HomeMy WebLinkAboutDisclosure to Support or Withhold ObjectionCITY OFitIAi:tI
,OSLJRE OF C N 11 ERATlON PROVIDED OR COMMITTED OR AGREEME1'I '0
UPPOI4T OR AVIT UU0L1? OB;IECTIO'
The ,4?v' €11 Miami 1equ res ant. 1 rson or 4ntrapes approv relief or other action bran the City Co iariSssio; o any of its
boards. authorities, agencies, councils or committees, 's, to disclose at the eommencem.eot for continuance) of the 'tinariii;_i%43 on the
issue: any consideration provided or committed, directly or on its behalf, to any entity or person for an aorearneni to support or
.\•bhhofti objection to the requested approval, relief or action. "Consideration' includes any gild, payment, contribution, donation, •lie,
commission, promise or grant of any money, property, service, credit or b17fii end assistance o1 any kin or value, whether direct or
implied, or any promise or ilgreenleni to provide an, of the -)oreguii.t. in the future,
Indivi luatained or employed by a principal as a iobhyist as defined in S=ce. 2-b53, and :appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees ;es solely in the capacity of a lobbyist and not as the applicant. or owners'
legal representative are not required to fill out this form:
Lucia A. Dougherty
HOME ADDRESS:
Cr
(First Name)
(Middle) (Last Name)
(Address Line 1)
I ION1E Pi10 f-i:
EMU.: doughertyl@gtlaw.com
(Address Line 2)
STATE:
Florida zip.
CALL PHONE: FAX:
BOSSINESS or APPLICANT or ENTITY NA
Lucia A. Dougherty, as attorney
BUSINESS ADDRESS: Greenberg Traurig, P.A.
(Address Line 1)
1221 Brickell Avenue, Miami, Florida 33131
(Address Line 2)
1. Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board,
authority, agency, council, or committee.
Approval of a substantial amendment to Capital at Brickell f/k/a SMA fUSP.
2, Has any consideration been provided or committed, directly or on your behalf, to any entity or person for an agreement to
support or withhold objection to the requested approval, relief or action?
I YES ?Xf NCB
If your answer to Question 2 is No, do not answer questions 3, 4 & 5 proceed to read and execute the Acknowledgment. If
your answer to Question 2 is 'Yes, please answer questions 3, 4 & 5 and read and execute the Acknowledgement.
Doc ao..86543
3; Please provid i tunc add ress a d phone a}ani;t t- e laers;aau(s) or entities ta, Iresa co sla3cr to Rn lr s t t;
or committed,
None substantial amendment
Add i;.it:°'€c. names can be placed cm ,:: s'p Page al • oiled to this fern):
4. Please describe the nature of the consideration,
An agreement was entered into wit x the South Miami Homeowners Assoc±
n for the
original .cusp.
5. i3escribe what is being requested in exchange for the consideration.
None for the substantial amendment,
ACKNOWLEDGEMENT OF COM.PL1ANC1
1 hereby acknowledge that it is unlawful to employ any device, scheme or artifice to circumvent the disclosure requirements of
Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; and that in addition to the criminal
or civil penalties that may be imposed under the City Code, upon determination by the City Commission that the foregoing
disclosure requirement was not fully and timely satisfied the following may occur:
1. the application or order, as applicable, shall be deemed void without further force or
effect; and
2. no application from any person or entity for the same issue shall be reviewed or
considered by the applicable board(s) until expiration of a period of one year after the
nullification of the application or order, :1
PERSON Si131i`I"i'IG LDISCLOSURE:
Sworn to and subscribed before me this
instrument .was acknowledged before me f>t'
as identification can±: o is pea•sonall known to one
STAT°', OF FLORIDA
CITY OF MIAMI
MY COMMISSION
EXPIRES:
Encl slue{s)
200 `"' 1 . The foregoiag
who has produced
did'did rot take an oath_
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