Norman C. Powell - The Crockett Family Trustf
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City of Miami Beach
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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.
?.0Ve// /1/4,/1/4/7 C .
NAME OF LOBBYIST: (Last) (First) (M.I)
14m; O/Ar 07/4/0•e i2 c ?o // /6 66 ∎%-f, �e�.�P C e weu u . A/e3
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) rfip Code)
786 a7,1= 69-73 7,6 - 3AP-0/4f nat 7 Cpave/i eorx
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
EX/Li/ y 7-RusT
NAME OF PRINCIPAL/CLIEN : ,
a06-- -V /3/5 ct' L) 7 y /LIB�4i/3eacX 3 3/3`9
BUS S NAME AND DRESS (Number and Street) (City) (State) (Zip Code) -
c/7 ) 57�- 6300
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) ) 1_
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] g
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: P .
• • IDENTIFY ALL PERSONS HOLDIN ,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: /(Qr9T . • .INDIRECTLY, // c'
II.SPECIFIC LOBBY ISSUE: Z e /9n "Ye viecd 13oa.4o( /1/'. a 3/3'0,
/74 Zi'scu s 26',' , /l' "u) &ao'A, r'/vk d' 3 3/3 9
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: eis.'9,r7 ev/e,.,.J'octipo(
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 relationship.
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
7-4i72 as �1,
v/OO4 Qy/ ?/a n nip q ,e /VO/✓E
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(g)Any Financial, Familial or Professional Relationship A/p /
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
-. D I? ' 3€ ,' i .e
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): ,
(REQUIRED). : R X2
(REQUIRED). de ei_
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=No: 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 14o: 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
ite ,shall register with the clerk as required by this section but,shall not be required to pay any registration fees.
Yes 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 COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
t/7
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I •ave read or am familiar with the provisions contained
in Section 2-482 of the Mian`Beach City Code and all rep• 'g req,ements.
Signature of Lobbyist: e.- - , !///
Signature of Principal/Client: (\'..
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Prsonals known(Lobbyist) � ersonal) known(Principal)
)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida,County of Miami-Dade State of Florida,Cou y"cS �N P{Nilg5 lt3@!46no�41 papuog `,,obi jo3,,,
Sworn to and subscribe before a Sworn arid subscrib=• b Igie33# uo!sslwwo0 )-age t
?,• II11 •ss
This / da of / /Q��,20 This ti of �� Z'g,�0#�!dx3 wwo0�W ;�, *,_
'�'' epl�ol j to alels--oIlgnd�(�eloN =;;,,e��yo?,�
Notary Public State of Florida ��i 113MOd 0 Nt1WlION -�d AN
�� ry—State of Fl
Ma commission 19r"" Signature ary—S o' a -i-
Signature o 'ubli ota y ission F� gnature of Pu is Ile a
Notarization of Lobbyist's signature wtl Expires 02ro5,^A• Notarization o Pr' cipal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF •NLY ,.
Annual Registration fee: I ]Yes(14No Amount Paid$_35-0 MCR#____Way_4,3 Date Paid q ? /)
Lobbyist Registration Form received and verified by: 2
/era--
y,y.,:1, °tALi\aFO MSti. 5YI T FQR S;?r� b tAz.r;t&' e5is raiio Form
Revised 01/22/2014
F:\CLER\SALLIaFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granath:), City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 ,Fax:305.673.7254
r
Aooefiflif-A/ -L®BBYIS
T NAME:
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 Iobby_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 of each year, 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.
i 41, 1/702®lJ
Signature: Date:
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
Miscellaneous Cash Receipt 47,6ts.00
CITY OF MIAMI BEACH
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El Cash El Credit Card Eeók# _ •
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Received of v s C-
Address 7/0.0 A/6" u /41,- e‘f,e1 -t-t, 33 40
For Z o 6 /V
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(THIS INFORMATION MUST BE COMPLETED) OffiCepf Finance Director
By
Account Number: — 3 6
Preparer: (42-- Dept:
OCT: 7/7/
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City of Miami Beach-Florida
Finance Department
1 City hall
1.508320-1 04/03/2015 BR 1 T 131
Fri AprO3,2015 1131AM Trans#17-17
17 $500.00 MCP,CL ERK - P�1CR-City clerk
* MCR#; 403403
1 ITEM(S): TOTAL; $500,00
Check (001339) PAID $500,00
Have a nice day!
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LAW OFFICES OF
NORMAN C. POWELL
1666 J.F.Kennedy Causeway,Suite 420
NORTH BAY VILLAGE,FLORIDA 33141
www.lawofficeofnormancpowell.com
TELEPHONE(786)275-6923
FACSIMILE(786)348-0167
n@normancpowell.com
April 1, 2015
VIA FEDERAL EXPRESS
Rafael E. Granado, City Clerk
City of Miami Beach ,---.
Office of the Clerk
1700 Convention Center Drive ND
Miami Beach, Florida 33139 cn
CD -,
Re: Lobbyist Registration—Norman C. Powell
r �
Dear Mr. Granado:
Enclosed are the Lobbyist Registration Form and our check in the amount of Five
Hundred Dollars ($500.00) for the same Lobbyist Fee Expenditure and Compensation
Form.
Should you have any questions, please contact me.
Very truly yours,
Norman C. Po
Enc.
City of Miami Beach
Lobbyist Fee Expenditure and Compensation Form
City Code Section 2-485
Due: IP cGcar y -2dia0/4—
Expenditure for period of: re.6r-lcdr y o,?',Ao/y through prCSe/)7' ( geerucc✓y a II.R4745
A statement shall be filed even if there have been no expenditures or compensation during the
reporting period. In order to withdraw as a lobbyist on an item which is no longer being lobbied,
initial in the appropriate space. Any item requested to be withdrawn will be removed
for the reporting period of: , through •- •_- -
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hObbyii i 11(74/i/y Q� & // *If you are no longer lobbying on this issue WITHDR
EMET.#1. F-*/4/ . -CROC4 C 77 -7-/O&E 7-
1t(i'•"s.:s:;y,c..,,r�ji �
^••,mi9F2{r pki - ' .. • .- �� WITHDRAW
M:�FTSng �.8 7'/eAro. a3)sD, /9/ /746�Ycus Avg ,/
y�{', c. � YES NO
Detail Compensation Received:
CATEGORIES OF EXPENDITURES
Food Beverage: ,x/p,v t
Entertainment: N61A/4
Research: NONE'- ,,
Communications: �pA/t- ri
Media Advertising: A/9/Vg __ ` `
Publications: i/p^Ie . •
Travel: A/6'^/c
Lodging: /I/PA/e- J
Special Events: ,/djl/E
Oath
State of Florida •
County of Miami-Dade
lobb ist do hereby depose under oath and affirm that the information disclosed herein and any •
1,the undersigned y y p
attachment hereto are true and correct.
/
e Notary Public State of Florida ' At,1
Paris H Baas '
ME Comi m02/05ission FF 198281 S••nat -
or pre s /2019 /
�
S - /- day of A7/4 ,20% ,7�-
Notary Public
, ii,, ,
My Commission expires: O /0_(-/36/rJ
This form is to be signed, notarized and returned to the City of Miami Beach, City Clerk's Office, 1700 Convention Center
Drive, Miami Beach, FL 33139 by February 28th. A fine of$50.00 per day shall be assessed for reports filed after the due
date. If you require any assistance please contact this office at 305.673.7411 or at Cityclerk @miamibeachfl.gova
I