Loading...
Wayne Pathman - Alton 633 Properties /-7 AREA)b Cl 3 i City of Miami Beach Office of the City a 1700 Convention Center Drive Y Clerk y�e . b , Miami Beach, FL 33139 Lobbyist means all persons emplo ed or r LOBBYIST REGISTRATION FORM Y etained, whether paid or not, by a principal who seeks to encourage the passage, defeat modification of any ordinance, resolution, action or decision of any commissioner; any action d Manager or any city board or committee; or any action, decision or recommendation of an g t or decision, recommendation period the City entire decision-making process on such action, decision or recommendation that fores eabl will commission, or a;city board or committee. The term specifically includes the principal y personnel during the time period of the activities. The term "Lobbyists" has specific exclusions. Please refer ae as well asa be y employee engaged ibnylobb my to Ordinance 2004-3435. lobbying Pathman Wa ne NAME OF LOBBYIST: (Last) M. (First) Pathman Lewis, LLP, One Biscayne Tower, Suite 2400 2 S (M.1) BUSINESS NAME AND ADDRESS BISCa me Blvd., Miami, FL 33131 (Number and Street) (City) (State) 305-379-2425 305-379-2420 (Zip Code) TELEPHONE NUMBER: F NUMBER: wpathman @pathmanleWIS.COm AX EMAIL: Please notify this office if your contact information changes: address hon I• LOBBYIST RETAINED BY: ' P e, or e-mail address. Alton 633 Properties, LLC /��J� �j / 22 NAME OF PRINCIPAUCLIENT: `" 6200 NW 167th Street, Building B, Miami Lakes, FL 33014 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER:(Optional otamkinco majl.com Fill out this section if EMAIL:(Optional) r• p rncipal is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY: Alan P 82(c)]n • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST PARTNERSHIP OR TRUST: Alan Potamkin 50% and Robert Potamkin 50% IN SUCH CORPORATION, ILSPECGFIC L:O`BBY ISSUE. _J To obtain approval to modify CD-2 Zonin g Cod Issue to be lobbied(Describe in detail): e permitted uses to include self-storage. nl. CITY AGENCIES/INDIVID,UA'LS TO DE LOBBIED: oe�)?� �1_12>v Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied, into any contractual relationship (paid or unpaid) with said city commissioner or d and whether the lobbyist has entered commencement of service with the city to the present date,stating the general nature of the subject contractual r personnel from 12 months preceding such person's ec 2-482(a)(4) Full Name of lndividual and –-- --- relationship. j title of person to be lobbied Contractupl•Relationship(Explain) YES NO and Development Committee, Historic:�r s erva-- — tion Board --- --, orber, Acting Dir, Plan & Zoning' None' ,� _ Wing, Tom Mo ney, Design & Preservn Mgr. None X ers - Joyce Meyers, Michael Belush - -_ -- ---- _ Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the eaten — I _ j relationship,or other relationship giving rise to an a ---_ NOn� �( t of any business,financial,familial or professional sou ht to be lobbied as identified on the lobb ist re istration form filed. appearance of an impropriety,with any curren,Lcity commissioner or city personnel who is Sec 2-482(g)Any Financial, Familial or Professional Relations y �'`j'ln hip - , None --- d 4, 1 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. Pathman Wayne M. NAME OF LOBBYIST: (Last) (First) (M.I) Pathman Lewis, LLP, One Biscayne Tower, Suite 2400, 2 S Biscayne Blvd, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 - 379 -2425 305 - 379 -2420 wpathman @pathmanlewis.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. LOBBYIST RETAINED BY: Alton 633 Properties, LLC NAME OF PRINCIPAUCLIENT: 6200 NW 167th Street, Building B, Miami Lakes, FL 33014 BUSINESS NAME AND ADDRESS (Number and Street) (City) 305 -665 -9600 305- 667 -5041 (State) (Zip Code) potamkincona,gmail.com 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: Alan Potamkin • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Alan Potamkin 50% and Robert Potamkin 50% ii.SPECIFIC LOBBY ISSUE: To obtain approval to modify CD -2 Zoning Code permitted uses to include self- storage. /e2 Issue to be lobbied (Describe in detail): ill. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: ;E3 4 /FPM 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 title of person to be lobbied Contractual. Relationship (Explain) YES NO Land Use and Development Committee, Historic Preservation Board Non- X Richard Lorber, Acting Dir, Plan & Zoning; Tom Mooney, Design & Preservn Mgr. None X City Planners - Joyce Meyers, Michael Belush Non: X 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. yI .�.JO �, !J).1 -7 Sec 2- 482(g) Any Financial, Familial or Professional Relationship -- .‘-' ".l.it None G :II V 6? ' 7 i -.:f Y..1' :, IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly - $350.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): Hourly - $350.00 (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 n 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 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. ❑ Yes 1 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 THE',._ VE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of ;..byist I do solemnly swear that all of the foregoing facts are true a correct and that I have read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach Ci _ - and all reporting requirements. Signature of Lobbyist: Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: ❑ Produced ID Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade Sworn to and subscribed before me This L4 day of 2O X 2012 j J / /X6-4- 4 rtZGl/1U i-AE— Signature of Public Notary — State of Florida Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: ❑ Produced ID Form of Identification • Personally known (Principal) State of Florida, County of Miami -Dade Sworn and subscribed before me This day of , wax 2012 Signature of Public Notary — State of Florida Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY -1 / / Date Paid ,/ 1-7 — Revised 1 /11 /Z011 Annual Registration fee: [ ] Yes [ ] No Amount Paid $ ,3 SD MCR # Lobbyist Registration Form received and verified by: IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly - $350.00 B) PRINCIPALS DISCLOSURE (OF LOBBYIST COMPENSATION): Hourly - $350.00 (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 En 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 J 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. ❑ Yes ® 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 REPORTING PERIOD. I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach City Code and all repo g re..' merits. Signature of Lobbyist: Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: ❑ Produced ID PRINCIPAL IDENTIFICATION: Form of Identification 0 Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade Sworn to and subscribed before me This day of , aoix 2012 Signature of Public Notary — State of Florida Notarization of Lobbyist's signature Produced ID Form of Identification Personally known State of Florida, County '1..s MY COMMISSION #OEE 027602 ?s•. �� .;1 EXPIRES: September 20, 2014 7, 9Y,i�•t`� Bonded Thru Notary Public Underwriters Sworn a ctsubscri d before me This . day of 6W C. IA, aOaX 2012 Signature of Pu.d otary — State of Florida Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ] Yes [ ] No Amount Paid $ MCR # Lobbyist Registration Form received and verified by: Date Paid Revised 1 /11 /2011 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachFl.gov CITY CLERK Office Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Wayne M. Pathman CityClerk @miamibeachfl.gov 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. Signatu - Date: