J.J. Wood - Russell Galbut �
MIAMI BEACH 303-7 anl-'L
City of Miami Beach Office of the City Clerk R E ;tC = I \ ' I
1700 Convention Center Drive, Miami Beach, FL 33139
11: 55
LOBBYIST REGISTRATION FORM 2013 MAY 10 AFB
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks t6'-coufa�ej(he`pa"ap`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.
Wood J.J.
NAME OF LOBBYIST: (Last) (First) (M.1)
Urban Robot Associates 5436 Pine Tree Drive Miami Beach Florida 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 246-4857 (786) 768-2537
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Russell Galbut
NAME OF PRINCIPAUCLIENT:
300-17 Investments, LLC 2200 Biscayne Blvd., 7'h Floor Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 573-4127 (305) 573-8489
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: 1IJ5E[.LGALbu1-
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
Development Board Approvals for 300-17 Investments, LLC
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 relati onshi .
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES I NO
title of person to be lobbied
Planning Department and Building Department Staff None X
B, HPB, BOA, City Commission, as necessary* 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
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) Al 0 Abb(L e0 KeC-)V 5,4+10'V
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): , T CC --h--h Lt�O�
(REQUIRED). 1�o D r/ I
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: A_rg.you lobbying on a present or oendina bid for goods,ea moment or services.or on a present or
oendina award for goods.eguipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobby^:na on a pending application for a Development Agreement with the City or application
LQc change of zonina map des18nation or change to the Gitv's Future Land Use Mao2
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.
Yes X N . Are you representing a not-for-profit corpgrabon or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE GIN CLERK A SIGNED STATEMENT UNDER
OATH. LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI BEACH
EM THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL R FILED EVEN IF THERE H"E BEEN NQ
EXPENDITURES OR
Sig at r o=Lobbyist, _�_
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 alll1portilig reguirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. /LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
v Produced ID ,lJ W _Produced ID
Form 8f Identification "'70I Form of Identification
a
_Personally known(Lobbyist) "' L2 Z personally known(Principal)
V 0)
CD
O d
VII. SIGNATURE AND STAMP OF NOTARY: a N
oN.3 n
State of Florida, County of Miami-Dade y State of Florida, County of Miami-Dade
Sworn t nd subscrib of re fie N m Sworn Aub his ) day f 20? 3 N -n fllis otary Public-State of Florida
s. m m.Expires Mar 16,2015
Si ture o Public Notary—State of Florida Sign ure of uborid"mission#EE 70292
Notarization of Lobbyist's signature No izatio of
TO BE COMP T D BY CITY CLERK' ST F6 Y
Annual Registration fee: ]Yes[ ]No Amount Paid MCR# lJJ Date Paid_5 bob
Lobbyist Registration Forin received and verified y
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F:\CLE istratign Form.doc Revised 04/27/2012
M
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, %"v%v.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: J.J. Wood
I understand that no later than February 28 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, 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 2-485 (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 lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
LO_T_�). 2
K- &I • 2012
Sign re: Date:
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MIAMI
City of Miami Beach, 1700 Convention Center Drive, 2013 MAY 10 AM 11. 55
Miami Beach, Florida 33139 www.miamibeachfl.gov
City Clerk' Office CITY CL ERi'i'S ()f-'F IC[--
Tel: 305/673 — 7411 Fax: 305/673 - 7254
ANNUAL LOBBYIST REGISTRATION FORM
Name: J.J. Wood
Business Name: Urban Robot Associates
Address: 5436 Pine Tree Drive, Miami Beach, FL 33140
Phone: (786) 246-4857
Email:
If more than on Lobbyist, please list:
1) Sebastian Velez
2)
3)
MCR #:
Amount paid: Date paid:
Processed by: Date:
Send this form with a check for $500 payable to
the City of Miami Beach for each lobbyist
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