HomeMy WebLinkAboutTab A9 - Disclosure of Consideration to support or withhold objectionCITY OFMIAMI
DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO
SUPPORT OR WITHROLD OBJECTION
The City of Miami requires any person or entityrequesting approval relief or other action from the City Conunission or any of its
boards, authorities. agencies, councils or committees, to disclose at the eonunencement (or continuance) of the heating(s) on the
issue, any consideration provided or committed, directly or on its behalf, to any entity or person for an agreement to support or
withhold objection to the requested approval, relief or action, "Consideration" includes any gift, payment, contribution, donation, fee,
commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or
implied, or any promise or agrcernertt to provide any of the foregoing in the future.
Individuals retained or employed by a principal as a lobbyist as defined in Sec. 2-653, and appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners'
legal representative are not required to fill out this form.
NAME:
Thomas Spencer Crowley
(First Name) (Middle) (Last Name)
HOMFi ADDRESS:. 98 SE 7 Street, Suite 1100
(Address Line 1) •
CITY: Miami
HOME PHONE: 305-374-5600
EMAIL:
(Address Line 2)
STATE:
Florida ZIP: 33131
CELL PHONE: FAX:
spencer.crowley@akerman.com
BUSS1NESS or APPLICANT or ENTITY NAME
Tobacco Road Property Holdings, LLC
BUSINESS DRESS:
21 SE 1 Avenue, Floor 10
(Address Line 1)
Miami, FL 33131
(Address Line 2)
I. Please describe the issue for which you are seeking approval, relief or other action from he City Commission, board,
authority, agency, council, or committee.
An amendment to the Brickell City Centre Special Area Plan (SAP).
2. Has any consideration been provided or committed, directly or on your hehalf, to any en
support or withhold objection to the requested approval, relief or action?
El YES VA NO
r person for an agrcement to
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,
Doe. No.:86543
3. Please provide the name, address and phone number of the person(s) or entities to whom consideration has been provided
or committed.
Name Address Phone4
a.
b,
c,
* Additional names can be placed on a separate page attached to this fomi.
4. Please describe the nature of the consideration.
5. Describe wbat is being requested in exchange for the consideration.
ACKNOWLEDGEMENT OF COMPLIANCE
I 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 he 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;
I. the application or order, as applicable, shall he deemed void without further force
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 expiratio a per i g of one year after the
nullification of the application o r.
%Aar
PERSON SUBMITTING DISCLOSURE:
ature
Spencer Crowley
Print Name
,Sworn ia and subscribed before me this day of , 20 Thcjbrcgoing
instrument was acknoilleclged before Inc. by Spencer Crowlell , Hilo has produced
as identification andfor is personally knolvn to me curd iiho dichlid not take an oath
STATE OF FLORIDA --
CITY 0 ., MI Diana Perez-Gata
MY C ,,,X 1";`,I,* NOTARY PUBLIC N
EXP I : geil, :11:--- STATE OF FLORIDA
'.0**-0.-30: Comm* '
FF233833
y7.-• ":::, . Prin a e
Cnc o.sureW Expires 6/8/2019
Doi, No K6543 Page 2
CITY OFMIAMI
DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO
SUPPORT OR WITHHOLD OBJECTION
The City of Miami requires any person or entity requesting approval relief or other action from the City Commission or any of its
boards, authorities, agencies, councils or• committees, to disclose at the commencement (or continuance) of the heating(s) on the
issue, any consideration provided or committed, directly or on its behalf, to any entity or person for an agreement to support or
withhold objection to the requested approval, relief or action. "Consideration” includes any gift, payment, contribution, donation, fee,
commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or
implied, or any promise or agreement to provide any of the foregoing in the future.
Individuals retained or employed by a principal as a lobbyist as defined in Sec, 2-653, and appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners'
legal representative are not required to fill out this form.
