Kent H. Robbins/30 Ocean Drive Condo Assoc.
bt'td
.-.e-~~()"
, II II'
&
r.h~H'TlI H....lftl
'::'(I~3
-
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 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 exclusions. Please refer
to Ordinance 2004-3435.
~O~N~
NAME OF LOBBYIST:
I ~Q) H I
BUSINESS NAME AND ADDRESS
~.. S3~~n&:>C
TELEPHONE NUMBER:
~tr\
(Last)
(First)
\-\rlg~,So ,..J
(M .1)
(Slate) (ZJP~ 1.3Cf
\~ rito.f}B~/~uifl+. Nt,
EMAlL:
I. LOBBYIST RETAINED BY:
301 OQ::f\tJ ~\\JE. C1N~. AssOC\fI\i'ON~~
NAME OF PRlNCIPAL/CUENT:
&1 Oc.-EY\,J O(2.,,/E' ~'AM' 331d
BUSINESS NAME AND ADDRESS (Num r and Street) (State) (Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
.
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: f
'+ e..fcN ~ PE I tJ c: cc.. tt ,0 - '/bF:5 1.f)(IV I
IDENTIFY ALL PERSONS HOLDING, DIRECTlY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
.
II. SPECIFIC LOBBY ISSUE:
, U 0 A' p.~ N~flltO,J CllJ~ I.ItI r wO 'OEv ~ fopI'( t~ 4\'\ 3lSJ 3::>lQ..OE"NJ De.
~obbled (Describe In detail): ::::J
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
/J tJ '" t-
(VJrJ,,-
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER): j, I
P A) LOBBYIST DISCLOSURE: (ReQUired[ ~O r
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
o Yes ~: Are YOU reoresentina a not-for-orofit corooration or entity without soecial comoensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1)
DYes rio:
Are YOU lobbyina on a oresent or oendina bid for aoods. equioment or services. or on a oresent
or Dendina award for aoods. eauioment or service?
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions By LOb,bvists On Real Estate Develooment Issues";
V.
SIGNATURE UNDER OATH:
I do solemnly swear that all of t e foregoing facts are true and correct and that I have read or am
familiar with the provision nt ned in i 2-482 iami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION.
o Produced ID
o Produced ID
Form of Identification
~IIY known (Principal)
Form of Identification
~ersonallY known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and SUbSCrjbed~; m,e j",
This 14 tA day of \. . 200 It"
~ - . .~
Signature of Public Notary - tate of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn and subscrib ~?f~ . ~
This-LL-dayo . O~f/
. . ,
, j
Signature of Public Notary - State 0 forida
Notarization of Principal's signature
'"'''''''' UUAM R. HATFIELD
l~m'~~V "~~ Notary PubJJc . State of Florida
:. '~__Feb18.2t09
\~ Z4:< CommIAJon # DO 375299
',:1,,9r.r..~" Bonded Iv NalIonaJ NotaIy Assn.
Annual Registration fee: (~ ] No Amount Paid
Lobbyist Registration Form received and verified by:
Revised 02/10/04 . LER\AL
,,~:.l3~'',:'''''' ULIAM R, HATFIELD
!~m;\ Nofory PubIlc - Stat. of Flortdc
:' '~__feb18.2OO;
\~'" 2.tTl Commission # DO 375299 ,
,,;.."'.....'fIj.~~
".."."" Bonded Iv NaIIonaI Notary A&r
~ ONLY .., II ,lrt'-
MCR # ~Datepaid~
,
MARIA-M\LOBBY ST\LOBBYIST FORM 04