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Kent Harrison Robbins - Mirador 1200 Condominium Association, Inc. trA I z Ft: s \ f p Er-ielVo 1818 City of Miami Beach Office of the City Clerk.�f��Er 1700 Convention Center Drive, Miami Beach, FLL[33139' L1. Sri 1 LOBBYIST REGISTRATION FORM Ci; F.1 p Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the p assage; 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.l) 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, ore-mail address. I. LOBBYIST RETAINED BY: Mirador 1200 Condominium Association, Inc. 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: Anthony Latini, President ' - Ch • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: NSA II.SPECIFIC LOBBY ISSUE: Legal Representation of Mirador 1200 Condominium Association, Inc. regarding land use issues related to the Mondrian, located at 1100 West Avenue, Miami Beach, Florida including, but not limited to,PB File No. 1898 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 • •. - B Planning Board None Land Use Board None • Planning Staff one ti.._ Ma nr a ' Pursuant to City Code Section 2-482(g)Every registrant shall be required n 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 Managers Office None X City Attorneys Office None X Historic Preservation Board None X IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $595.00/per hour(Payment by Mirador 1200 Condominium Association, Inc.A Florida Non Profit Corporation) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $595.00/per hour(Payment by Mirador 1200 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 [X 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 N 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 IN 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 SHA L SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL 'S 'OMPENSATIO REC : L-,, IN THE CITY OF MIAMI BEACH FOR /:( THE PRECEDING CALENDAR YEAR. A STATEMEN BE FILE= =V,' N IF ER HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO . /1 Si. ature of Lobbyist I do solemnly swear that all of t.- =or-;•oing fac -fie true - • ,orrect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami;,-a ity Cod -t� y all rep -.6 uirements. (!l ;� 4 / Signature of Lobbyist: A..1 ∎fAil∎ Signature of Principal/Client: WI Igif__._� L�, 1 F(Auth'rize. A. - t) •VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: (Authorized Agent) N:.c . ❑ Produced ID ❑ Produced ID Z g Form of Identification Form of Identification Q w N ``�e���1►iiuoli,/i,, ..) ` PNIE,9 i, ' , g. E gmz 0 Personally known(Lobbyist) •��dC . •.. � Personally known(Principal) '144..-- . • 4a 22, °,1,..e,. C� (Authorized Agent) a ( J3 '', VII. SIGNATURE AND STAMP OFZII�TARY. Z g w . ®: a' • e W O rr w La .g J State of Florida, County of Miami-Dade °._..'wEEi9i409 ,,• * State of Florida,County of Miami-Dade }a. >- X LL w S orn fl subscribed b-fore - �09� ° ,�%h \co, Q.. `. Sworn and subscribed before me Y ay of■,t:: .� .1l... 'x015 /i�AG.:t •••••• cizs ` a = 3 of V 02015 ,,yc.,*....04 N .t.A.1),■.Auln 4 sir° StATE OF ��\�� I� `a0. _�`• 041,11110,0 1 Signature of 'ublic N• ary-State of Florida : • .„.04,..Sig- re f 'ublic Not-u� ��FI•�rida I�r".., g`°�, Notarization of Lobbyist's signature Nota ion • °-incipa s signature (Authorized Agent) TO BE COMPLETED BY CITY CLERK'S STAFF ONLY t �p Sr--' Annual Registration fee: [ ]Yes[ No Amount Paid$ MCR# `�(5 � . / Date Paid L 1/2 I J 1 J Lobbyist Registration Form receive and verified by: arvI _ R V A L I\a L O B B Y I S T w sT FO Ms\Lobbyist Annual R ga tion Famhdoc Revised 1/11/2011 r� r • • t -- - } City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.741 1 , 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 Miami-Dade County Commission on Ethics and for code violation evaluation. In a., i on,,..nce an issue I have registered to lobby on has been resolved, I am required to :'mm=di,-%tely notify the City Cl-rk's Office of lobbyist withdrawal in writing. it I Pq/iS Signature: Date: A „. :_,_,:_/.....„:,-__t?,. .._,--,..._. ,,,_ _ -_„„,-„,—...),a �_ _ . „,....,.,, •,..,,,_,,,:___.=._ , _-_ h- _ z PPP' a r_ 0 a a a• (111•A i... V -0.'3. - cn : a a-: � =- c p. i -a [ _, y.:.:,§ _ i 0 G --.-,,, , - , : : 5 iis .: [. :„..1:_i_ g....,i .:_.-i c'' ..1-1?„. --4,., .7,---T ._ lc-Nil\. : s' . E 0. .- - : ,; Nimummimmumw o C _ I C) 0U .I- ms' s City of Miami Beach-Florida :' '” - -:Finance Department �`` [:�•1 City Hall _ ;�. 0 \ s -a• . Y - E -� ••1532820-1 11/24/2015 BR1 T134 - Tue Nov24,2015 01:22PM Trans#15-15 15 $350.00 MCRCLERK - MCR-City Clerk .1:1 ` * MCR#: 408327 .- r 1 ITEM(S): TOTAL: $350.00 [:. ° _ . Credit Car PAID $350,00 Have a nice day! .; } [... ...-.-- . :,_-_..=:--i's_ :,. las \mss --....,,:::!.-,,r.,° ti N CITY HALL CASHIER OFFI 1700 CONVENTION CNTR a MIAMI BEACH, FL 33139 t: .._ , ' 11/24/2015 -� C 13:22:58 m ?� - `L -� CREDIT CARD L AMEX SALE c--:. . k CARD# �� -° �- L.:. �-.., - � 1009 - o ,--Chip Card: Chip Card AID: AMERICAN EXPRESS - `` A/TC: A000000025010801 INVQICE 7F1338C6FE1E A65 SEQ#: 0003 Batch#: 0003 Approval Code: 001295 Entry Method: 830955 Mode: Chip Read SALE AMOUNT Issuer $350,00 CUSTOMER COPY Detail by Entity Name Page 1 of 3 FLORIDA DEPARTMENT OF STATE 444... r `' DIVISION OF CORPORATIONS 16j Y Detail by Entity Name Florida Not For Profit Corporation MIRADOR 1200 CONDOMINIUM ASSOCIATION, INC. Filing Information Document Number N05000006430 FEI/EIN Number 20-3140477 Date Filed 06/21/2005 State FL Status ACTIVE Principal Address 1200 WEST AVE MIAMI BEACH, FL 33139 Mailing Address 1200 WEST AVE MIAMI BEACH, FL 33139 Registered Agent Name &Address CORPORATION SERVICE COMPANY 1201 HAYS STREET TALLAHASSEE, FL 32301 Name Changed: 07/02/2015 Address Changed: 07/02/2015 Officer/Director Detail Name &Address Title President Latini, Anthony A 1200 WEST AVE MIAMI BEACH, FL 33139 Title VP Gaccione, Richard 1200 WEST AVE MIAMI BEACH, FL 33139 Title Secretary, Treasurer http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/25/2015 Detail by Entity Name • Page 2 of 3 Chernoff, Peter 1200 WEST AVE MIAMI BEACH, FL 33139 • nnual Resorts Report Year Filed Date 2015 01/12/2015 2015 07/01/2015 2015 11/09/2015 Document Ima•es 11/09/2015 --AMENDED ANNUAL REPORT View image in PDF format 07/02/2015 -- Reg. Agent Change View image in PDF format 07/01/2015 --AMENDED ANNUAL REPORT View image in PDF format 01/12/2015 -- ANNUAL REPORT View image in PDF format 04/10/2014 --AMENDED ANNUAL REPORT View image in PDF format 01/03/2014 --ANNUAL REPORT View image in PDF format 01/02/2013 --ANNUAL REPORT View image in PDF format 04/25/2012 --ANNUAL REPORT View image in PDF format 01/06/2011 --ANNUAL REPORT View image in PDF format 08/03/2010 --ANNUAL REPORT View image in PDF format 05/10/2010 --ANNUAL REPORT View image in PDF format 01/07/2010--ANNUAL REPORT View image in PDF format 12/15/2009 --ANNUAL REPORT View image in PDF format 02/02/2009 --ANNUAL REPORT View image in PDF format 02/02/2009 --ANNUAL REPORT View image in PDF format 06/10/2008 -- ANNUAL REPORT View image in PDF format 01/14/2008 -- Reg. Agent Change View image in PDF format 05/01/2007 --ANNUAL REPORT View image in PDF format 07/03/2006 -- ANNUAL REPORT View image in PDF format 06/15/2006 -- Reg. Agent Change View image in PDF format 03/03/2006 --ANNUAL REPORT View image in PDF format 06/21/2005 -- Domestic Non-Profit View image in PDF format Copyright©and Privacy Policies State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/25/2015 Detail by Entity Name Page 3 of 3 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/25/2015