Robert S. Goodman - Portman Holdings (QV\ Co sN'J'
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City of Miami Beach Office of the City Clerk S :a °� PH 2: '7:3
ter Drive Miami Beach, FL 33139
1700 Convention Cen ,
LOBBYIST REGISTRATION FORM
Lobbyist means alll 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 ci4riboard or committee;or any action,decision or recommendation oft any city personnel during the time period of the
entire decision-mak ng process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city
commission, or a cl y board or committee. The term specifically includes the principal as well as any employee engaged in lobbying
activities. The ter',"Lobbyists"has specific exclusions. Please refer ti Ordinance 2004-3435.
idhe.,n NAME OF LOBBYIST l (Last) (First) i i (M.1)
�'O d.'',4 (9� 1/70., c 3X ,- rv4 0 , t ,1,<, / '{7�'r"��r (City) , (State) (Zip Code)
BUSINESS NAME AN ADDRESS 'Number and Street) (C y) i
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ELEPHO 1 NUMBEIR: r.: NUMBER: v M L.
Please notify(hi. office ifyour.confact information changes:laddreSS,phone,ore-mail address.
I. LOBBYIST ETAINED BY: !
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PO i� ' 'OA o/L//n s
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NAME OF P NCIP I 'CLIENT: �/ t D�
,S613 OF
;r tee Cei9 /er l e X57,5,/9/Ado 7 ,
(Number and Street) (City) i (State) (Zip Code)
SINE N D ADDRESS ( )
TELEP E NUMB:i: FAX NUMBER:(Optional) i EMAIL:(Optional)
Fill out this section i principal is a Corporation,Partnership or Trust[Section 2-482(c)]
I
• NAME OF NIEF OFFICER,PARTNER,OR BENEFICIARY;'TAO( j eitAn-14jn I 007e
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.--SR___ • IDENTIFY 'p_PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNER` IP OR TRUST: A/A. I i
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SPECIFIC L1).BBY ISSUE:: i
Ifroi/clopmo-,) _021' Me_,M_nvne ige_C?C A a/2!venie/0,-3, Gi.7) hiok /
Issue to be fabled(Describe in detail):
iii CITY AG_EI!J IES'/INDIVI®IJALS TO E LOBBIED: 1
Pursuant to City C I ie Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into any contractu-1 relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of ervice with the city to the present date,stating the generallnature of the subject contractual relationship.
Sec 2-4::2(a)(4)Full Name of Individual and ;Contractual Relationship(Explain) YES NO
i tle of person to be lobbied �,,[ 8r-hr).91-4 1
(11/7:y o f (/f 155/0/1 Yn//7/S i //oith' y S l
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1G I r p rob o r?O ass/ CO,
Pursuant to Ci ty Co.e Section 2-482(g)Every registrant shall be required to sthte the extent of any business,financial,familial or professional
relationship,or otfi:i•relationship giving rise to an appearance of an impropriety,with anylcurrent city commissioner or city personnel who is
sought to be lobbie"as identified on the lobbyist registration form filed.
Sec 2-482(g)Any ',inancial,Familial or Professional Relationship
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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.
-. --ti y)-1,22,74 idAer71- S•
NAME OF LOBBYIST: (Last) J (First) (M.I)
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
1),5 2 -5177 J529-1 ?V2 JytSi'rb , - irn7n-Con
'N NUMBER: EMA L:
ELEPHO NUMBER: P' U ��
;Please notify this office if your contact information changes:address,phone, ore-mail address.
I. LOBBYIST RETAINED BY:
Pr7'nw �o/a�/nqs
NAME OF P NCIPAUCLIENT: J
J
SI
0,3 edc ree G,) )'er re. X57,5' /9/12/2/0? 6/9 <10�3
SINE N' y •D ADDRESS (Number and Street) (City) (State)' --' .._ - _
TELEP ! E NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)(Zip Code)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: TocK Vork- hgln 1607c
,-SZ__ • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: ✓/A..
.SPECIFIC,PL® BV_ISUE
j 'v c/i/�� -_� -- • ,r/ A • !L 01 -. ♦ V-./ r OI / I'o k
Issue to be ..bbied(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 general nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
CD/73/7)/:55/D title of person to be lobbied �� //n � m//�/571/4470'
/4470' &irn&ci j4 /Gh'r S
has kS1 'd 7 ,&/-4 oadlw
kr prob o no 0765456/r o,
Pursuant to City Code Section 2-482(g)Every registrant shall be required to st5te 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. DISCLOS '-E OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOUR 45Y,FLAT RATE OR" ,--
OTHER): 1615'Pr'r l l' —
A) LOBBYIST DISC uSURE:(Required) �*
�g� Li;�\
B) PRINCIPAL'S DI:( LOSURE(OF LOBBYIST COMPENSATION): $ .t `) Iii. _
(Required). I
The following info imation must be answered:
1) Pursuant it Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
❑ Yes iio: A - you lobbying on a present or pending bid for goods,equipment or services.or on a present or pending
a'':rd for goods,equipment or service?
