Charles Pinkham- Portman Holdings/CMC Group MIAMI BEACH
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.
a W, LL 1 es
NAME OF LOBBYIST: (Last) (First) (M.I)
i' s 3 P �...�-Aa_ �'�575
BUSINESS NAME AND ADDRE (Number and Street) (City) (State) (Zip Code)
(tic
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
"Please"notify thts'nfflce if-your contact information changes:address,.phone,or a-mlafl address.
v 1. .LOBBYIST RETAINED BY:
PORTMAN HOLDINGS/CMC GROUP,INC.
flW1effLTcA%TNUE,SUITE 2410 - MIAMI FL 33131
BUS $ N��OE,AND ADDRESS (Number and Street) (City) (State) (Zip Code)
� EGG JJJU
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:JACK PORTMAN/UGO COLOMBO/ART MURPHY
/ROGER ZAMP13ELL
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II :.� ' �
vF..x.x�.�
REDEVELOPMENT OF MIAMI BEACH CONVENTION CENTER(R.F.Q.)NO.22-11/12
Issue to be lobbied(Describe'ln detail),:`
IIIINCM /tNC1.v� i � � � r� �:
•kwaL�s,.,3"u.ss... .-.t-a.._,..,.,.a.,.r„c... .�.,�.,w.>,aa'�=,... x?ccw-:.. ."aM��<
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(x)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
CITY MANAGER,CITY COMMISSION X
CITY DEPARTMENT LAND USE BOARDS X
CITY STAFF X
I
Pursuant to City Code Section 2-482(8)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 -e 9
f d 9 1 irr Eipz
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) pRINCIPAL
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): PRINCIPAL
(REQUIRED).
The following inforrnation must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
X Yes No: Are you 12bbvina on a present or pending bid for goods equipment or services,or on a present or pending
award for Bloods,gauipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
XYes—No: Are you lobbying on a pending application for a Development Agreement with the City or application for
chance of zonina map designation or chanae 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 2481 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" Io• Are you retwesentina 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 LOBBXING_ EXPENDITURES, S O PENSAT N E EIVED I T C T OF IAMI EACH FOR
THE PRECEDING CALENDAR YEAR. A STAIEMENT SHALL BE FILED EVE&IFTHERE HAVE BEEN DIO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyis
I do solemnly swear that all of the foregoin cts are true and correct and I have read or am familiar with the provisions contained
in Section 2482 of the Miaml ode and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
``,®tjl l i fl 111®I
Produced ID �� .. ��` i� Produced ID
rwY
�nt on •°`•.'9 'ie Form of Identification
Form of I ce__
Personal) known LobbAbl= �
Y ( .4 Personally known(Principal)
ap
VII. SIGNATURE AND STAM s f: V
State of Florida,County of Miami-Dad tats of Florida,County of Miami-Dade
I
Swor to nd subscribe before meZ012 ij' R(�;`'` ��� Is day and day of i b re m2012
y JANET GONZALEZ
NOTARY(PUBLIC
nat re ot Public botary—State of Florida Sl Pub Notary-State of STATE OF FLORIDA
Notarization of Lo s' sl ature No riz signatu Comm#EESM18
TO BE COMPLETED BY CITY CLERK' STAF NLY E>gDi[reS 1/26/2017
IN, itel ia�ratlon fee;.[ Yes t No. ' VCFt-0 Deft-Paid
� bcl' �teglstr�146 F&M fiice rep eirra ve�l'�ed ti
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MIAMI .
`.EAC H_
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E.Granado,City Clerk CityClerk@miamibeochfi.gov
Tel:305.673.7411 ,Fax:305.673.7254
r, ,
LOBBYIST NAME: k6�_e
:z 0
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
falls to timely file a Statement and ih addition to any other penalties which may be
Imposed as provided In Section 2-485.1, a fine of$60.00 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 thheAlaml-Dade County Commission on Ethics and Public Trust.
mia
Signature: Date:
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