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Gregory Kyle/Stiles Development - Mark Van Dyke'fig 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 33`d Avenue, Suite 109 Fort Lauderdale Florida 33309 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (954) 535-5105 (954) 739-2247 greg.kyle@kimley-horn.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Stiles Development -Mark Van Dyke NAME OF PRINCIPAL/CLIENT: Stiles Development - 300 SE 2nd Street Fort Lauderdale FL 33301 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 954.627.9280 markvandyke@stiles.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: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Redevelopment of Southwest Corner of Collins Avenue & 69th Street - 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 ~t ~ _, - ~_ . 'a ~ n ~ ~z :~ ~~ Qz ~n~ soo? * Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a public hearing setting. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OROTHERf C~ ~] A) LOBBYIST DISCLOSURE: (Required) $ ~-1 _~ I~ B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 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 present or pendina bid for aoods, eauipment or services, or on a present or pendina 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 pendina application for a Development Agreement with the City or application for chanae of zoning map designation or chanae 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.. Yes X No: Are you representing anot-for-profit corporation or entity without special compensation 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. a ~... 1 ~~ ignature 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 re uirements. , ~ Signature of Lobbyist Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: Produced ID Form of Identification Personally kn ... _. __.__,,,,~„~, VII. SIGNA' State of 7P ExPIRE9!A~O 06474 Baded Thru Ndery puDllo undonrrlWn 20V'~ Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This day of , 20_ Si~nature of Public Notary -State of Florida Signature of Public Notary -State of Florida N tarization of Lobbyist's signature Notarization of Principal's signature t ____ FOR CLERK'S U ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid '~ MCR # Date Paid PRINCIPAL IDENTIFICATION: Produced ID Form of Identification Lobbyist Registration Form received and verified by: Entere x.11- / F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 08.doc ~ la~-9_.,. ~- ~~ Q ~ 7 Revised 12/08/04 ~} ~: 'fie foyer ~~~~5~~~` ~:~ ~:rssisai~r~~l~fit'~~a~h~'~.~3~ ~8=~i~"~sbl~iiCe~f3`t~tr}pat~#~ois;:B~Ct:[t~,.-S~ ~~~iaei s~ ~~e. ~i~i~~orS~:zia~~s fac`t~ are try Ord rr. ~"!~ fi.t X i~ ,r~ai~ car q 1;~ ~~ 'CIE ~h;: ~tY G~cia end, 3~t t~pot'~t~ j -._ _ Stake BFI ~~~ " ~ ~ .. ~~~rtcl~f ty Uf-7~'[YdS~F-i~d~ -,. Svc m ' ~{, ., ~ ~ :.flee m~' ~' ~ `c"i i~ a ..~...........K ~ c ~ ~'l+~ ~.- -~~~ ~f "~y C4AtMtii ~S7Q3628r~ ~ ~A ~ ' ~ (f @1N ( ~~ S+ n~ ~PtikFlicN~ ar~ ~a~e'a~l~~" ~s~+~atu~ c~ P~f~ hiQEary ~ _ .....`6»:.~'~`.....• ~s _ _ _ ,-: ~~.~~~r 's~-g~a: .. i+tci~at~ttatiEtif ~ilt3c-i~ss~;t~ttatitir , e _: ,, , [, I ~e~:G ~ ;Atrl~nt Paid j~l~R ~ _ :- #7®i~^.#aai •.. - =~~;X' ~~~~ pR~tC!~t~7iilE~3F-mss': eU71'OF1 tiAYNE .~t~i city of Miami Beach, 1704 Convention Center Drive, Miami Beach, Fbrido 33 ~ 39, www.miomibeochA.gov CITI' CLERK Okice CifyClerk~miomibeachF{.gov Tel: 305.673.74! 1 ,Fax: 305.673.7254 LOBBYIST NAME: ~ ~-~ ~~ ~~~ ~~'P~ I understand that no later than October 1st of each year, 1 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 violotion evaluation. In 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: ~ Date: Reprised 02!0412008 P•'i:?.?:R'.i.OIiT~I'1tiT~.G~pcn,ii^:rc ti Di,ciosiva rnr;ti: lir dnc u°~ t ~~ .., ;. _, U'' .jgt ii5 ~: ~ w ~'~ f+J ~•.~ .~_ ~_, •~~ ;~. r•d .',d <s- a `; i. C fS t :~ :!} s"~ '. ~ '_~_ f.+ :.. DC? K? 0 Z ~~ a .m v d OG .c = ~v Vu~ ~m a°~ g eg tai V O ~~ ~'v L N U o ~ m ~ '° m a C 7 a L Q m a