Lucia A. Dougherty RP Hotel Holdings, LLC @ Royal Palm t
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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 20043435.
Dougherty Lucia A.
NAME OF LOBBYIST: (Last) (First) (M.I)
Greenberg Traurig, P.A. 333 Ave. of the America, 44th Floor Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 - 579 -0603 305 - 961 -5603 doughertyltgtlaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
LOBBYIST RETAINED BY:
RP Hotel Holdings, LLC
NAME OF PRINCIPAUCLIENT:
RP Hotel Holdings, LLC 100 Fillmore Street, Suite 600, Denver CO 80206
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
720 - 284. 6418..
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: RP Hotel Holdings, LLC
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached
II.SPECIFIC LOBBY ISSUE:
The James Hotel at Royal Palm
Issue to be lobbied (Describe in detail):
nl. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(aX4) 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
Historic Preservation Board, Board of Adjustment
Planning Board
City Departments
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)
$500.00 hourly
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $:500.00 hourly
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 IA No: Are ou to . ' in* on a *resent or '* endin . bid for oods - * ui . ment or ervice ; or on a *resent or • endin
award for goods, eguiprrent or servige?
2) Pursuant to Miami Beach City Code 2 -490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues ":
Yes E No: Are ou Iobb i . on a *endin. a*. ication for a Develo • ment A . with the CI or a • • Iication for
change of zoning map designation or change to the Cites 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.
13 Yes P«' No: Are you representing a not -for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEB • UARY 28th • F CH YEA EACH LOBBYIST SHALL SU = IT TO THE CITY C . ERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PR_EEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF T RE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist 2
I do solemnly swear that all of the foregoing facts are, ue and correct and that I have read or am familiar with the provisions contained
in Section 2 -482 of the Miami Beach City Code - i - ' - orting requirements.
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Signature of Lobbyist
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Signature of Principal /Client:
5 � ° � ` �; •• . .. 10 ■
VI. LOBBYIST IDENTIFICATION: - • PRINCIPAL IDENTIFICATION: a ,70
El Produced ID �, , El Produced ID PUBLIC..
Form of Identification 4' Form of Identifica1i \..9) ••.......••'.
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Personally known {Lobbyist} go � C z ersonally known (Principal} e o ,, 10, 201►
VII. SIGNATURE AND STAMP OF NOTARY: ° 3 a c
State of Florida, County of Miami -Dade 0 c m - n State of.- F4er.icla, County of M rrri- Dette-
Sworn to and subscribed before me z = - , c- Sworn and �ubscribed before me
This 15 day of A • , 111 v y d a This 3;r-d ay of , '_ 11
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.No ;State o Florida $ `0": o nature of Public Notary - State of G�et, c)
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N. rization - R • • 1� „• - y • co o Q otarization of Principal's signature
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TO BE COMPL i� r�: RK'S STAFF ONLY
Annual Registration tee: ( ] Yes [ ] No Amount Paid $ -- MGR # • Date aid r ! , i
Lobbyist Registration Form received and verified by: 1 , 2c.,'
F: WCLER ‘$ALL\aFORMS \LOBBYIST FORMS \Lobbyist Annual Registration For®n.doc ` t 1/11/ 2011
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamilaeochfl.gov
CITY CLERK Office CityClerk@rniornibeachFl.gov
Tel: 305.673.741 1 , Fox: 305.673.7254
LOBBYIST NAME: Lucia A. Dougherty
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.
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Signature: Date: