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Kent Harrison Robbins - Beach Towing Services, Inc. G4Aittk-- /4A-vr part/47 • A t\A B 1-7 r e, rt 20'6ilfi , �i91e2 City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 ;: c.. - 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) 242 Northeast 27th Street Miami Florida 33137 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: Beach Towing Services, Inc. NAME OF PRINCIPAL/CLIENT: 1349 Dade Boulevard Miami Beach, FL 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: Michael Festa, President • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Juan Antonio Rivera and Michael Festa II.SPECIFIC'LOBBY-ISSUE: Legal r_ep ation of BeacbSowing Services, Inca concerning the development of the formerGiant-Motors-Property Issue to be lobbied(Describe in detail): III.CITY AG::ENCIES/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 Zoning Board of Adjudlrnem Nude X Planning Board None X Dcsig”Rc„iew O,n d 'NW,rr X Land Use Board None X City Commission Neae X Planning Staff. None X Mayor -Um? t( 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 anager's Office None X City Attorneys Office None X Historic Preservation Board None X � I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) S595.00 I per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $595.00/per hour 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 IS 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 21 No: Are you lobbying on a pending application for a Develo_sment 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 21 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 •=MIT TO THE CITY CLERK.A"S NED STATEMENT UNDER OATH.LISTING LOBBYING EXPENDITURES,AS WELL ; C• ,PENSATI• R'CEIVED . THE ITY OF MIAMI BEACH FOR THE PR EDING CALEND•R YEAR. A STATEMENT.•. BE FILED - THER . •VE-_.N NO E - DITURE •i COMPENSATION DURING THE REPORTING PERIOD AL/WM ill Sig =tune of Lobbyist I do solemnly swear that all oft ing facts are -an. correct tha have read or am familiar with the provisions contained in Section 2-482 of the Miami c Code and . l •' g requir en d/Signature of Lobbyist: 4... -7 7 // Signature of Principal/Client /r// • VI. LOBBYIST IDENTIFICATION: / PRINCIPAL IDENTIFICATION: ❑ Produced ID D Produced ID e `�� 0%11111i//iii, Form of Identification 7 •• Form of Identifica;ckq\4041E/ i�i * d° 9'Personally known(Lobbyist) '',•'�°°M 22,2 ;•, �% )J' Personally known(Principal) $•P 2 So VII. SIGNATURE AND STAMP OF r�0'I�A_.4: ®®® .*E.#EE191409 , fili County of Miami-Dade o� .'., • Q State of Florida,County of Miami-Dade State of Florida, tY "99` •.°ooh,stse � S f_:Tne S wo a • -n. -ubscri-: . b •re - �,� ,--0„,., •., �c.;<- , Sworn and subscribed before me �. 9 I,day of _1 2018 ;�ii���'l`.STAR ,A\�``� ��;his Zv day of yJ r>t ,2018 ��,w`•�.- � R Signa e • ' •is •to --State of Florida S• -7174!!!!is Notary- to of Florida °ti- - `,:� Notarization of Lobbyist's signature No.. - on of Principal's sig tore 'i...- �.. t;,.r,Y, (Authorized Agen _ TO BE COMPLETED BY_Ill CLERK'S STAFF ONLY " Annual Registration fee: [ ]Yes o Amount Paid; - ; . 1 ' Di~ Date Paid • • i. s .'• Lobbyist Registration Form received srTd verified by: T:n :. . .ate ° `� �_-.,_# F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised-4/4° ..,-• .\e.-,�� . w • - `\• . IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) S595.00 f per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $595.00/per hour 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 E 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 N 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 COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. • Signature of Lobbyist • I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: /7 / VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: * ❑ Produced ID D Produced ID Form of Identification Form of Identification �1 GI Personally known(Lobbyist) 4X Personally known(Principal) m 8`o r? 70 2�' rrn VII. SIGNATURE AND STAMP OF NOTARY: 11174 State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade g Sworn to and subscribed before me Sworn and subscribed before me _�, This day of , 2016 �`Lo day of Jk•' , 201E6 a. M _—.*1611■1111■6—__ Signature of Public Notary-State of Florida S nat -2-711M is Notary- ate of Florida Notarization of Lobbyist's signature No". iza ion of Principal's sig .ture (Authorized Agen TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ j Yes[ j No Amount Paid$ MCR# Date Paid • Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 1./1-1720/1 L _ j • tal MIAMIBEAC H City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miomibeochll.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 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 immedi tely notify the City Cie s Of'ce of lobbyist withdrawal in writing. 7-1/7 7/ 0 Signature: Date: • Miscellaneous-Cash Re_ ceipt- _ ; L,k. 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