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Kent Harrison Robbins - Ken and Marietta Harte • on pe,Oo• 16_002 el. MIAMI BEACH , . " • City of Miami Beach Office of the City Clerk �, 1700 Convention Center Drive, Miami Beach, FL 3313�011 F " AN 0 f LOBBYIST REGISTRATION FORM CITY f,L L ,C5 OH.I I t 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: office i Y ,.__Contact g.-._._._...__.----...-s,_phone, ore-mail address. ("Please nof' this office if our contact information changes:addres - - i I. LOBBYIST RETAINED BY: Ken and Marietta Harte NAME OF PRINCIPAUCLIENT: 70 W. San Marino Drive Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 302-8200 kharte(a�bramanmiami.com 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: I k- • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: k II.SPECIFIC LOBBY ISSUE: LelgafiRepreseritatlort orKenar1cf-Marietta Harte concerning DRB File No. 16-0072. Issue to be lobbied(Describe in detail): Ill.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 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 Adjustment - None X Planning Board None X Design Review Board None X Land Use Board None X Planning Slaff None X Mayor None X 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 Manager's 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 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 L No: Are you lobbying on a present or pending bid for qoods,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 SHAL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS MPENSATION RECEIVED, E CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEME A BE FILED V IF THE EEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERI D. . Si ature of Lobbyist I do solemnly swear that all of the - -goirg facts are true and correct . 0 that I have read or am familiar with the provisions contained in Section 2-482 of the Miami BA h f it Co.e an': reporting req e -;+'s Signature of Lobbyist: ___. A'4��' _ i",1 s� ow '., Signature of Principal/Client: /ri��A�•I ,, ArINW LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ti 1Si ❑ Produced ID ❑ Produced IDS_ _ 141 Form of Identification Form of Identification �i:t„••' ' II!' Personally known(Lobbyist) Personally known(Principal) � g 1 SIGNATURE AND STAMP OF NOTARY: la Z ,y i:to of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Z BE rnti l .rn to -.d subscri. -+ b fore m: .worn and subscri.-o oefore me ,. day of .' ___4 .016 his da�of, e 1 , 2016 t .lit/.:.;� S :',:lour • ignatu - o' " '. is otary—°.tate o Ionia Signal re of Public No -ry—State of . ida Notarization of Lobbyist's signature Notari'ation of Principal's signatur- (Authorized Agent) TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes 1' 1 No Amount Paid$ 150- 0° MCR# 4(`4 5-?5 Date Paid °2'°to"f 7 Lobbyist Registration Form receive and verified by: � .,/ <4.7.v.y.,•., RG . F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 1/11/2011 MIAMIBEACH 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 addition, .nce an issu I have registered to lobby on has been resolved, I am required to immedi..'ely notify the City Clerk's OP.' ce of lobbyist withdrawal in writing. .k■ 7 - Sig ature: Dat: : - ys-^Tb H''-. x y.' d _ 4',,,` .1 . 3 T .- m4D m O w - .r �, C 5: 'cif '�. v, f 'tiI O®, a `.vc �� aW ter▪ 'Q'4 O. i ' " fx ^7.N-^ 5 1- + 1 1a.;• . _ a.i }1% } G - .-® �, r �) � r c 1 (2 1 <- a _ -,e: XT'7 � IN J k.,..-n•:- e- -`ss L 9a a . ! O 1 i -c ' ?�� p .; 1 :, } � t; .• -- : y i r.▪ • -_,_; z O v, z , n y� _ 1 rm r. �r •ate f� ,- -7 -- _ -- N c °' 1 - - - � O Y '- Q,_ ,:i m I :' N ,•:4 O _' • • •