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City of Miami Beach Office of the City Clerk 2012 OCT -3 At!��10: 56 � Z
1700 Convention Center Drive, Miami Beach, FL 3 139 9 b,
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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.
Legon Todd R.
NAME OF LOBBYIST: (Last) (First) (M.l)
Legon Ponce&Fodiman,P.A. 1111 Brickell Avenue-Suite 2150 Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-444-9991 305-444-9937 tlegon @lpflaw.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:
Residencies at the Bath Club Condominium Association,Inc.and Residences at the Bath Club Maintenance Association,Inc.
NAME OF PRINCIPAL/CLIENT:
5959 Collins Avenue Miami Beach FL 33140
BUSINESS NAME AND ADDRESS (Number and Street) . (City) (State) (Zip Code)
305-866-8799 305-866-8601 manager @bathclubresidences.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:
K. =r2lQlld,i a5 �rPS id e�td�' bo'! h
AAsoci"oyns
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY QR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: 13a�h C,lillrj E�1-Fermi nment I L•L.C• S% in i2-tideme3 P+ii%e CIJb lylcti l r"Ce-
II.SPECIFIC LOBBY ISSUE: ssocia 'rn,znc.
Opposition to Appeal(file 3602)before the Board of Adjustment,1700 Convention Center Dr.,3rd Floor,Miami Beach,FL to be held on October 5,2012 @ 9:00 am.
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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 NO
title of person to be lobbied
Members of the City of Miami Beach,Board of Adjustment none 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.
Sec 2-482 Any Financial,Familial or Professional Relationship -, c g;.! 1 '
None.
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
Hourty rate of compensation SM.and relmbursoment of expenditures.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED).Hourly rate or oompeneallon S375,and reimbursement of erpendllures.
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 lobbyina on a present or pendina bid for-goods,equipment or services,or on a present or pendina
award for goods,equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: Are you lobbying on a pendina 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 Section 2-482(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.
_YesiNo: Are You representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 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 ED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
gig=t-qgbbyist
do solemnly swear that all of th 'foreg ing facts are true t I have read or am familiar with the provisions contained
in Section 2-482 of the Miami .1ch C' Code and all reportin ents.
Signature of Lobbyist:
Signature of Pr' ' al/Client:
VI. LOBBYIST N FICATION:-- RINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Zpersonally known(Lobbyist) �( Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY: R9TA ELEK
State of Florid =* '* �f WSSION#EE036453
State of Florida,County of Mian-10 k, pUylq A ,
Sworn tand subscrib�before * MyCOMMISSIOaf DD89 M Swom and su a or9ftRES November 13,2014
712�4i-;t d ay of Ltr s EXPIRES:July 5,2013 This da Q ,2t1 Notafysorvica.com
. (2 rq Bonded Thiu Budget Notary SeMa
Signature of Public Potary-State of Florida Signature of Public Notary-State of Florida
Notarization of Lo bylst's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MC.R# Date Paid
Lobbyist'Registration Form.received and verified by:
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Formrevised 5-30-2012.doc
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F:\CLEI ,istration Form.doc Revised MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel:305.673.741 1 , Fax:305.673.7254
LOBBYIST NAME: Todd R. Legon
I understand that no later than February 23 of each vim, 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 DORM
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, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-435 (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 2-435.1, a fins 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 lobbyist, who fails to file the required Statement by April 30th, 20129 shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appea!P11 to the Miami-Dade County Commission on Ethics and Public Trust.
zr� October 2, 2012
S' a ure: Date:
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