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Kent Harrison Robbins - Eleanor Cohen vE 10 M EAC"H JA�Vd V! CIO City of Miami Beach Office of the City Clerk 1. 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.1) Law Offices of Kent Harrison Robbins, 1224 Washington Avenue, Miami Beach, Florida 33139 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: Eleanor Cohen NAME OF PRINCIPAL/CLIENT: =' 5151 Collins Avenue, Unit 429 and 431 Miami Beach Florida 33140 �_ , X° 71 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code; (305) 374-8113 - TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) .� Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] CD �6 _-r-1 r\) • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: ' 4, 7, CD • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: OegPECIFICLOBBY ISS�9E°al epresentation-concerning development and land use matters at the property located at 5101 Collins Avenue, Miami Beach, Florida 33140("Seacoast Towers") Issue to be lobbied(Describe in detail): III.CITY'AdE'ICIES/INDIVIDUALS."TO'BE LOBBIES: Pursuant to City Code Section 2482(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 general 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 Zoning BoarTo-f Adjustment qone Planning Board 14one Design Review Board 14one Land Use Board one City Commission one Planning Staff one 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. SECTION 2-482(a)(4) CONTINUED Mayor None Uity Manager's ice None Uity Attorney's Uttice None Police Department None SECTION 2-482 (g) ANY FINANCIAL, FAMILIAL OR PROFESSIONAL RELATIONSHIP - NONE d �I �1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYI T DISCLOSURE:(Required) $495/Hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED).$49S/Hnllr 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 XNo: 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues` _Yes X.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 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.XNo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS CO PENSATION RECEIVED N E CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SIIALLAE FILED EYEIN IF THERE WAVEF 13REN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.0 . YA—AV-4. Sig tore of Lo byist I do solemnly swear that all of the fo oin facts are jr a correct and t I a read or am familiar with the provisions contained in Section 2-482 of the Miami Bea y ode d a o ing requirem Signature of Lobbyist: Signature of Principal/Client: Gir��'✓ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: 1 Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) Q ••R. v Personally known(Principal) VII. SIGNATURE AND STAMP OF N@TAR #, ?,22,?p .•C1 County of Miami-Dade = ®®® _ S ate of Florida, County of Miami-Dade State of Florida, ty "= Z #EE191409 � S orn a subscri d of a me S orn rid subscri d before g► • • is day of 013 �9' •'•••• �sts+ e•.•'�Q `•� his day of�W 2013 ST �"Wl11111111�� Notary Signa re of Public Notary—State of Florida Signatu —St tM7,Paid ry PuMicState of Florida Notarization of Lobbyist's signature No riz n of ci al's sign Mariely Jennings My Commission EE 853207 TO BE COMPLET D CITY CLERK'S STAFF ONLY Expires 12/15/2018 Annual Registration fee: [ ]Yes[ ]No Amount Paid$ 19� MCR# D Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc listration Form.doc Revised 04/27/2012 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk@mlamlbeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: 6&d_ 61-rics6-)i &&b,/q/?_S ,..Of I 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 2485 (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 suspended fr m lobbying until all fines are paid, unless the fine has been ape ed to thel4lami-Da ounty Commission on Ethics and Public Trust. W_ 0 /Q � [/3 Signature: Date: C-\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Forrnrevised 5-30-2012.doc