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Timothy J. Plummer - Portman Hholdings/CMC Group, Inc. V . BEACH G 1 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 I as well as any employee engaged in lobbying activities. The term"Lobbyists"has specific exclusions. Please refer to Ordinance 2004-3435. Plummer Timothy J NAME OF LOBBYIST: (Last) (First) (M.f) . 1750 Ponce de .Leon Blvd_ coral Cables . Florida 33114 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 44.7-n9nn 3n5_aa4-a9RA tim.plummer @dplummer.com TELEPHONE NUMBER: oFAX NUMBER: EMAIL: Please notlfy`:thls office :your contact Infbi*ation changes:address,.phone, ore-mall address. I. ,LOBBYIST RETAINED BY: PORTMAN HOLDINGS/CMC GROUP,INC. BWHIIT'kW&UE, SUITE 2410 MIAMI FL 33131 B Si!`I SS,N ffltND 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:JACK PORTMAN/UGO COLOMBO/ART MURPHY /ROGER ZAMMLL • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,'A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: s ^'a REDEVELOPMENT OF MIAMI BEACH CONVENTION CENTER(R.F.Q.)NO. 22-11/12 Issue to be lobbied(Describe In detail): .�� <w � .,.x.,w...a•...:.,:.,.. III. >..��. c 5',E as w M,-.. x -.x. ,wt•:?.FR w, Pursuant to City Code Section 2.482(x)(4)Include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered Into any contractual relationship (pald or unpaid) with said city,commissioner or personnel from 12 months preceding such person's commencement of service with the cl to the resent date.statln the eneral nature:of the subject contractual relationship. Sec 2-482(x)(4)Full Name of Individual and' Contractual Relationship(Explain) YES NO title of person to be lobbied CITY MANAGER,CITY COMMISSION X CITY DEPARTMENT LAND USE BOARDS X CITY STAFF X Pursuant to Clty Code Section 2.482(8)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 Any Financlal .F.amlllal or'Professional Relationshi - r C 1Users\clerhat\AppData\LocaNMicrosoft\Windows\Temporary Internet Files\Content.Outlook183LGQDDH\Lo-�yl t. obistraugn Formrevised 5-30-2012.doc . � rl IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) PRINCIPAL B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): PRINCIPAL (REQUIRED). 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°: X Yes No: Are you lobbying on a Rresent or oendlna'bid for goods eauloment or services,or on present or Pending award for goods.:eaulprnent or service? 2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": XYes No: Are you lobbying on a aendina application for a Development Agreement yylth the City or application for change of zoning map deslanation.or chance to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2.482(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• Ar®you representing anot-for profit corporation or entity without special compensatlon or relmbursementt V. SIGNATURE UNDER OATH: ON FEBRUARY 28 OF EACH YEAR,EACH_ LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER O LISTING O G P D U E S S C PENS C EIVED,IN THE CITY OF BEACWFOR HE CEDING CALENDAR YEA STATEMENT SHALL BE FIL&PSkVWjE THERE HAVE.-BEEN.NO ExPrENDITURES.OR COMPENSATION DURING THE REPORTING..PERIOD% _ Signature of Lo y1st I do solemnly swear that all of the foregoin r e nd correct and at I have read or am familiar with the provisions contained In Section 2-482 of the Miami a an I ortlng requirem ts. Signature of Lobbyist: Signature of Principal/Client: CN V I. LOBBYIST IDENTIFICATION: u P RINCIPAL IDEN FICAT : Produced ID Produced ID Form of Identification Form of Identification 44- Personally known(Lobbyss Personally known(Principal) VII. SIGNATURE AND STAMP MSARIO a•BERWIOES PIS-Shih of Florida Ml►Cennn: State of Florida,County of Miami-Da 1W 21.2015 State of Florida,County of Miami-Dade COM is$ 114 EE 181.923 S subscribe of re me Sworn o and subscribed b me too �'� ��gh t1atlan�l Niit This day of Wary Assn, i ay of 2 JANET GONZALEZ NOTARY PUBLIC n ture Public Notary-State o Florida Signatu of u wyal's ry—State of STATE E FLORIDA No zation of Lolbbylst's signature Notar flop - -signature E866818 Expires 1/26/2017 TO BE COMPLETED BY CITY CLERK'S ST"ONLY, bb�u ~ ta#ratton fee::[ ,j.Yes( No.: Amount Paid` CR e = e Paid lii std Re9lstration Form fecehied andwerlfletl b C:1UserstclerhaUNAppDatal LocallMicrosofttWindows\Temporary Internet Files\Content.0ut1ook183LGQD H1Lobbyist Registration Formrevised 5-30-2012.doc - it G6: i Ilstrador Fo�rn doc r. ` '` Re ftd a41 7 2012- M I AM I EtS& E_A(._P�%H City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411 ,Fax:305.673.7254 LOBBYIST NAME: Timothy J. Plummer,,. PE 1 understand that no later than February 28 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, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal In writing. Pursuant to Section 2-485 (d), the City-Clerk-shall notify any lobbyist(or principal)who fails to timely file a Statement and in addition to any other penalties which may be imposed'as provided in.Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on.Ethics and Public_ Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who falls to file: the required Statement by April 30th, 2012, shall be automatically susp nded from'.lobbying.until all fines are paid, unless the fine has been appealed to th ade County Commission on Ethics and Public Trust. G _ /3 , Signatur Date: C:1UserslclerhatilAppData\Loc al\MicrosoftlWindows\Temporary Internet Files\Content.Outiook183LGODDH1Lobbyist Registration Formrevised 5-30-2012.doc