Kent Harrison Robbins/1300 Pennsylvania Partners, LLCm N~IA~J~IBEACH
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 inGudes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please
refer to Ordinance 20043435.
Robbins Kent Harrison
NAME OF LOBBYIST: (Last) (First) (M.I)
1224 Washington Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 532-0500 (305) 531-0150 khrobbins@kentharrisonrobbins.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
1300 Pennsylvania Partners, LLC
NAME OF PRINCIPAL/CLIENT:
407 Lincoln Road, Suite 12 J Miami Beach FL 33139
BUSINESS NAME AND 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
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Ryan Freedman, Managing Member and Laurin Seiden, Managing Member
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached disclosure .
n.SPECIFIC LOBBY ISSUE' Legal representation before the Flood Plain Management
Board concerning variance waiver for apartment building at 1300 Pennsylvania Avenue
Issue to be lobbied (Describe in detail):
ul. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to city code section 2-4s219-
include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an
appearance of an impropriety, with any Clty personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) -from 12 months preceding the
commencement of service of City personnel to be lobbied.)
A Full Name Olf Individual Title B An Financial, Familial or Professional Relationshl
Flood Plain Management Board Attorney for Board Member Herb
family.
JJI ~ ~1 ~,'~>+~'i~ ,l ll~
~ £ :~ w~ c ~ r~nr eo~z
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LO BYIST DISCL SURE: (Required)
475.00 hr
B) PRINCIPAL'S QISCLOSURE F LOBBYIST COMPENSATION):
(Required). $ 4 7 5. 0 0 r
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 ~NO: Are you lobbying on a aresent or sending bid for goods. equipment or services. or on a
present or sending 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 I!I NO: Are you lobbvina on a pending aaalication for a Develoament Agreement with the City or
application for chance of zoning maD 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 snot-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 l1~ N0: Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1sT OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
Signature of Lobbyist: /~ ~ r'~-
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICA ION: PRINCIPAL IDENTIFICATION:
^ Produced ID ~~~,
~ ~~
,..,,~ Q/~ ~,/
t~ Produced ID x43572 ~' ~Z"
.~,
,
Form of Identificati ~
~ ~~S„ Form of Identification ~_
,~~
IJIf Personally known (Lobbyist)
~ ~
^ Personally known (Principal) "
n
~
VII. SIGNATURE AND STAMP OF NOTA
~
~ -~ ro ~=
State of Florida, County of Miami-Dade
Sworn to a
r
d s
b
c
ib
d b
f i ~
r
~ ~ ~
~ ~
State of Florida, County of Miami-Dade
S
d
b
ib
d b
f ~ -
y u~
~
"'' (
~
u
s
r
e
e
ore me
t
day of l~r1c,
This~
2008 y
vc worn an
su
scr
ore me
e
e
This/lo~~ day of c7-c~IIG
2008 ~
~ i ~ °
_
, ~
~~g , ~g ~
~
Signature of Public Not - Sta of Flori da ~' ~ ~ Signature of ublic Nota a of Florida N
Notarization of Lobbyist's signature ~ Notarization of Principal's signature
J
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid S~,S ^- MC # .Date Paid
~ ~ d
Lobbyist Registration Form received and verified by: _ __ n ~
!L-
P:}~LEk1~QSBYtSfvl.isbbylst R~3istratltan ryarm 3~7ti8.doG Revised 03/27 /2008
I do solemnly swear that f t e foregoin are tr an correct and that I have read or am familiar with the
provisions contained in e~ti -482 of thl~~~ Bea Ci f7jo~ and all reporting requirements.
.1
6
~~ i
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
CityClerk@miamibeachfl.gov
LOBBYIST NAME: Kent xarrison Robbins
I understand that no later than October 1st of each year, I must file the following
forms, 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 Form
2) Disclosure 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.
6 /6 Dg
Signature: Date:
F:iCLER\LOBi3Y1ST1Lobbyist f2egistration Form 32708.doc