Carter N. McDowell - Jeffrey Miller •
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City of Miami Beach Office of the City Clerk [c—< ` V ` ' '
1700 Convention Center Drive, Miami Beach, FL 33139JUL H , :
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to e'rtcourage 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.
MCDOWELL CARTER N.
NAME OF LOBBYIST: (Last) (First) (M.I)
Bilzin Sumberg Baena Price&Axelrod LLP-1450 Brickell Avenue,23rd Floor,Miami,FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-350-2355 305-351-2239 cmcdowell @bilzin.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:
JEFFREY MILLER
NAME OF PRINCIPAL/CLIENT:
125 East San Marino Drive Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
n/a
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:
5e2 4 iie jt.e`.-.�:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
All matters regarding land use/zoning/development of property located at 125 E.San Marion Drive,Miami Beach,FL
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 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
x
Planning/Zoning and Staff
x
Board of Adjustment and/or Design Review Board and staff
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
None
MIAMI 4642 790.1 70000/60139
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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/$690
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):(Required).Hourly/$690
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 V 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
€ Yes V No: 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 2-484 (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 V No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATIO RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED - f IF THERE H;V7 BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD. ,,1� >
''' '-',, .
Signature of Lobbyist: Carter N. McDowell
I do solemnly swear that all of the forego' % facts are tru- a +/correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beac 'i ode -.� /IVY g requirements.
Signature of Lobbyist: 1 /
r N. MdDo.'e
Signature of Principal/Client:
i. Jeffrey i filler
VI. LOBBYIST IDENTIFICATI r, : PRINCIPAL IDENTIFICATION:
€ Produced ID € Produced ID
Form of Identification Form of Identification
I
€ Personally known (Lobbyist) € Personally known(Principal)
�pRY PVB IBIS DIAZ �"- `.
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VII. SIGNATURE AND STAMP s =D J,4 0MMMISSION#FF 111262
'� }' EXPIRES:May 24,2018
0:- Bonded Thru Budget Notary Services
State of Florida, Coun of Miami-D�oFF�0�' State of Florida, County of Miami-Dad%o,00;ii;ioibP`r
Sworn to -nd subscri•- before me / Sworn d subscrib d before me .#4,. .X?OSrTO ////,
This ' A day of .._ , 201 f'p, T 's 1 day of:awl E _,2Q:4 ;•��9S10NF••.
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Signature of Public Notary—State o ori-a ignature Pu lic Notary—State of Flor 6'6• •Q
Notarization of Lobbyist's signature Notarization of Principal's signature �2 #EE222595 •:e
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY �'�q9`••ry. icA. .•O1C
Annual Registration fee: [ ]Yes[ ']No Amount Paid$ �i 0 V MCR# 4O tt'S � Date Paid 1l:,, LIC S4le�ke
Lobbyist Registration Form receive `and verified by: 71 t i ig'r'sl
Revised 4/27/2012
MIAMI 4642790.1 70000/60139
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City of Miami Beach,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: Carter N. McDowell
I understand that no later than February 28th of each year, I must file the following forms, 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 Form 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, 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.
//
Signature: Date:
MIAMI 4642790.1 70000/60139
Camm, Patrick
From: Ibis Diaz <idiaz @bilzin.com>
Sent: Wednesday,July 01, 2015 10:47 AM
To: Carom, Patrick
Subject: Miller,Jeffrey
Re: Lobbyist Registration regarding Principal - Miller, Jeffrey
On behalf of Carter N. McDowell and Carly Grimm; please be advised that Jeffrey Miller is an
individual - not an entity.
Sumberg
Ibis Diaz
Legal Assistant
Bilzin Sumberg Baena Price&Axelrod LLP
1450 Brickell Avenue, 23rd Floor Tel 305.374.7580 x 3065
Miami, Florida 33131 Direct Fax 305.374.7593
www.bilzin.com idiaz a(�bilzin.com
This message contains information which may be confidential and privileged. Unless you are the addressee (or
authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any
information contained in this message. If you have received this message in error, please advise the sender by
reply e-mail or reply to info @bilzin.com, and delete the message. Thank you very much.
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