Todd R. Legon - Bath Club Maintenance Association, Inc. 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.
Legon Todd R.
.NAME OF LOBBYIST: (Last) (First) (M.I)
Legon 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.
1. LOBBYIST RETAINED BY:
Residences at the Bath Club Condominium Association,Inc.and Residences at the Bath Club Maintenance Association,Inc.
NAME OF PRINCIPAUCLIENT:
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: Thomas K.Ireland,as President of both Associations
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Bath Club Entertainment,LLC—5%in Residences at the Bath Club Maintenance Association,Inc.
II.SPECIFIC LOBBY ISSUE:
Issues related to the use and operation of the Bath Club building and surrounding facilities and appeals before the BOA.
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 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
Members of the City'of Miami Beach, Board of Adjustment none X
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 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(g)Any Financial,Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
Hourly rate of compensation$375,and reimbursement of expenditures.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). Hourly rate of compensation$375,and reimbursement of expenditures.
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 lobbWpg_on a present or e�dina bid for goods.equipment or services.or gr a present or pending
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 loboyLng 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.
_Yes X Now Ares u 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
IHE ERECEDINQ CALENDAR XEAIR. A 1EATEMENI 11 or% MAIM IE THERE HAVE BEEhj bjO E2jPENDITUHE
COMPENSATION DURING THE REPORTING PERIOD.
SignatuLorrect L bbyist
I do solemnly swear that all of t e oregoing facts are true and and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami e h City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/CI nt:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
_JLPersonally known(Lobbyist) A_Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida,County of Miami-Dade
Sworn to and subscribe fore me Sworn subscribed before me
This day of 201 Thisa day of QAW 201
�,•jPay P 11 ODALYS VALDES
RITA ELEK
e Notary Public-State of Flor ture of Public Nota f OMMISSION#EE036M
Signature of ublic Notary—Sta J6 I _ 'i9 ry
Notarization of Lob byts is •'=MY Comm.Expires Aug 31,2Nd rization of urr�XPIRES November 13.2014
Commission# EE 16917
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Annual Registration fee: es[ _]Z u Date Paid
Lobbyist Registration Form received and verified by: -,
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MIAMIBEACH
I
LOBBYIST NAME: Todd R. Legon
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, .1 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.
February 27,2014
Sig ure: Date:
FACLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH:
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Received of s �� y
Address
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(THIS INi".61RMAYION MUST EE COMPLETED)
Office. Finance Director,
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Account Number:
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