A1AMd

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,

lobbying

city board or committee. The term specifically includes the principal as well as any
The term " Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.

or a

activities.

Cotter
NAME OF LOBBYIST:

Anne

Last)

Arquitectonica

First)

2900 Oak Avenue

BUSINESS NAME AND ADDRESS

employee engaged in

Miami

Number and Street)

305) 374- 5300

M. 1)

Florida

33133

State)

City)

Zip Code)

305) 377- 6222

TELEPHONE NUMBER:

FAX NUMBER:

EMAIL:

Please notify this office if your contact information changes: address, phone, or e- mail address.
I.

LOBBYIST RETAINED BY:

Donahue Peebles
NAME OF PRINCIPAUCLIENT:

6747

Property Holdings,

LLC

5937 Collins Avenue

BUSINESS NAME AND ADDRESS

Number

and

Street)

Miami Beach
(

Florida

33140

State)

City)

Zip Code)

305) 372- 1812

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: Donahue Peebles 100%
1

ry

IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH COBIDORATION,

PARTNERSHIP OR TRUST:

Ii. SPECIFIC LOBBY ISSUE:

Development Board Approvals for 6747 Collins Avenue, Miami Beach

Issue to be lobbied( Describe in detail):

Ill. CITY AGENCIES/ INDIVIDUALS TO BE LOBBIED:

Pursuant to City Code Section 2- 482( a)( 4) include the commissioner or personnel sought to be lobbied,
into any contractual relationship ( paid or unpaid) with said city commissioner or personnel

and whetherjhe

) jbyistlas

entered

from

12 months. preceding such

person' s commencement of service with the city to the present date, stating the general nature of the subject contractual relationship.
Sec 2- 482( a)( 4) Full Name of Individual
title of person to be lobbied

Planning

Department

B, HPB, BOA,

City

and

Building

Commission,

Contractual

and

Department Staff

None

as

None

necessary*

Relationship(

Explain)

YES

NO

Pursuant to City Code Section 2-482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional
relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is
sought to be lobbied as identified on the lobbyist registration form filed.

Sec 2- 482

Any Financial, Familial or Professional Relationship

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l
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IV.

DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION( DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERr

A)

LOBBYIST DISCLOSURE:( Required):

B)

PRINCIPAL' S DISCLOSURE( OF LOBBYIST COMPENSATION):

Hourly rate of$ 220 per hour.

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

No:

Are you lobb3dng on a present or mending bid for goods, eguipment or services. or on a present or

pending award for goods. eguipment or service?

2)

Pursuant to Miami Beach City Code Section 2- 490 Entitled" Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes

No:

Are you lobbldng on a pending application for a Development Agreement with the City or application

fa change of zoning map designation or change to the Cityes Future Land Use Maw
3)

Pursuant to Miami Beach City Code Section 2- 482( h) Any person ( except those exempt from the definition of" lobbyist" as set
Section 2- 481 above) who only appears as a representative of a not-for-profit corporation or entity without

forth in
special

compensation

or

for

reimbursement

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:

SIGNATURE UNDER OATH:

V.

ON

Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.

Y 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER

EE113

EM TIJE

E! REQEDING

CALENDAR

YEAR,

STAIEMEbIT

SHALL
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.

if

rw.

1E

MERE

HAVE

BEEN

NO

Signature of Lobbyist

I do solemnly

that

swear

in Section 2- 482

of

all of

the

foregoing fa
City Cod

the Miami Beach

are

true an

nd al

epo

orrect and

th

have read or am familiar with the provisions contained

requiremen

Signature of Lobbyist:

Signature of Principal/ Client:

VI.

LOBBYIST IDENTIFICATION:

PRINCIPAL IDENTIFICATION:

Produced ID

Produced ID
Form

Personally
VII.

State

Identification

of

Form of Identification

y`

known( Lobbyist)

Personally known( Principal)

SIGNATURE AND STAMP OF NOTAR

of

Florida,

Sworn t

County

of

nd subscribed

This

dav

of

Miami- Dade

befog
ttS

Sworn and subscribed before me

2013

This

LA;
Signature

o
of

Notarization

Public
of

Notary

Lobbyist' s

State of Florida, County of Miami- Dade

a:'

me

e of

Florida

signatu re

of

Public

Yes[

No

Amount Paid$

Notary State

of Florida

Notarization of Princil2al' s signature

TO BE COMPLETED BY CITY CLERK' S STAF

Annual Registration fee: [ ]

2013

of

.
Signature

4:.

day

MCR#

LY

Date Paid

Lobbyist Registration Form received and verified by:

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IV.

DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION( DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER):

A) LOBBYIST DISCLOSURE:( Required):$

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

No:

Are you lobbying on a present or nendina bid for goods. eauiument or services, or on a oresent or

pe,ndd* 13g award for goods. eauioment or service?

2)

Pursuant to Miami Beach City Code Section 2- 490 Entitled" Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes

3)

No:

Are you lobbying on a pending application for a Development Agreement with the City or anplication
fgr ghamae of zoning map designation or change to the City's Future Land Use Map?

Pursuant to Miami Beach City Code Section 2- 482 ( h) Any person ( except those exempt from the definition of" lobbyist" as set
in Section 2- 481 above) who only appears as a representative of a not-for-profit corporation or entity without

forth

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 Now Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
SIGNATURE UNDER OATH:

V.

ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH,

EM

LISTING LOBBYING

THE

PRECEDING

EXPENDITURES,

CALENDAR

YEAR,

AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI

STATEMENT

SHALL

BE

FILED

EVEN

IF

THERE

HAVE

BEACH

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/ Client:

VI.

PRINCIPAL IDENTIFICATION:

LOBBYIST IDENTIFICATION:

Produced ID

Produced ID
Form

of

.....

SIGNATURE AND STAMP OF NOTARY:

Signature

day

of

Notarization

Public
of

r:

Novem

Notary

Lobbvist' s

State

of

Lobbyist Registration

bp938q

ade4sl,

No

0+`Sworn

Amount Paid$

orm received and verified

This7''

Ee` e++`

subscribe

befor

me

day

7,
Notarization

signature

Yes[ { ]/

Personally known( Principal)

2013

of

Sig4ul-Pubiblvotary State of Florida

Florida

TO BE COMPLETED
Annual Registration fee: [ ]

Expires o

9)`,

2013

of

rrM.

j
pvgL G' Q ,- Mate of Florida, County of Miami- Dade

State of Florida, County of Miami- Dade

Sworn to and subscribed before me
This

of

known( Lobbyist)
SAY

VII.

Form of Identification

i,,

Personally

U>>>

Identification

y:

By,,PITY

CLERK' S
MCR#

of

ST F jQ

Erin

signature

ate

Paid

J- 3

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F:

CLE

istration Form. doc

Revised 04/ 27/ 2012

MIAMIBEACH
City

of

Miami Beach,

1700 Convention Center Drive, Miami Beach, Florida 33139, www. miamibeachFl. gov

CITY CLERK Office

Rafael E. Granado,
Tel: 305. 673. 7411 ,

City

Clerk

LOBBYIST NAME:

CityClerk @miamibeachfl. gov

Fax: 305. 673. 7254

understand

Anne S. Cotter

that no later than February 28

to Section 2- 485

pursuant

of

of each

the Miami Beach

City

I must file the following form,

with the City Clerk' s Office for all

year,

Code,

active lobbying issues.

1)

LOBBYIST EXPENDITURE AND COMPENSATION 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

that issue

for that

or

lobby on has been resolved, or I am no longer

I am required to immediately notify the City Clerk's

registered

lobbying
Office of lobbyist withdrawal in writing.
on

principal,

to

Pursuant to Section 2- 485 ( d), the

City Clerk shall notify any lobbyist ( or principal) who

timely
a Statement and in addition to any other penalties which may be
imposed as provided in Section 2- 485. 1, a fine of $ 50.00 a day shall be assessed for all
Statement( s) filed after the due date.
The City Clerk shall notify the Miami- Dade
Commission
on
Ethics
and
Public
Trust of the failure of a lobbyist ( or principal)
County
to file the Statement or pay the assessed fines after notification.
fails to

Any

file

lobbyist,

automatically
appealed

who

fails to file the

suspended

to the

from

mi- Dad

required

Statement
fines

by

April 30th, 2012,

shall

are paid,

2I

2a

Signature:

Da t4:'/

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be

unless the fine has been

lobbying
unty Commission on Ethics and Public Trust.
until all

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