Carter McDowell/1220 Collins Avenue, Inc. John F. Hotte, Esq.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 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.
MCDOWELL CARTER N.
NAME OF LOBBYIST: (Last) (First) (M.I)
Bilzin Sumberg Baena Price & Axelrod LLP. 200 So. Biscayne Blvd.. Miami. Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code)
305-350-2355 305-351-2239 CMcDowell(a~bilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
1220 Collins Avenue. Inc.
NAME OF PRINCIPAL/CLIENT:
c/o John F. Hotte. Esq.. 6550 No. Federal Highway. Suite 220. Ft. Lauderdale. Florida 33308
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
954-928-1800 954-928-1865 JohnH@fhapalaw.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: Marc H. Dubreuil and Luc Robert
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Buildins~ Permittinsr Issues for orooertv at 1220 Collins Avenue
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship r.,,
a
Planning and Zoning Department none -<
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Building Department none ~ tv
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IV.' DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $535.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $535.00 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":
g Yes ~~No• Are you lobbying on a present or pending bid for goods equipment or services or on a present or
pendino 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":
g Yes ~~No: Are you lobbyina 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 snot-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..
q Yes ~~ No' Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement?
V. SIGNATURE UNDER OATH:
ON OCTOBER 1St OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TOT CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPE TION RECEIVED, IN E CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SH FILED EVEN IF TH HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PE
Signature of Lobbyist -Carter N. McDowell
I do solemnly swear that all of the fore n facts are true and correct and that I have read or am familiar with the provisions
contained in Section 2-482 of the Mi i Bch City Code~nd a~repArting requirements.
Signature of Lobbyist:
r .
Signature of Principal/Client: ~/
VI. LOBBYIST IDENTIFICATION: PRINCIPAL I EN~ICA IT ON:
q Produced ID q Produced ID
orm of Identification rrz~-eLld ification
q ovally known (Lobbyis q ersonally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swo to and subscribed before me ~.
This ~~~~,da ~pY~`~jNL~~ 20
Slqn ~.- •.~; IIC b et I
____.State of Florida, County of-AAia~i-BadeBROWARD
~'` Swom .- subscribe before me
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of Public Notary -State
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`~t9R 8/18/2009
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FOR CL'I
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR ~ ~ ~ Date
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M1Lobbyist\LOBBYIST FORM 05.doc ~ ~ , ~ i, ,
Revised 12/08/04
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City of Miami Beath, 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:
I understand that no later than October 1st of each year, I must file the following
forms, 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 Form
2) Disclosure 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, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
a~
Signature: Date:
F.lGL.ElLC7Yi~Ttabbyist ~egiskratian Farm 32708.~iac