David Martin - 8701 Collins Development, LLC it
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City Of Miami Beach Office of the City Clerk Gv
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.
Martin David
NAME OF LOBBYIST: (Last) (First) (M.I)
Terra Group 2675 S. Bayshore Drive Miami Florida 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)416-4556 (305) 777-3040 DMartinaterraaroup.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
.Please notify this office if your contact information changes.address,phone, or e-mail address.
1. LOBBYIST RETAINED BY: �} Ev�v �O
NAME OF PRINCIPAL/CLIENT:
Terra Group 2675 S. Bayshore Drive Miami Florida 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
j (305)416-4556 (305) 777-3040 DMartin()t erragroup.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust(Section 2-482(c)]
C7 N
NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: (24Ev
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN UC4t-ORPORATION,
PARTNERSHIP OR TRUST:
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II.SPECII=IC LOBBY ISSUE:
Land Development Approvals for 8701 Collins Avenue, Miami Beach, Florida -; w`►
Issue to be lobbied(Describe in detail): -, '.• --�
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: CD r —
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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 general nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO
title of person to be lobbied
Planning Department and Building Department Staff None X
PB, HPB, BOA, City Commission, as necessary* one X
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
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IV. 'DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $
' B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(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"-
Yes X No: Are you lobbying on a present or pending bid for goods.eguipment or services.or on a present or
pending award for goods.eguigment 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 Man?
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 X No: 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
06TH,J.ISIING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION C CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YE STA111 HAL6 BEAILgD EVEN IF THERE
EXPENDITURES OR COMPENSATION DURING THE REPQ
Signatur of Lobbyi t
I do solemnly swear that all of the foregoing facts are e d rrect and that have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach Cit o nd mg requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATIO PRINCIPAL IDENTIFICATION:
o ,
Produced ID Produced ID
Form of Identificatio =moo Form of Identification =
ZPersonally known(Lobbyist) Personally known(Principal) C-)o N o
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VII. SIGNATURE AND STAMP OF NOTAj o H-z v ° 3.Z
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State of Florida, County of Miami-Dade o y.3 a State of Florida,County of Miami-Dade c ; D
Sworn to a d bscribe befo a me - o ,,,M Swor nd subscribed bgfore me - o '�
This l7 day of ,2014 0',; T is day of ,2014 _o m
(I//(/A ° o O °' o O
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S a re f P c Notary—State of Florida co t re of P bli Nota —State of Florida co
Nota zat on of Lobbyist's signature Notarization of 's signature
TO BE.COMPLET BY CITY CLERK'S SJ�1 �
Annual Registration fee: [. ]Yes[ }No Amount Paid$ MCR# 5 6 Date id
Lobbyist Registration Form received and verified by:
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F:�CLE istration Form.doc Revised 04/27/2012
MIAMIrBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, %vw..v.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk Citydierk@miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST [NAME: David Martin
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 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 fails to file the required Statement by April 30th, 2012, shall be
automatically suspended fro lobl#ing until all fines are paid, unless the fine has been
appealed to the Miami-Dade oun mission on Ethics and Public Trust.
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Signature- Date:
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The Lave Offices of Kent Harrison Robbins
October 29, 2014
By Hand Delivery
By Email to rgranado miamibeachfl.gov
Rafael E. Granado
Clerk of the City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 3139
Re: Supplement noting change of Principal/Client from Terra Group to 8701 Collins
Development, LLC to David Martin's Lobbyist Registration concerning the Land
Development Approvals for 8701 Collins Avenue, Miami Beach, Florida.
Dear Mr Granado:
David Martin is the registered lobbyist for concerning the Land Development Approvals
for 8701 Collins Avenue, Miami Beach, Florida, please see the May 5, 2014 Lobbyist
Registration form, attached hereto. Since that Lobbyist Registration form was filed, the
Principal/Client on this matter has changed from Terra Group to 8701 Collins
Development, LLC.
Please supplement Mr. Martin's Lobbyist Registration as follows:
• Section I — Lobbyist Retained By; Please change the principal/client to reflect the
following:
8701 Collins Development, LLC
2665 S. Bayshore Drive, Suite 1020
Coconut Grove, Florida 33133
Email: dmartin _terragroup.com
Phone: (305) 416-4556
Chief Officer: David Martin, Managing Member; Pedro Martin, Managing Member
Persons holding ownership interest: Howard Lorber, Steven D. Salla, Allesandro
Pallaoro
All other sections remain the same. Thank you for your prompt attention and courtesy
in this matter.
Since I
y,
K arrison Robbins
Enclosure
1224 Washington Avenue Miami Beach FL 33139-4614
305 532 0500 Fax 305 531 0150
info®khriawoffices.com khrlawoifices.com
Offices—Miami Beach FL i Montreal QC 1 San Juan PR