I •
2) Pursuant le Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Develop T:nt Issues":
11 Yes leNo: e you lobbying on a pending application for a Development Agreement with the City or application for
c -nqe of zoning map designation or change to the City's FuturelLand Use Map?
3) Pursuant if Miami Beach City Code 2-484(h)Any person(except those exempt from the definition of"lobbyist"as set forth in
Section 21.81 above) who only appears as a representative of a not for-profit corporation or entity without special
compens1 ion or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any
item,shall egister with the clerk as required by this section but,shall not be required to pay any registration fees.
1 I
❑ Yes o: A • you representing a not-for-profit corporation or entity without special compensation or reimbursement. .
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V. SIGNATU! UNDER OATH: I
ON FEBRUARY 2•
h OF EACH YEAR.EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING Iii.BBYING EXPENDITURES,AS WELL AS COMPENS'ATIO RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING 1 ALENDAR YEAR. A STATEMENT SHALL BE FIL b - N IF1 HE- HAVE EN 0 E DITURE
COMPENSATION DURING THE REPORTING PERIOD. 1 .
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Signature of Lobbyist' i
I do solemnly swe- that all oft for=%oing -cts - •rue and correct -.':that I ha - read or am familiar with the provisions contained
in Section 2-482 of be Miami B-•a Pity r o•- d :II r porting r:-.5- :its.
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—
Signature of Lobb t.
.�lSignature of Princi•:I/Client:
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VI. LOBBYIS IDENTIFICATION: 1 PRINCIPAL IDENTIFICATION:
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Produced o 1"C, 4 oe' S L'k. . _ .aRo c.Fd,. LI Produced ID I
Form of Identification r,, ,° ``. Q I Form of Identification 01111110//
/❑ Personall known(Lobbyist) 5; ,_ w m r ersonally known(Principal) ♦z. ..1M�SSIOH•.•• is
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VII. SIGNATU°E AND STAMP OF NOTARY: , �, • v Aga �O �/- v%• Q e
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State of Florida,C. my of Miami-Dade rer c , f I State of Florida,County of Miami-DI e o 18L1G o
Sworn to and subs(ibed •efore me z ,, U ..j, I Swor ar t subscrin-. before me •., Art o♦�
This d-- f rte,- 01 4 , I This I day of i l /: i ,201 0/ '• /+�
n> BER 8;•.•
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.1 ,r► � 01111
Signature o P blic� ota ate of Florida o Si•n. re if'ublic Notary—State of Florida
Notarization f Lo b fist's signature •„p,;,� Na�ta tion of Principal's signature
1
TO BE COMPL BY CI CL 'S STAFF ONLY ,�
Annual Re istratioQi eei- Yes No Amount Paid,$ MCR#' W,04_(1t( ` 'Date.Paid 5�+8 `�
Lobbyist Registrat:nlForm receivend verified by I I •
Ff\CLER\$ALL\aFORi45\LOBBYIST FORMS`Lobbyist'Annual Registration;F r doc 1 : r, : • . . . ' `...Revised 1/11/2011
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required) ..O
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $00
(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 iNo: 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 lobbvinq 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 2-484(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.
El Yes 5 No: Are you representing a not-for-profit corporation or entity without special compensation 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 COMPEN ATI*_ RECEIVED IN THE CITY OF MIAMI BEACH FOR )
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FIL'E'_6i11 1a4:7, a_V/ :,1 ilas_14:!,a=f'1I�]t11I:74 %=Fr,i COMPENSATION DURING THE REPORTING PERIOD. ,
Signature of Lobbyist
I do solemnly swear that all of t for-%oing 4,ts - : 'rue and correct that I ha - read or am familiar with the provisions contained
in Section 2-482 of the Miami B a •ity •o•- - d II r-•orting r:.•U. ,.ments.
2
Signature of Lobbyist:
r
,x Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID '2L) Jeg-'; Lc . .a o ;?' o Produced ID
Form of Identification v
° `� h Form of Identification
"+i m ik a
El Personally known(Lobbyist) z co w ❑ Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY: Q .o S..r if
,v 4,E.ti p l
State of Florida, County of Miami-Dade o E State of Florida,County of Miami-Dade
Sworn to d subscribed •efore m- / c°: ,%-iii. Sworn and subscribed before me
This d-.-,•f "r ►01 'y This day of ,2011
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Signature o ' -blicNo a — ' ate of Florida / Signature of Public Notary—State of Florida
g f �','` '`,..` �' Notarization of Principal's signature
Notarization r f Lobbyist's signature L ••'14:9 VP'
nae'` •1
TO BE COMPL :4.,:Y CITY CLERK'S STAFF ONLY
Annual Registration C'W 4 C[".
istration fee: Yes No � O:''- `'MCR# � -Date Paid ��'�
9 [ ] ['
Lobbyist Registration Form received nd verified.by •
F:\CLER\$ALL\aFORMS\LOBBYIST FO .S\Lobbyist Annual Registrat n: orm.doc Revised 1/11/2011
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MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: 4 '4et
I understand that no later than February 28th 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, I am required to
immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
1/44 if
Signature: .ate: