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Amendment to Lobbyist Reg. AMENDMENT TO LOBBYIST REGISTRATION FORM Name of Lobbyist: Kent Harrison Robbins Address: 1224 Washington Avenue, Miami Beach, FL 33139 Telephone No.: (305)531-0500 (305) 531-0150 Fax No.: Email: Khrobb@bellsouth.net Lobbyist Retained by: Address: Miami Beach Hotel Investors, LLC 4385 Collins Ave. Miami Beach, FL 33139 Specific Lobby Issue: Appeal of Design Review Board Order Amendment to Item III. City Agencies/ Individuals to be lobbied: A) Full Name of Individualffitle: Miami Beach City Commission Financial, Familial or Professional Relationship: None C") c:> --. U1 ~< <- c:: r-'~};~:f: r. r"' ?'''' -'c.... ,..<.~ :0 rn I co t'-~; ~'-. , ,<::. 1"11 ~ '2 0 ~ N C"> f"1"\ 'r'; ~ v. _~ "".111'1, Hr,un lQ t=d , ., mi" ~(IUJ - , City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 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 Oty Manager or any dty board or committee; or any action, decision or recommendation of any dty 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 dty commission, or a dty board or committee. The tenn specifically Includes the principal as well as any employee engaged in lobbying activities. The tenn -lobbyists- has specific exdusions. Please refer to Ordinance 2004-3435. ~oo NAME OF LOBBYIST: (Last) l2Z "l BUSINESS NAME AND ADDRESS 3D5 '5~2 - iJ ROO TELEPHONE NUMIfR: ken+ (Rrst) +far rCLX:>n r and Street) (Oty) ~ -0(50 (M.I) .r=; 331 (State) (Zip Code) ~robb @, ~H south. nq.. EMAIL: . I. LOBBYIST RETAINED BY: NAHE~~~ &-O/Al() I 01m~h-1" -.In tGrq'. ($,1'111 h ..lW.-1 InVtA-\zx~. LLC '-J31f5 CoIIrYl.5/h1e.. M,ami" Beach, n BUSlNfSS NAME AND ~I.mb."nd SIreel) (cty) (-, (ZIp Code) 3313 TELEPHONE NUMBER: FAX NUMBER: (OptIonal) EMAIL: (Optional) Fill out this section If prlndpalls a Corporation, Partnership or Trust [Section 2-482 (c)] · NAME OF OiIEFOFFICER. PARTNER, OR BENEFICIARY: An\hony S:~rwn 11Yl~1~ muo~ . IDENTIFY ALl PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUOi CORPORATION, PARlNERSHIP DR TRUST: 'So!<l -I\~ S~4 '3 ~ ~ .-) ...t: t:J I.:> \ en c:f) II. SPECIFIC LOBBY ISSUE: ~.lc:t'\()1Dl1 o~ -tAme h:dmg~ biL<Slqt'\ khfltuJ &:ard. Issue to be lobbied (Describe in detail): --0 lJ III. CITY AGENCES/INDMDUALS TO BE LOBBIED: ....."'-. rJ, () -1'"', -n ~ -0 " - ~ rn '0 N - A) Full Name of Indiyldual/TIU6 rn B) Any Flnandal, Familial or Professional Relationship f5CX?1 rd S+a~~ No~ No~ APR 1 8 2005 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOURL Y, :. FLI. T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) . B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION: (Required). ~ ~ h LA. r D ~es rio: Are YOU reDresentin9 a not-for-Droflt corooration or entity without s~ecial comoensation or reimbursement. Pursuant to Ordinance No. 2004-3435. . , D Yes ~: 2) DYes ~: v. h6u..v 1) Pursuant to.Ordinance ,No. 2003-3393 Amendina Mia~i. Beach a~~;:~~~ 2E~~~e ~~ ~~~:n 5 Thereof Entitled "Campaign Finance Reform" Via The AddItion Of ~ " h Campai9n Contributions BY Lobbvlsts On Procurement Issues": Are YOU lobbYinG on a Dresent or oendinG bid for Goods. eauiDment or services. or on a Dresent or oendlnG award for Goods. eau'Dment or service? Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach ~ ~;,haot~ 2E~~~e ~II ~~::::t 5 thereof Entitled "Camoaian Finance Reform", Via The Addition c: I~~~ 'n 2-4 0 . "ro i . Camoaign Contributions Bv lobbYists On Real Estate Develoom nt ": Are ~ lobbylno on a Dendlna apallcallsln for a ~~~~~ ~~:. aDDhcation for chanGe of zoninG maD desiGnation or chanG; · U MaD? SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, U5nNG LOBBYING EXPENDITURES, AS WELL AS COMPENSADON RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE P CALENDAR A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO E COM ON DURING THE REPORllNG PERIOD. I do solemnly swear that all of th familiar with the provisions conta' requirements. Signature of Lobbyist: Signature of Principal/Client: VI. rrect and that I have read or am Beach City Code and all reporting o Produced ID PRINCIPAL mENTIFICATION: ~odUCed ID FL.4~/A'" /),RIVU> L~ (.. . Form of Identification Form of Identification XpersonallY known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: D Personally known (Principal) State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn to and subscribed before me ~ Ulltllllll Sworn and subscribed before me 20a ~~\~~ BA'f~~1'11~ This ../..Lday of M~...It . 20~ -Jf.~ \) ....... 'y!' ~ ~" 11111'",,1. .' ~~\SSIO.t;... ~ /.: ~ BA'f"'1t:lII~ . 0 ~ 6. <00 ~'. ~ 'l' ~ f Ffmq6$ ~ ~ ~\ 3>i ature of Publi No ry - te 0 'di'~~\SSIO.t~.. ~ at1M' : .... (f> : *)f tarization Prindpal's signath l ~ ~'i 6. 200.... ~.. ~ :~. . :- ;: . U'~ ::.: l.~'. '00210415 :~~ =*: .... :*. ~ e.:\ IL._. ..~~ : : . .;:.. ~~)-'.."~~d\lllll~~.&,,$' ~a~ '00210415 :!(;::.:. ~ A... *iiclJn6t... ~....~ ~ ~ . ~ ..!iii;;: ~",t"c'"ST~1r. ~~\\\'" %~;;:.:?,~~.~~ "'/1111111\\\\ ~"..V8'......... r:Jc ~~ ""/ ..Ie ST~i~ ~\\'l :l/"I,jllttt""'~ ~ FOR CLE~'SJJ.5.n)NL:a" /) '1~1 Annual Registration fee: [\....o1Yes [ ) No AmouC\t P.i'I~ J ..U U M~ ltJ;)... 7 Date Paid Lobbyist Registration Form received and verified by: --.bd _ . 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 l\1IAMI BEACH HOTEL INVESTORS LLC: Anthony S. Brown Frank DeLeonardo Steve Carlson Sharon Brown ; .""'~ ./ '"