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Robbins Kent H/Anthony S Brown I>'':14T11 ~.. ,".11 ItI1!td 'iiiP m 2OU3 - '3bS 532 0600 TELEPHONE NUMBER: C) 0 _\ cJi ::n J: ::J:. r'l1 LOBBYIST REGISTRATION FORM ,: , ~ .~ ," ~ Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the pa~e, ~at ~ or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommencfjton o.f,.\he ,/ City Manager or any city board or committee; or any action, decision or recommendation of any city personnel def~d in;iny - manner in this section, during the time period of the entire decision-making process on such action, decision or reco~nda.tiOn rn that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically inolUde~oe 0 principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Ple"j$e rdr to Ordinance 2004-3435. ~ -l &1w,n :) Kent tkrrt son (Last) (First) (M.I) BUSINESS NAME AND ADDRESS 122t.1 (State) (Zip ~e) 3 3 \3Cj Kh~Obb~~uih.n~ EMAIL: , City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 NAME OF LOBBYIST: 305 63L.aJ6o FAX NUMBER: , OOllna~lmb'f JY1J~m., r3IQc.~kUn\J{.01l>("~ LLC LJ~5 Collans ~. M'aMi 'Bt"ach BUSINESS NAME AND ADDRESS (Number and-Street) I (City) .-eState) (Zip Code) rL 33\39 LoBBYIST RETAINED BY: 8nt~oo~" 5.~rOU)() NAME OF PRlNOPAL/C ENT: I. 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: Anthony 5 '~Ou)(),1 manoal~ ty\t'm b2r . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: S~tl G\*~h~cl Sh<Z~1 II. SPECFIC LOBBY ISSUE: " . , 1 ~,:~41aJ...~ ""ac.tr-i\t.~~e.t~- ~ ~ '1llm.llD~ ~ TfdJt' Iss be 10 ied (Describe in detail): 6 ~' "Be> J (M ~ III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: ~e "t11 0 t) ,,::> A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship etlt Nonl. No e. a.~ 0'1' A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). DYes ltrNo: Are YOU reDresentinq a not-for-Drofit corDoration or entity without sDecial comDensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code ChaDter 2, Article VII. Division 5 Thereof Entitled "CamDaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions By Lobbvists On Procurement Issues": D Yes ~o: Are YOU lobbvinq on a Dresent or Dendinq bid for qoods, eqUiDment or services, or on a Dresent or Dendinq award for qoods. eqUiDment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled "CamDaign Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited CamDaian Contributions Bv Lobbvists On Real Estate DeveloDment Issues": V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CI1Y CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CI1Y OF MIAMI BEACH FOR THE PRE EDING CALENDAR YEA STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO N URES OR COMPENS ON URING THE REPORTING PERIOD. familiar with the provisions requirements. [! Produced ID Signature of Lobbyist: 0ignature of Principal/Client: VI. ,LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ~oduced ID Ftb~./I1A AJfIV~ i-I<:-EN$G Form of Identification ,"'mil Form of Identification /' lo""\'~" BA y'~/"'111. ~,\,\,'lU""'II',,1. \/I" Personally known (Lobbyist) ~ \..~"SS/'~4')' ~D Personally known (Principal) #,'~\)~~.~~r~4'!"~ ~ ..- >>~\ ON l'. 'l. ~ .":,,,,IS510N ;". ~ ~ .0 v~ 6, 2a '-to'o ~ ;:: 0 d~'" 6 ~'-t.. ~ SIGNATUREANDSTAMPo.fN'~RY: i?.>%Oo. ~ ~ ..,>...~~'!,200.>'%.o ~ ~ - : :~ ~~. ~- ~*: .. : = =*. -- _. .... t .*_ .... ..... _*_ State of Florida, County of Miami-Dade~ B ~ 1100210415 .: ~~ate of Florida, County of Miami-Dadti z~ '1100 210415 : i - ;;..\. -f< . ~;t... d b 'b d b ~ -0' ..:!t'- Sworn t9 a d subscribed before me ~&..'\ ~dedt\ll'l ~..~.' ~~worn J1~a su scn e e ore me ~ ~...~ ~ . t-""'~~ This 'J..,: day of 20~:?;J:..o~1.~~~~~,'~~~'ThiS -h-day of /11'tIlCII, 20~"",;J-A..'.~~t:~;"~--9~ "JI"'I.'8llc ST",t a~",'\l . "JI"I.~ .....\ O~ ~# ') ~ A"? ~"''''f'''I''\\'\~ Sa..' II,i, S1~1\\\"\~ Signatu Public otary State of Florida Signature f Publi N tary - ate 0 Florida zation of Lobbyis s signature Notariza ion Principal's signature VII. FORCL~ONLY 1 cb Annual Registration fee: [ Yes [ ] No Amount Pai . MCR V be, Lobbyist Registration Form received and verified by: Revised 02/10/04 F: CLER\ALL\MARIA-M\LOBBYIST\LOBBYIST FORM 04 PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN MIAMI BEACH HOTEL INVESTORS LLC: Anthony S. Brown Frank DeLeonardo Steve Garlson Sharon Brown ,/