Kent H. Robbins - Gopman Consulting Engineers, Inc.~ -~ ,
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
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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 H.
NAME OF LOBBYIST: (Last) (First) (M.I)
Law Firm of Kent Harrison Robbins, 1224 Washington Ave, 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:
I. LOBBYIST RETAINED BY:
Gopman Consulting Engineers, Inc.
NAME OF PRINCIPAL/CLIENT:
192 NE 168th Street N. Miami Beach, Fl 33162
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
(305) 352-3614 MDPPAG@gmail.com
IL~~~~~~I~ ~®BE3Y ~~~~~e
legal representation concerning the Terra Project
Issue to be lobbied (Describe in detail):
II1. C~1`Y ~'IGENCIE~/1N®ii/6Dl1AL~ ~C3 ~E LOBBIED: Pursuant to City Code Section 2-482(g) include
a statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an
appearance of an impropriety with any City 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 said City
personnels' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
A Full Name of Individual/Ttle B) Any Financial, Familial or Professional Relationship
Mayor and Commission None
Building Department None
City Manager's Office None
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Planning Department None ~~ ~Qt , ~ ~ ~~~ ~~QZ
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'r IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
5375.00/hr
B) PRINCIPA 'S DISCLOS RRE (OF LOBBYIST COMPENSATION):
(Required). ~3 7 5 . 0 0 yhr
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 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 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 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 ®No: Are you representing anot-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
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
BE FILED EVEN IF THERE HAVE BEEN NO EXPEND RE R C NSAT D ING THE REPORTING
PERIOD. ,, ~®
Signature of Lobbyist
I do solemnly swear that all of or oin t re true
provisions contained in Sectio -4 2 f Mi each
Signature of Lobbyist:
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Signature of PrincipalfClient: '~ ~
VI. LOBBYIST IDENTIFICATION:
~ ~ ^ Produced ID
n c Form of Identification
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~ ~ ~ Personally known (Lobbyist)
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VII. SIGNATURE AND STAMP OF NOTARY:
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~ ~+ State of Florida, County o mi-Dade
Sworn to scribe bef a me ®®
This y of , 200
Si nat o u - ate of Florida
Notarization of Lo yist's signature
-ect and that I have read or am familiar with the
and all reporting requirements.
PRINCIPAL IDENTIFICATION:
0 Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of ~ami-Dade
Sworn and subscribed b ore me 1G
This a of , 20~
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S' na r o - rids
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
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Annual Registration fee: ( ]Yes ( ] No Amount Paid $ MCR # Date Paid
Lobbyist Registration Form received and verified by:
~a1~~.~~~s.~~,~~~~~~i~~~~~ ~t~~~~_~£~yi~~ ~~~ ~~~~~g~~~ ~~~ ~~~.f~~,~cs~ Revised 02/11/2009
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City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.7411 ,Fax: 305.673.7254
CityClerk@m iam i beachfl.gov
LOBBYIST NAME: ~`~""'" ~'" " - - ~ ~ ~~' ' " ~~~
I understand that no later than ®ct®ber 1st ®f a®ch dear, 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.
fn addition, once an issue I have registered to lobby on has been resolved, I am required
to immedia~ly notify the City ~rk's Office of lobbyist withdrawal in writing.
F:\GLER\LQBBY{ST1Lobbyist Registration Form 32708.doc