Kent Harrison Robbins/Lennox Miami Corp I AM I B E
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 teen 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 Harrison
NAME OF LOBBYIST: (Last) (First) (M.I)
1224 Washington Avenue, Miami Beach, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (Stale) (Zip Code)
(305) 532-0500 (305) 531-0150 khr @khdawoffices.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:
Lennox Miami Corp.
NAME OF PRINCIPALICLIENT:
229'A 19th Street Miami Beach, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (Slate) (Zip Code)
(305)439-2320
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section If principal Is a Corporation,Partnership or Trust[Section 2482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Diego Agnelli, President
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
ii.SPECIFIC LOBSY.!ISSUE t g '
Legal Representation of Lennox Miami Corp. regarding City of Miaml Beach Planning Board File No. 1988
Issue to be lobbied(Describe in detail):
ul.CI'TY_AGENCIES./INDIVIDUALS T:O;BE LOBBIED:
Pursuant to City Code Section 2482(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 NO
title of person to be lobbied
Planning Board None X
Pursuant to City Code Section 2-482(g)Every registrant shall be requlred 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
sou ht to be lobbied as Identified on the lobbyist registration form filed.
Sec 2-082 Any Financial Familial or Professional Relationshi
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHERI:
A) LOBBYIST DISCLOSURE:(Required) Flat Rate Fee$7,500.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). Flat Rate Fee$7,500.00
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 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
O 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 2484(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.
O 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 SMALL B9 FILED EVEN4F fHERE HAVE gM NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signs re of Lobbyist
I do solemnly swear that all of the foregoin cts are true and c nd that I have c m familiar with the provisions contained
in Section 2-482 of the Miami Be ity ode and all rep r ments.
Signature of Lobbyist:
Signature of Principal/Client
VI. LOBBYIST IDENTIFICATION- aRINCIPAL IDENTIFICATION: "
OO_N
N
Produced ID 0 Produced ID $
Form of Identification Form of Identification
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®Personally known(Lobbyist) ``�t�trrrrlir��� Personally known(Principal) o W
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VII. SIGNATURE AND STAMP OF#
State of Florida,County of Miami-Dade '4 O,%.. State of Florida,County of Miami-Dade
S am to and subscribe efore me =*: m - Swom and subscribed before me
s I l day of 201
This I 2,01,2� •.r,rt;�•'
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Sign turf of Publt -No State-of,Flori � �� A \�%I- -Signature of-Public State-of-Florida
Notarization of Lobbylst's signature �IhglrllllII10�\\\ Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: r ]Yes[ ]No Amount Pald S MCR Date Pald
Lobbyist Registration Form received and verified by:
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City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florido 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel:305.673.741 1 ,Fax:305.673.7254
LOBBYIST NAME: Kent Harrison Robbins
I understand that no later than Februo y 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
provided in Section 2-485.1 , a fine of $50.00 a day shall be assessed for all Statement(s)
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 Iobb who fails to file the required Statement by April 30th, 2012, shall be
au ti a suspended from lobbysn until all fines are paid, unless the fine has been
eal d a the i- ade Cou C fission on Ethics and Public Trust.
5 j 1 If
Sign Lure: ate:
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