent statement or representation in this
affidavit shall be guilty of a violation of Official Code of Georgia 16-10-20
Sworn to and sttrbscrri ed
34"A5
Signature of Applicant Print Name
Before me this 11 day
Of ;','-'y 41-11A. V' 20 2-: (SEAL)
Notary Public
My Commission Expires:
(
Keosha Banks
NOTARY PUBLIC
DeKalb County, GEORGIA
My Commission Expires 10/24/2426
Proposal C I V I C
FORWARD
STRATEGIES
For Governmental Relations Services for the City of Tybee Island
August 2023
Overview of Services
For the City of Tybee Island, Civic Forward Strategies will proactively lobby on behalf of the
city for the passage of a general law which gives local governments enhanced powers to
respond to unpermitted special events which arise or are planned and promoted through
social media. Civic Forward Strategies will coordinate bill drafting in concert with members of
the Tybee Island legislative delegation, other members of the General Assembly who have
an interest in addressing special events like this across the state, and with the Office of
Legislative Counsel. Civic Forward Strategies will also work with legislators to plan for the
introduction of legislation, analyzing strategic and tactical considerations to secure passage
of the legislation.
Professional Price Arrangements
For governmental relations services necessary to navigate the legislative process Civic
Forward Strategies proposes three options for the City of Tybee Island.
Option 1: For a monthly retainer of $5,000, Civic Forward Strategies will proactively lobby on
behalf of the city on any issues as directed by the Mayor and Council, such as securing
funding for beach renourishment, protecting the city's ability to regulate short-term rentals
within its jurisdiction, and enhancing the city's powers to control crowds and traffic resulting
from social media promotions.
Option 2: For a monthly retainer of $3,000, Civic Forward Strategies will lobby on behalf of
the city for the passage of a general law which gives local governments enhanced powers to
respond to unpermitted special events which arise or are planned and promoted through
social media.
Option 3: For a project fee of $25,000, Civic Forward Strategies will lobby on behalf of the city
for the passage of a general law which gives local governments enhanced powers to respond
to unpermitted special events which arise or are planned and promoted through social media.
The term of this project would be August 2023, through April 2024, after the General
Assembly has adjourned sine die and during the period when Governor Kemp will be
considering measures to sign or veto.
i
TOM GEHL
Civic Forward Strategies, www.civicforwardstrategies,com
TomGehl@CivicForwardStrategies.com
(404) 444-8900
2
For all three options, any travel costs for meetings with legislators or executive branch staff in
Atlanta would be borne by Civic Forward Strategies. Should attendance be required for
meetings in other locations across the state or meetings be necessary with key legislators
and stakeholders, Civic Forward Strategies asks for reimbursement of actual travel and any
lodging costs. Travel, lodging, meals, and out-of-pocket expenses will always be discussed
with the point of contact in the City of Tybee Island prior to expenditure.
Firm Principles
Civic Forward Strategies is an independent governmental affairs firm centered in political
reality, upholding the highest ethical standards, and focused on client results.
Civic Forward Strategies' Founder and Principal Tom Gehl has extensive bi-partisan,
statewide political relationships cultivated beginning with every consecutive General
Assembly session since 1990 and through wide-ranging involvement with thought -leaders
throughout Georgia. Prior to founding Civic Forward Strategies, Tom lobbied on behalf of the
537 municipal governments for the Georgia Municipal Association (GMA) for 22 years. For
more information, visit: www.civicforwardstrategies.com.
Acceptance of the Proposal
City of Tybee Island;,
Date:
/ 2-0"3