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Robert S. Fine - 1701 Collins 1 /01 co at hi eA. AA MAMIBEACH RFC.;FIVFD City of Miami Beach O ce of the City Clerk 1700 Convention Center Driv , Miami Beach, FL 33139 2011 FEB _$ Ah 9: LOBBYIST REGIST TION FORM rr,�� Lobbyist means all persons employed or retained, whether paid or no , by a principal who seeks to encourage as `d o ICIE Y� P P Y P P 9 P modification of any ordinance, resolution, action or decision of any mmissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or re ommendation of any city personnel during the time period of the entire decision - making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please r fer to Ordinance 2004 -3435. Fine Ro ert S. NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig, P.A. 333 Ave. of the America, 44th Floor Miam' Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 - 579 -0826 305 - 961 -5826 finer ©gtlaw. co m TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. I. LOBBYIST RETAINED BY: 1701 Collins (Miami) Owner, LLC NAME OF PRINCIPAUCLIENT: 1701 Collins Avenue Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305- 531 -6181 305 - 531 -6863 www. s be. co m TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2 -482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: IL , Bet Building , Zoning Code, Life Safety Code and Historic Preservation (0 /7 7'- .- /,7 s C . Issue to be lobbied (Describe in detail): Pursuant to City Code Section 2- 482(a)(4) include the commissioner or pe sonnet sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city com issioner or personnel from 12 months preceding such person's commencement of service with the city to the present date, stating the ge eral nature of the subject contractual relationship. Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied Planning and Zoning department Building Department, Fire Department, City Commission Public Works, Finance, Planning Board, Board of Adjustment , HPB Board , Flood Plain Mgmt BD Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2- 482(g) Any Financial, Familial or Professional Relationship NO /f , - 7 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $550.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $550.00 Hourly 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 ® No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present 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 ® No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 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 a not - 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 ® No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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 FIL VEN IF THFRE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 1 Signature of Lobb st I do solemnly swear that all of the foregoing facts are and cor - have read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach City Coe nd al r po . • ' r Signature of Lobbyist: , e s, Sign - . ure of Principal /Client: , s!-% . 1 �NC �+ N a~i �. • LOBBYIST IDENTIFIC' • : PRINCIPAL IDENTIFICATION: o c• eo ° ...c . a : 0 o a Produced ID 0 Produced ID I' c z • Form of Identification Form of Identification .Y 9 Personally known (Lobbyist) 1r , � , , . ; , , ', -e •nally known (Principal) Calm. Pak - sub N Florida Z a VII SIGNATURE AND STAMP OF NO ,Calm. Explp{jai it 2013 0 um i F ,' si , :: - f Florida, County of Miami - Dade r . Florida, County of Miami -Dade i.._ .; t o and • cribed before me w I ,� +. �� • s.,, t of ;.!!Rls , 2011 This subscribed before me day of 2011 • ssar -I v. �`. 1.. ' _ "- gnatur. of Pu• j. Ty — State of Florida S . 2 nat?e of Publi Notary — State o lorida ' • • •t•• ignature Notarization of Principal's signatur TO BE COMPLETED BY j C4 TY LERK'S STAFF ONLY j� Annual Registration fee: [ ] Yes [ ] No Amount Paid $ c'3 t. CR # • i ' J Date Paid C1 // Lobbyist Registration Form received and verified by: . F :\CLER\$ ALL` aFORMS\ LOBBYIST FORMS ' t Lobbyist Annual ' Registration Form. p', / - Revised 1/11/2011 • PO 1A A 1 BEAC H City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Robert S. Fine I understand that no later than February 28th of each year, I must file the following form, pursuant to Section 2 -485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) Lobbyist Expenditure and Compensation Form Failure to file these forms on a timely basis will result in my name being transmitted to the Miami -Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. 01/21/2011 Signature: Date: