Jennifer McConney - 983 Washington Avenue MIAMI BEACH
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 3HJB91AR 13 Aft 8: 55
LOBBYIST REGISTRATION FORM CITY C L E R i; S 0 F F I L i_
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.
McConney Jennifer
NAME OF LOBBYIST: (Last) (First) (M.1)
KOBI KARP ARCHITECTURE & ID. INC. 2915 BISCAYNE BLVD. #200 MIAMI FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 . 573 . 1818 305 . 573 . 3766 JMCCONNEY @KOBIKARP.COM
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Ile (tub -Znve-Amen+ Cyrauo , LLC --E74QeA L'oMezrrn rod i MA rrq! icr
NAME OF PRINCIPAL/CLIENT:
(Colo � n/IyeSdyn &rteyp, LLC 16PSo NAL(cj ,' Ave, (bzZ Flo 1g 33139
BySNES NAME AND ADDRESS (Numbe and Street) (City) (State) (Zip Code) L
TELEPHONE UMBER: 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: tet je ^t o M4_, -rQPbd i AA4�95 e!-
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 55%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
c(n iren� r�vq �� t' n 1 to c4�ed 4+
Issue to be lob ied(Describe in e il): ��ng /t_ , M_qAA,
Ill.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: �V�+ `�
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 I NO
title of person to be lobbied
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AS AXCA-S
Pursuant to City Code Section 2-482(g)Every egistrant 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): �J�
A) LOBBYIST DISCLOSURE:(Required) /150 r
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (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":
nYes X 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":
nYes X 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 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..
n Yes X 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 COMPENSATION RECEIVED, IN THE CITY OF
MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN
NO EXPENDITURES OR COMPENSATION DURING THE R PUUOD.'- /-/"-7 -
'�\ e ure of bbyist
I do solemnly swear that all of the foregoi g fand correc t an 1/1/at . have read or am familiar with the
provisions contained in Sectio o e MianILBeactp City Code and all reporting requirements.
Signature ofLobb '
Signature of Principa —"' ���`�—�
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: 2h7�o o
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VII. SIGNATURE AND STAMP OF NOTA „ppM Cr e / g " CJ
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LU �rUUrq,
State of Florida, County of Miami-Dade o State of Florida, County of Miami-D de u- N �.`
Sworn to and subscribed before me ,`�m Sworn and subscribed before me
This la At— day of Y\z-4 - , 201 - Q ....' e. This day of 20
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Signature of Public Notary U State 9f Flori Signature of Public Notary-State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
FOR LERK'S USE ONLY !3
Annual Registration fee: [ ]Yes[ ]No Amount Paid O r MCR# /S/�o Date aid
Lobbyist Registration Form received and verified by: ' Entered Byl
Revised 1/11/2011
C -orm.doc Revised 1/11/2011 IM MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME: JENNIFER McCONNEY
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.
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
i in tin 2-485. 1 a fine of 50.00 a day shall be assessed for all Statement(s)
provided Section $ y ( )
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 lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatLca
# suspended from lobbying until all fines are paid, unless the fine has been
app a ed t the iami-Dade County Commission on Ethics and Public Trust.
/ Z / Z
Sign re: at .
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