John C. Portman, III - Portman Holding r
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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.
Portman,III John C
NAME OF LOBBYIST: (Last) (First) (M.I)
303 Peachtree Center Avenue Atlanta GA 30303
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
404-374-6100 jportman @portmanholdings.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:
�0 L Nta� 11oG�itiG
NAME OF PRINCIP UCLIENT:
A-57 boyc--
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
Ii.SPECIFIC LOBBY ISSUE:
(2014 Annual Lobbyist ( . 040,0 L/9!A:JZd&1
s ue to be lobbied(Describ 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 cItV to the present date,stating the general 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
Board of Adjustment,Dept of Public Works,Historic Preservation Board N/A
City of Miami Beach Commissioners,City Manager,City Attorney,Fire Dept N/A
Planning Board,Design Review Board,Building Dept.,Planning Dept.
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
Non
F:ICLERI$ALL1aFORMSILOBBYIST FORMS\Lobbyist Registration Form.doc
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
Owner of Company
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). Owner of Company
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 j�No: Are you lobbying on a present or pending bid for goods,equipment or services,or on a present or.pendin-g
sward for-goods,equipment or service? But potentially
2) Pursuant to Miami Beach City Code Section 2-480 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
+Yes-AVo: 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 CiWs 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-Mo: Are you representing a ngl-fo"r-ofit corporation or entity without s cial com nsation 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 COMPENSAT EIV D IN THE ClIX OF MIAMI BEACH FOR
THE PR9CI5DING CALENDAR YEAR. A STATEMENT SHALL BE FILED&IMM IF ER AVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD. LAt
Signature of Lobby'
I do solemnly swear that all of the foregoing facts are true and correct and that I ea iar with the provisions contained
in Section 2482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
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Produced ID �e NAM s� Produced ID
Form of Identificati�3` �•••M�ssioy gC'ee Form of]dentificatiol lti%
Personally known(Lobbyist) O; OT 9• �,Personally known(Principal).%,
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VII. SIGNATURE AND STAMP OF NO' q,'0(/BL�G �•��` s m;� �� �
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State of Florida,County of Miami-Dade �0,,0••�°��ER e�Z�°'•!`� � State of Florida,County of Miami a q,��B1.��' O
Twsrn o nd sday ofb efore me '�CQ e��`` 3wSr d aayscri efore me�1 r •%,O•••••••z°•� o�
Sig a r Public'Notary—State of Fiend <A Signatu e o Public Notary—State of
Notar ion of Lobbyist's signature (Notariz of Princlpal's signature
TO BE COMPLETED BY CITY CL TAFF ONLY
Annual Registration fee: [ Yes[ ]No Amount Paid$ -f MCR# b Date Paid
Lobbyist Registration Fon-n received and verified by:
F:\CLER\$ALL\a FORMS\LOBBYTST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
1
MIAMIBEACH
City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado,City Clerk CityClerk @miamibeachfl.gov
Tel:305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: John C. Portman, III
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 clue 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 falls to file the required Statement by April 30th, 2012, shall be
automatically s)xpeA0ed from lobbying until all fines are paid,unless the fine has been
appealed to i- ade unty Commission on Ethics and Public Trust.
Signature: Da e:
FACLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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