Wayne M. Pathman - Bart Reines C t�5 - -oV
MIAMI BEACH �00
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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.l)
Pathman Lewis,LLP, 2 S Biscayne Boulevard, Suite 2400, 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.
I. LOBBYIST RETAINED BY:
Bart Reines
NAME OF PRlt4CIPAUCLIENT:
Bart Reines
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
c/o Bart Reines Construction, Inc. , 1800 Sunset Harbour DR,Suite 317,MB, FL 33139
TELEPHONE NUMBER: 3 0 5-5 3 4-9 0 9 9 FAX NUMBER:(Optional)3 0 5-5 3 4-9 0 0 6 EMAIL:(Optional) bart re ine s @mac.C Om
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] NOT APPLICABLE
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
ii.SPECIFIC LOBBY ISSUE:
Single Family Home Legislation re Architectural Significance,Demolition and
Issue to be lobbied(Describe in detail): Involuntary Designation (18 0 0 Sunset Harbour Drive)
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 eneral 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, Land Use and DevelOpm nt Committee X
Mayor and City Commissioners X
Richard Lorber, Acting Planning and Z ning Director 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 i !f i C i, J TIM
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C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQbbH,lLi bf ystBegl t- tion
Formrevised 5-30-2012.doc �/, /a
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $450 . 00 Per Hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $450 . 00 Per Hour
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 XNo: 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: 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 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.
_YesX No: 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 COMIVNSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE F L EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of byist
do solemnly swear that all of the foregoing facts are true and rrect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Cod�and l
Signature of Lobbyist: - -
Signature of Principal/Client:
VI. LOBBYIST IDE IFICATION: PRINCIPAL IDENTIFICATION:
IG
_Produced ID o _Produced ID
Form of Identification N Form of Identification
X Personally known(Lobbyist) _j 23 w _Personally known(Principal)
Ge
VII. SIGNATURE AND STAMP OF NOTARY: y �
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn t subscribed before me � �� Sworn and subscribed before me
This and
of JW1Vt- 2= 2013 This day of JAVY 2013
S gnature of Public qotary-State of Florida Signature of Public Notary-State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLET D Y CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# ate_Pai
Lobbyist Registration Form received and verified by:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $450.00 Per Hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $450.00 Per Hour
(REQUIRED).
The following Information must be answered:
1) Pursuant to Miami Beach City_ Code Section 2488 Entitled'Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yea XNo: Are You lobbying on a Present or oendinahla for^^^d° eauloment or services or on a aresent or aendina
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 pending application for a Development Agreement with the City or application for
chance of zoning man desianation or change to the Citvs Future Land Use Man?
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 2A81 above)who only appears as a representative of a not4or-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 tut,shall not be required to pay any registration fees.
_YesXNo: Are you represenllnaanot-for Profit corporaflon or entity without special"nigensal on or reimbursement.
V. SIGNATURE UNDER OATH:
ON FE BRUARY 2s oF F-AcH YEAR,EACH L0013YIST SHALL U M 0LERK A SIGNED STATEMENT
OATH,USTING LOBBYING EXPENDITURES,AS VVEU_ SATION RECEBID, IN THE CITY OF MIAMI
THE PRECEDING T S A F1 N IF THERE HAVE NO EXPENDITURES
COMpENSATION DURING THE REPORTING PERIOD
f Signature of t
Ii I do solemnly swear that all of the foregoing facts are true and rect end that I have read or am familiar with the provisions contained
In Section 2-482 of the de and all reporting equirements.
Signature of Lobbyist:
Signature of Principal/Client:
V1. LOBBYIST ID FICATION: PRINCIPAL IDENTIFICATION:
_Produced ID _Produced ID
Forth of Identification
Form of Identification fication
g
X Personally known(Lobbyist) J ersona0y known(Principal)
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VII. SIGNATURE AND STAMP OF NOTARY: Y�����,MA....
State of Florida,County of Miami-Dade State of Florida,County of Miami-08kQ 0n 14.z0
Sworn' subscribed before me Sworn aeipd�,s�ubscri befor l me_ '' 013 w••
` This t�L9 day of /V 1IDd8 2 013 This�I daY of _
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nature of Public otary-State of Florida S gnature Public Not ate of Flond �,s',9�••,ay •����
Notarization of Lobbyist's signature Notarization of Principals signature ��sA�••••••• Oti.�.
r, LIC STA...
TO BE COMPLE O BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ']No Amount Paid$ MCR Q to Paid
Lobbyist Registration Forth received and verified by:
C:\Users\GerhatllAppData\LocaWicrosoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Forrnrevised 5-304012.doc'
F:\CLEI lis1ralion Form.doc Revised 04/27/2012
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City of Miami Beath, 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: Wayne M. Pathman
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
appea d to the Miami-Dade County Commission on Ethics and Public Trust.
Signatur Date:
C:\Users\clerhatlWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc