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Graham Penn - Crescent Heights City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 r- - ' r ° 4 2016 JAN 28 Ph 2: 5 2 Expenditure report for period of:1/1/2015 through 12/31/2015 C1.1-` O - U A statement shall be filed even if there have been no expenditures or compensation during the reporting period. 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.gov. Lobbyist Graham Penn Principal Russell W.Galbut/Crescent Heights Issue Developmental Board Approvals for Shelborne Hotel at 1801 Collins Avenue. PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: $475 per hour CATEGORIES OF EXPENDITURES Food and Beverage: $o Entertainment: $o Research: . $o Communications: $0 Media Advertising: $o Publications: $o Travel: $0 Lodging: $o Special Events: $0 CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 d leed nd any a achment hereto are true and correct. b 'is nature SIGNATURE AND STAMP OF NOTARY: 'V:`‘) Produced ID , Form of Identification Signature of lic Notary—State of Florida SworJ J and s pscribed before me Personally known This VI day of_Afia 20 i b P Notary Public State of Florida i Diana Ramos / • My Commission►FF 201119 ,;a� Expires 0411012019