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Gregory Kyle/304-312 Ocean Drive, LLCm MIAMIBEACH 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. Kyle Gregory S. NAME OF LOBBYIST: (Last) (First) (M.I) Kimley-Horn and Associates, Inc. 5200 NW 33rd Avenue, Suite 109 Fort Lauderdale Florida 33309 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (954) 535-5105 (954) 739-2247 oreo.kvleCa~kimlev-horn.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: 304-312 Ocean Drive, LLC NAME OF PRINCIPAL/CLIENT: 600 North 3rd Street. 2nd Floor Philadelphia PA 19123 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (215) 625-9722 (215) 625-0167 IouisiorocofskvlC~earthlink.net TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) out this section if principal is a Corporation, Partnership or Trust [Section 2-482 • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Phillip McFillin, Louis Orocofsky • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Phillip McFillin II. SPECIFIC LOBBY ISSUE: Redevelopment of 304-312 Ocean Drive - COA, Variance Approvals, and Conditional Use Permit 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 Planning Dept., HPB, BOA, Planning Board, City Commission * None ~~i~~r~ ~.~,°~,`~~~~ 1~lJ~ 6S ~6 ~~ I I ~fl~ 8QOl * Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not Iobffie~Gt3i~e~ ~uWlaring setting. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) $ 224.73 oer hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $~~_~~er 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": Yes X No: Are you lobbvina on a vresent or vending bid for aoods, equipment or services, or on a present or vending award for aoods, eauipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes X No: Are you lobbvina on a vending avvlication for a Develovment Agreement with the City or avvlication for chance of zoning map designation or chance to the Citv's Future Land Use Mav? 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 anot-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.. Yes X No: Are you renresenting anot-for-vrofit corvoration or entity without svecial comvensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Sign re of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. ~••t A f ~ Signature of Lobbyist: ~ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Produced ID y--°`~ "" entification onally known (Lobbyist) EXPIRES: STAMP OF NOTARY: w of Miami-Dade before e of S~ 20d~ PRINCIPAL IDENTIFICATION: Produced ID Form of Identification Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This day of , 20_ Signatur~'of Public Notary -State of Florida Signature of Public Notary -State of Florida Notarization of Lobbyists signature Notarization of Principal's signature [ ] FOR CLER~S~ E ONLY /G~~ ~J ~7 ~ ~ . Annual Registration fee: [ ]Yes No Amount Paid ~ "` MCR J Date Paid Q Lobbyist Registration Form received and verified by: Entered By: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04 1V. Ul~I:LUJUKt OF ItKM~ AMU AMUUIYID Ut LVtftSll~l I.VMF~t1YJA11V1Y (Ul~I,LVDt WMtll'ItK /'/~/!/KL1, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) ~}1~oer hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ ~1oer 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": ^ Yes X No• Are you lobbying on a present or pending bid for goods eguivment or services, or on a present or en nding award for goods equiument or service 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes X No• Are you lobbvina on a vending application for a Development Agreement with the City or application for change of zoning may designation or change to the Citv's Future Land Use Mau? 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.. ^ Yes X No• Are you revresenting anot-for-profit corvoration or entity without svecial comvensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Clie VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification ^ Personally known (Lobbyist) PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: PR pti;lo,. State of Florida, County of Miami-Dade State of f~ler+da, County of Mia~+-Bade Sworn to and subscribed before me Sworn and subscri before me This day of , 20_ This 3/Sfday o~ Signature of Public Notary -State of Florida Signature of Pu is NQ~~ g~gq~q Notarization of Lobbyists signature Notarization o Prin~p~bt~ MV CQmmicsirul f„XDif2S FOR CLERK'S USE ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid _ Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIS7 fORM OS.doc Entered By: 11,2010 Revised 12J08/04 1 '"mss r '; c^'4 3,.. _ ~? City of Maar»i Beach, ] 7U0 Canven~on Center 1}rivE, Miami Beach, Fbritla 33139, vrww.miomibeachfl.gov Cl~ ~~.~~,~ [.}~ifG@ Tel: 3Q5.673.741 2 ,Fax: 305:b73.7254 Cityc lerk~miam ibeochFl.gav ~i r ~S ! understand that no later than ~ctbber ~ si of each yes, !must file the Following forms, pursuant to Section 2-4$5 of the Miami Beach City Code, with the City Clerk's Office far all active lobbying issues. 1 } Lobbyist Expenditure Form 2J Disclosure Farm 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 cads violation evaluation. to addition, once an issue I have registered to lobby on has been resolved, 1 am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Signature: ate: t~~W;s~ch c~%~c~~, a~~a -o m m o m a 0 c 2 c m U~ V7 2 O 70 z ~ ~. c m m n ~ ~ ~ ~_ m v h ~, v w a ---~,~ ~ n t ~ ~1 ~ I~ d Z O v O~ C N ~_~ ~~ ~~ ~ ~ ~_, O -C ~~ n C7 ~ Z ?~ m _r.: ~,:} ~=-I t~-, ~~ r _~ r.•;: ., to ~-- r,:: ~ .. I ` t; ~ r~. i o--- +,LI ~n ~~ I>~. r.: ~, ICI r,; I Iii rrI M5' r ~ ~T,.I I~~ I_t w N+ r-r I: ~I I,~