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Kent Harrison Robbins - Spencer Kramer MIAMI B 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) 1224 Washington Avenue Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 531-0150 khr@khrlawoffices.com (305)532-0500 � ) @ TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: Spencer Kramer NAME OF PRINCIPAUCLIENT: 2800 Regatta Avenue Miami Beach Florida 33140 B INE NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) skramer(c�sobepromos.com 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: NA • IDENTIFY ALL PERSONS HOLDING,DIR CTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: NA II.SPECIFIC LOBBY ISSUE: Legal Representation of Spencer Kramer concerning DRB File No.23113. Issue to be lobbied(Describe in detail): lll.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 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 Board of Adjustment None x Planning Board None x Design Review board Nixie x Land Use Board None x City Commioaion None x Planning Staff None x Mayor None x r� Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or-city personnelrWho is sought to be lobbied as identified on the lobbyist registration form filed. c---, —11 Sec 2-482( . �g)Any Financial,Familial or Professional Relationship I City Aye,iuealhi rviduala u be Lubbied. City Manager's Officc None -- Y X City Attorney's Ciffrp None r �t X -1 t i 6 v F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $565.00 / per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $565.00 / 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 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 XNo: 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. YesXNo: 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 SHAL . SUBMIT TO THE CITY CL K A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS C MPENSATION RECEI HE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT BE FILE P N IF TH ( ,Y E BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD Sig ature of L:•byist I do solemnly swear that all o e forgoing facts tr r and c• r- a • that I have read or am familiar with the provisions contained in Section 2-482 of the Mia i c ,City Code reporting • rep ;-nts. Signature of Lobbyist: I . Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ✓ a /vel- uCEnvs' Produced ID ;4*�:�"'• _-ti=!�;;�r:,:.:-. Produced ID r C Form of Id: '•re'';i ti!V�-"'�»iSSi;; • ;�:.�;r; Form of Identification /Personally - �R�, ` � Bonded Thru _ •known(Lobbyis " '� Personally known(Pri '. SOFlATERRIIIAS VII. SIGNATURE AND STAMP:OF N� r ':'t�!TFgq * *- YCOMMISSION,FF 105996 With*"25,2018 T-� = ;;:,► �!ON FF 105996 ,�;+•• ecnd'd Thru Notary Public uRderoraets State of Florida, County of Miami-Dade %� XPthES:�4arvh�,2018 •tate of Florida, County of -= '.' ' •, Bonded Thrutyo:, r•,,;,clinde rc .worn end subscribed before me Sworn tq.and subscribed before me _Al�;t� �'v This d of�Lr►u4r , 201 =d,:.�,. 'is day of r I _LJ , 201$ WW. ■16d .dra Signa it o 'ublic otaV State of Florida Sign s re if Public No' —State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ .� � MCR# 3(04-63 (Q Date Paid i ti is it Lobbyist Registration Form received and verified by: C./t C.—fl F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granath), City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Kent Harrison Robbins 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 lobb ist, who fails to file the required Statement by April 30th, 2012, shall be automa .'cally suspended from lobbying until all fines are paid, unless the fine has been iap al:=d to the Mr:mi-I': County Commission on Ethics and Public Trust. _ - _ 1/ (i/ i s Signature: te: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc CITY HALL CASHIER OFFI 1700 CONVENTION CNTR DR MIAMI BEACH, FL 33139 "(TI:ji 01/06/2015 08:49:44 Merchant ID: 000000005148978 Terminal ID: 02013135 275202450886 CREDIT CARD �0.� MC SALE . - CARD# 004. • 4032 INVOICE 0006 Batch#: 001439 Cty of Miami Beach-Florida 81855P F inance Department Approval Code: Swiped Entry Method: Online 1 CitY Hall Mode: 1500613-1 '1/"/2015 m T raps#1-1 350,0Q n06,2015 08'49AM Clerk SALE AMOUNT Tue Ja KR-City 1 $350.00 MCRCLERK - * MCR#: 36266 1 ITEM(S): TOTAL: $350.00 CUSTOMER COPY Credit Car PAID $350.00 . Have a nice day! Miscellaneous C h R - 3'=3} '�;: ; 1. .2 1 001 121 as eceipt t- k 4• i,, ., . CITY OF MIAMI BEACH s t.. _. ,;�1 :g�> nw .i Na 36266 0 Cash Credit Card 0 Check# " $ "--C623- 7---- 1 Received of - , K- ��, 20 it 4-79 ,/../2 l Address c • For /- - -c Lj, 62-,0 C' l (:-..e7")(4. 1j ; J � �f� p am I (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director By -1 7)a-- - Account (Number: /J 0. 36". 9VY Preparers --- " _ -�-: iL Dept: 0 a (/ 4