Pedro Martin - 120 Ocean Drive, LLC �IG
NAIAMI BEACH P-4 )A ode
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.
Martin Pedro
NAME OF LOBBYIST: (Last) (First) (M.I)
120 Ocean Drive, LLC -2675 S. Bayshore Drive, Coconut Grove, FL 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)416-4556 (305) 377-3040 PMartin @terragroup.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL:(Optional)
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
I. LOBBYIST RETAINED BY:
120 Ocean Drive, LLC .
NAME OF PRINCIPAUCLIENT:
120 Ocean Drive, LLC -2675 S. Bayshore Drive, Coconut Grove, FL 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 416-4556 305 377-3040 DMartin@terragrquR.coM,
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] f
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:David Martin 1z CD O
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPO61 TI N,
PARTNERSHIP OR TRUST: See attached
II.SPECIFIC LOBBY ISSUE:
Legal representation concerning development approvals and permitting Issues,including,but not limited to Historic Preservation Board,Planning Board
and City Commission,relating to approvals for modifications to design and robotic/mechanical parking for the property located at 120 Ocean Drive,Miami
Beach,FL
Issue to be lobbied(Describe in detail):
Ill. CITY AGENCIEWINDIVIDUALS 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 relationshi .
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Department and Building Department Staff,Mayor's None
Office,City Manager's Office,and City Attorney's Office
PB, DRB, HPB, BOA, FP, City Commission, Mayor, as None
necessary*
Pursuant to City Code Section 2-482(g) Every registrant shall be required Pursuant to City Code Section 2482(g) Every registrant shall be
required to state the extent of any business,financial,familial or professional relationship,or other rela ion hi ivin ire tq,a earance
of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied& 6&if1P9on IiQ yi t� istration
form filed.
Sec 2-482(g)Any Financial,Familial or Professional Relationship
NONE I __J
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$N/A
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $N/A
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 X No: Are you lobbvina on a present or pending bid for goods.eauiament or services.or on a present or pending
award for goods,eauiament or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
❑Yes X No: Are you lobbvina on a pendina application for a Development Agreement with the City or application for
change of zonina map designation or change to the Citv'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 X No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
QN EEBISL16RY 281h OF C CLERK
OATH LISTING LOBBYING EXPENDITQRES, AS WELL AS COMPENSATIdN RItCEIVED. IN THE CITY QF MIAMI BEACH
EM IHE PgECEpING CALENDAR
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
do solemnly swear that all of the fo going facts are true and rect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach C ty C e al in men s.
Signature of Lobbyist: Y`
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATIO —IDENTIFICATION:
❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification
Zpe ,.��;011 Pcl; S DWG8*N'QSown
SANDRA RAMOS Commission#EE 178548
EE ne 0(Principal)VI Commission#EE 1 78548 My�p"'1 TP3 1I �%T P OF
My Commission Expires ;°;;; "�1i� tf�NOTARY: ��o��•' April 30, 2016
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and su cribed before me Sw rn and subscribed before me
This y of ,20 it 1-,K(szff2 dayofvianvar4,20IZg
Sign ur Public 'o —State of Florida Sig to =' 9 State of Florida
No ariz do signature No iariltion of signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ �D MCR# / Date •d `
Lobbyist Registration Form received and verified by:
r;
/\AIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,wvvw.miamibeachfl.aov
CITY CLERK Office CityClerk(amiamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: Pedro Martin
I understand that no later than February 28th ®f 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 lobbyis who fails to file the required Statement by April 30th, 2012, shall be
automatic ly s pended from lobbying until all fines are paid, unless the fine has been
appealed o the is -Dade County Commission on Ethics and Public Trust.
Signature: Date:
FACLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc