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Graham Penn - JHPSB Collins Ventures, LLC City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 r n a 2 6 J fl 28 2: 51 Fri • Expenditure report for period of:1/1/2015 through 12/31/2015 , A statement shall be filed even if there have been no expenditures or compensation during the reporting period: ��' ' i '- This statement 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,per issue,shall be assessed for statements filed after the due date.If you require any assistance,please contact this office at 305.673.7411 or at citvclerkPmiamibeach.eov. Lobbyist Graham Penn Principal Jason Halpern/JHPSB Collins Ventures,LLC Issue Development Board Approvals. PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: $475 per hour CATEGORIES OF EXPENDITURES Food and Beverage: $0 Entertainment: $0 Research: $0 Communications: $0 Media Advertising: $0 Publications: $0 Travel: $0 Lodging: $0 Special Events: $0 CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disc • :% herein and any attachment hereto are true and correct. f-obb • " : . re SIGNATURE AND STAMP OF NOTARY: \ . - rj 1 1 Produced ID \`�, ' Form of Identification Signature of Public otary-State of Florida Sworn to and s .scribed before me ,Personally known This1day o IL 0 LAP is Notary Public State of Florida Diana Ramos My Commission FF 207719 %of of Expires 04/10/2018