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Kent Harrison Robbins - Dr. Stephen Soloway (2) ZO60 (of(i e CA AA City of Miami Beach Office of the City Clerk S 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. Robbins Kent Harrison NAME OF LOBBYIST: (Last) (First) (M.I) 19 W. Flagler Street, Suite 402 Miami Florida 33130 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 532-0500 (305) 531-0150 khr @khrlawoffices.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: Dr. Stephen Soloway NAME OF PRINCIPAUCLIENT: 101 20th Street, Unit 3701 Miami Beach, Florida 33139 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: N/A • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A II.SPECIFIC LOBBY ISSUE: Legal Representation of Dr.Stephen Soloway,Owner of Unit 3701 at the Setai Resort&Residences Condominum Association concerning impacts to the Setai related to PB File No. 1609, PB File No.2277 and PB File No.2278,the development projects at Issue to be lobbied(Describe in detail):2000 Collins Avenue("The Boulan/Bagatelle/Sweet Liberty") 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 Planning Board None Land Use Board None Planning Staff one Maynr 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 City Agencies/Individuals To Be Lobbied: City anaoe s Office None X City Attorney's Office None X Historic Preservation Board None X ft ' 7 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $495.00/per hour(Payment by Setai Resort&Residences Condominium Association, Inc.A Florida Non Profit Corporation) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $495.00/per hour(Payment by Setai Resort&Residences Condominium Association, Inc.A Florida Non Profit Corporation) 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 IX 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": El Yes IN 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. El Yes EN 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 SHAL UBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES,AS WELL AS P•MPENSATI N RECEI ED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT- . L BE Fl D EN IF ''1 RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO r. / II Si•nature of Lobbyi I do solemnly swear that all of -- 'rev:sing facts e and • - t and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Ma 'ity Code - report.. • • -tr-.yrents. Signature of Lobbyist: • i;; % 4 i Signature of Principal/Client: �4��-�. m VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: cv �3m ❑ Produced ID 0 Produced ID Qoz X43 Form of Identification Form of Identification mN o N ``\��11111I I I Illll/Ilir m.o v 71 Personally known(Lobbyist) `�����QNANIFA(�1�i���' 0 Personally known(Principal) W.ON.cL 5 �pMMiSS/p .."yam =c -E V 0 VII. SIGNATURE AND STAMP OF NOTA QQ n m' E State of Florida, County of Miami-Dade zo ;� ®``'® � v State of e, County offv . on. Swom o nd subscribId bef re me y :"a� EE19�gp9 a � Sworn an• subscribed before me co is 9 day o i . , 2015 �9A'°: ,,. �Q `�: This 2 - e'.' 8g 201$ o '��' 1st Slate ° ' . .,4 11 r. , //,, 'STATE OF v ign. ure of Public No ary—State of Florida '47/111Il111111"� Signature of Pub - ►• -• tate of let Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETE pY CITY CLERK'S STAFF ONLX Annual.Registration fee: [ ]Yes[ ]No Amount Paid$ ') MCR# q O' O b`'1 Date Paid 16(2(i( Lobbyist Registration Form receive and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual R i r t on Form.doc Revised 1/11/2011 AAIA 1 �� City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: Kent Harrison Robbins I understand that no later than February 28th 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 Y Y 9 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,.l am required to immediat- y notify the City Clerk's Office of lobbyist withdrawal in writing. Si.' ature: ate: Miscellaneous Cash Receipt ti....,..,.} J..-- 10/11-21-;:o ,-,: #,YE.i 1:,: CITY OF MIAMI BEACH x t, t, .r F �0:-..t,_ - . � ,,tits No 0 apt eil C/ rido t6. } . ❑ ❑Credit Card heck# 1 $ Cash C C C k k : 20 .15 ., KteA A-g 011 t1 Received of •.�� ' r 5 _ For( 1 )(i "i U ( (.CCy, )\144.../ I i 5511 _ :1C 1 (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director i ft ,v�i) `/ Account Number - j .- r f. .� c —) 7e' g Ems: 1l Preparers ; .. i i Dept: s 1 L a) r CO C) N t a . 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