Kent Harrison Robbins - MDPL 00
jM I Ai,\A1 B EAC H
City of Miami Beach Office of the City Clerk 2013 FEB -4 Phi 3: 25
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)
1224 Washington Avenue Miami Beach Florida 33141
i
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 532-0500 (305) 531-0150 khr @khrlawoffices.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Miami Design Preservation League
NAME OF PRINCIPAL/CLIENT:
1001 Ocean Drive Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
ii.SPECIFIC LOBBY ISSUE:
Legal Representation of Miami Dade Design Preservation League concerning DRB approval of demolition of improvements at 42 Star Island,and
Historic Designation of 42 Star Island.
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date,stating the eneral 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 Board None X
Land Use Board None X
Planning Staff qone
Pursuant to City Code Section 2482(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
Ci Agencies/Individuals To Be Lobbied:
City aaes Iffice Noe
City Attorney's Office None X
Historic Preservation Board None X
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) 40BBYIST DISCLOSURE:(Required)
$0 . 00 ./ per dour. Pro Bono
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $0 . 00 / per hour. Pro Bono
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 IN 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 2484 (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.
6��Yes N No: Are vou re resentin a not-for- rofit corporation or entity without special com ensation 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 COBEENSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT S4ML,91E FILED EV6N JF THERE EEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
do solemnly swear that all of the for of g acts are ue a d correc n t t have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach de a ep ing req e e
Signature of Lobbyist: 11A .41
Signature of Principal/Client: tj
VI. LOBBYIST IDENTIFICATION: 1`"V� ( PRINCIPAL IDENTIFICATION:
El Produced Produced ID El Produced ID Q' ortM4/1L
Form of Identification \%%X\\\Ilt`. Form of Identification Ur`rs �
A$ YIV5;CJ
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' Personally known(Lobbyist) C,.. �P 22;�O**. Personally known(Principal)
VII. SIGNATURE AND STAMP OF NO"Y; ®®�,
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State of Florida,County of Miami-Dade �y •.s�,, •- OQ a State of Florida,County of Miami-Dade
Sworn and subscri before me �'����,o��' ;;r `°•��0�v�� Swor d subscribed before me
day of 2013 ii� (lc,SA O- `��� This day off 201 S
df ublic No ary--State of FloricTa Signature of Public Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETEDJEW CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form receiv d and verified by:
>\cLF \S"AL OFORMS\LOBBYIST FORMS\t.obbs rise Annual Regi4aticn F or€r dad Revised 1/11/2011.
•`�A�„",'� SUSAN WALCUI T
? MY COMMISSION#DD 981145
W EXPIRES:May 21,2014
'y'i, Bonded Thru Notary Public W*w t m
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City of Miami Beath, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME:
I understand that no later than February 28th ®f each dear, 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 immed' tely notify t City Cler ' Office of lobbyist withdrawal in writing.
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Signature: Date:
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