Kent Harrison Robbins - Mirador 1200 Condo Association •
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of
any ordinance, resolution, action or decision of any commissioner, any action, decision, recommendation of the City Manager or any city board or
committee; or any action, decision or recommendation 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
refer to Ordinance 2004 -3435.
Robbins Kent Harrison
NAME OF LOBBYIST: (Last) (First) (M.I)
Law Offices of Kent Harrison Robbins, 1224 Washington Ave, Miami Beach, F1 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)532 -0500 (305) 531 -0150
khrobbins @kentharrisonrobbins.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Mirador 1200 Condominium Association, Inc.
NAME OF PRINCIPAUCLIENT:
1200 West Ave, Miami Beach, Fl 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 - 538 - 7545
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:
Ron Wolff, President
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
Legal Representation concerning land uses and operations at 1000 through 1200
West Ave.
Issue to be lobbied (Describe in detail):
lll. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2- 482(g) include
a statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an
appearance of an impropriety with any City personnel sought to be lobbied -- further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding said City
personnels' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
A) Full Name of Individual /Title B) Any Financial, Familial or Professional Relationship
Zoning Board of Adjustment None
Planning Board None
Dceign Review Beard None
Land Use Board None
City Commission None
"rlanning Staff None
Mayor None
City Manager's Office None
City Attorney's Office None
Police Department None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$475.00 / per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $475.00 / per hour
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 IN 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 0 No: Are you representing a not - for - profit corporation or entity without special compensation or 1
reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL , OMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC a ING CALENDAR YEAR • , TEMENT SHALL
BE FILED EVEN IF THERE HAVE BEEN NO EXPE • UR• OR COMPENSATION ' - t THE REPORTING
PERIOD.
11
ignature o Lobbyist v
I do solemnly swear that all •f the fo -going fa r true and co - . . th. 1 have read or am familiar with the
provisions contained in Se). n 2 *, oft - Mi i ch City Co : O • -, /- • :rting requirements.
II •
Signature of Lobbyist:
Signature of Principal /Client: f
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"1111i . VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: N
I f ii $ ■ 111 uce
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I S o ` Form of Identification Form of Identification '8
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' g Personally known (Lobbyist) ❑ Personally known (Principal) 3 g
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l. 4 s (1/II. SIGNATURE AND STAMP OF NOTARY: ec d E-
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M ate of Florida, County of Miami Dade State of Florida, County of Miami Dade s i
Sworn to . • subscrib d Wore me Sworn . • • - cribad • -fore me N .u•,,,,,
4 e : his .4 i d ay of (: t b , 209IS I/ This i • - of f" ■ , 2081 I # •
's, ,, i gnature of '" blic otary - State of Florida Signa ure o • diary - S . e of Florida N
° .,,• N otarization of Lobbyist's signature Notarization of Principal's signature _
♦ - --
TO BE COMPLETED BY CITY CLERK'S STAFF ONL
Annual Registration fee: [ ] Yes [ ] No Amount Paid $ v,SC MCR # b 4 17 6 6 • ate Paid —2// -s ///
Lobbyist Registration Form received and verified by: Iv,' I / J 1 1
F: \CLER \$ALL \aFORMS \LOBBYIST FORMS \Lobbyist Registration Form 21109.doc ,�" "" - I tRevised 02/11/2009
M IAMIBEACH
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: -& 1 hA SD/3 bF w s
I understand that no later than October 1st of each year, I must file the following
forms ursuant to Section 2 -485 of the Miami Beach City Code, with the City Clerk's
P h' h'
Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure 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 immedi.tely notify the City Clerk's Office of lobbyist withdrawal in writing.
4 e,
Signature: D te:
F:ICLERILOBBYIST1Lobbyist Registration Form 32708.doc