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Kino Don ta ,., City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRA nON 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 defined in any manner in this section, 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 exdusions. Please refer to Ordinance 2004.-3435. NAME OF LOBBYIST: Kino (Last) Don (First) (M.!) Smith Architecture 206 Phi DOS Plaza BUSINESS NAME AND ADDRESS (Number and Street) Palm Beach (City) Rorida (State) 33480 (Zip Code) _(561) 832-0202 TELEPHONE NUMBER: (561) 832-3443 FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Joseph W. Blount NAME OF PRINCIPAl/CUENT: 2535 Lake Avenue. Sunset Island No.2, Miami Beach BUSINESS NAME AND ADDRESS (Number and Street) (City) Florida 33140 (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Parblership or Trust [Section 2-482 (c)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY: . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Variance Application in connection with Single-Family Residence Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVI~ALS TO BE LOBBIED: \ A) Full Name of Individual/Title B) Any Financial, Familial or profession4 Relationship " Jorge Gomez None Richard Lorber None \ FEB-28-2005 13:46 CITY MIAMI BCH CLERK DEPT 305 6737254 P.0V01 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURlY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (iieq"lred) ~ .00 I H~ . 4 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST Q)MPENSA1l0N): (Required). -.fiO,N') I t-\fl. . *= ArB YOU reDNSentlna II "Ot-for-DrafIt: col"DOrat:lon Or entity without sDedal camDenSation or relmbul"MlnMt.. Pursuant to Ordinance No. 2Ga4w3435. 1) Pursuant III OrdInance NO. 2003-3393 Amending Miami BP.ad'l atv Cod, Chactet 2, ArtIcle VII. DMSIM 5 Thereof' EnUlfed "CamMlan Finance R.eformn Via The AdcS~ or Code SectIon 2-488 Enlll:led ftProhlblted ~mDalan Conb1bu~ BY lobbvlsts On Ptocurenlfmt rssues": i Y~ No~ Are vou fobbvlno on a present or DeNtlna bid for GOOds. eclulDn)8nt Or servlCW, Dr on a Dl'Hflnt "Dr D€lndlno award fDr a~lI, eaulDIIIsnt Dl: seNlce? 2) Pul!iUant to Ordinance ND, 2003-~95 Amending Miami Beach otv Code ClaDtel' 2. Article IflI DiviSIon 5 thereof Entitled "Campa Ion Finance Reform". Via The A9~rtlon Of Code Section 2-490 Entitled ftProhlblted camoale;," Conll'Jbutlons BY LobbvlS1'5 00 Real EstatJ Dtwl!'!looment rssu!!S"~ ~~:'=~:~~=~"=':':i!IRl V. SIGNATURE UND9. OATH: ON OCToBER 1ST OF EA(;H YEAR, EACH LOBBYIST SHAll. SU8Mn TO THE CITY CLERK A SIGNED STATEMENT UNDM OATH, USTlNG LOBBYING EXPENDITURES, AS WEll AS COMPENSATION RECEIVED, IN THE crrv OF MIAMI BEACH FOR THE PRECEDING LEND R YEAR. A ATEMeNT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR G THE REPORnNG PERIOD. I do solemnly swear that all of the foregoing fa am familiar with the provisions contained in reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDEN11F1CATlON: PRJNCI [J Produced 10 X'ProdUced 10 IJrIH' J t, tt1 I{ Form of Identification Form of Identification 'X Personally known (lobbyist) VII. SIGNATURE A~~: OF NOTARY; State of Florida, County 0 )l! ~cJ... swon;;rr- il.Pd subscribed before me is rq day of ~ua.o I 2025 rl Personally known (Prindpal) State of Florida, County of Miami-Dade Sworn and sub re me _ This ~day of .20~ Signatur of IiIItit Notarl ~.. , ......... :II. ..'~:; t ~, FOR C~K'S USE ONLY t 2/ i.f'il '" 1~ id MCR #1...7t.f 1 ~~'1 Date Paid l- 2- ~ - a by: F: -M\LOBBYI5T\lOB8YIST FORM 04 1 FII'St Revision - 0S-17.Q2 TOTAL P.01