NAME:
Thomas
(First Name)
Spencer Crowley
(Middle) (Last Name)
HOME ADDRESS: 98 SE 7 Street, Suite 1100
(Address Line 1)
(Address Line 2)
CITY: Miami STATE:
HOME PHONE: 305-374-5600
Florida ZIP: 33131
CELL PHONE; FAX:
spencer.crowley@akerman.com
131ISSINESS or ,APPLICANT or ENTITY NAME
2 Indian Creek Holdings, LLC
I3USINE S ADD1kFSS:
21 SE 1 Avenue, Floor 10
(Address Line 1)
Miami, FL 33131
(Address Line 2)
Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board,
authority, agency, council, or committee.
An amendment to the Brickell City Centre Special Area Plan (SAP).
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?
YES [KJ NO
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. No486543
3. Please provde the rnme, address and phone number of the person sentities to whom onsideration has been pro ided
or committed,
Name Address Phone0
a.
b.
e,
* Additional al es can be placed on a separate page attached to this fonn.
4. Please describe the nature of the consideration.
5. Descrbe what is being requested in exchange for the consideration.
AC OWLEDGEISIEN'T
I hereby acknowledge that it is unlawful to employ
Ordinance 12918 and such circumvention shall be
or civil penalties that may be imposed under the
disclosure requirement was not fully and timely satisfied
1. the application or order, as applicable,
effect; and
2• no application from any person
considered by the applicable
nullification of the application
PERSON SUBMITTING DISCLOSURE:
OF COMPLIANCE
any device, scheme or artifice to circumvent the disclosure requirements of
deemed a N101110011 of the Ordinance; and that in addition to the criminal
City Code, upon determination by the City Commission that the foregoing
the following may occur:
shall be deemed void without further force or
or entity for the same issue shall be reviewed or
board(s tuitiexpiratioq..La periot of one year after the
• I der.
)
th."..„..
Signature
Spencer Crowley
Print Name
Si t'unz to and subscribed before me this
instrument nas acknoliledged before me
as identification
day of , 200 . The fbregoing
by Spencer Crowley , iiho has produced
audio,- i,s personally known le and- 10 did,did not take an oath
STATF OF IiiiiaTz_Gata
' -` '-'11' . lisktetlikRY PUBLIC
BiATINOF FLORIDA
": otrAtMr.--e - commit FF233833
6/8/2019
Print Name
Fnclowrch )
Doc No '86 41 Page 2
CITY OFMIAMI
ISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO
SUPPORT OR WITHHOLD OBJECTION
The City of Miami requires any person or entity requesting approval relief or other action from the City Commission or any or its
boards, authorities. agencies, councils or committees, to disclose at the commencement (or contUtance) of the hearing(s) on the
issue, any consideration provided or committed, directly or on its behalf, to any entity or person for an agreement to support or
withhold objection to the requested approval, relief or action, "Consideration" includes any gift, payment, contribution, donation, fee,
commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or
implied, or any promise or agreement to provide any of the foregoing in the future.
Individuals retained or employed by a principal as a lobbyist as defined in Sec. 2-653, and appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners'
legal representative are not required to fihl out this form.
NAME:
Thomas Spencer Crowley
(First Name) (Middle) (Last Name)
HOME „AD . . , 98 SE 7 Street, Suite 1100
(Address Line 1)
CITY: Miami
JIOME PHONE: 305-374-5600
(Address Line 2)
STATE: Florida ZIP: 33131
CELL, PHONE: FAX:
WAIL: spencer.crowley@akerman.com
BUSSINESS or APPLICANT or F,NTITY NAME
BCC Road Improvement, LLC
BUSINESS ADDRESS:
98 SE 7 Street, Suite 600
(Address Li
Miami, FL 33131
(AddressLine 2)
I. Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board,
authority, agency, council, or committee.
An amendment to the Brickell City Centre Special Area Plan (SAP).
2. Has any consideration been provided or committed, directly or on your behal
support or withhold objection to the requested approval, relief or action?
Ell YES [Xi NO
to any
r person for an agreement to
If your answer to Question 2 is No, do not answer questions 3, 4 & 5 proceed to read and execute the Acknowledgment. I
your answer to Question 2 is Yes, please answer questions 3, 4 & 5 and read and execute the Acknowledgement.
Doc. No.:86543
3. Please provide the name, addre.ss and phone nurnber of the person() or entities to whom consideration has been provided
or committed.
Name Address Phone#
a,
b.
c.
* Additional names can be placed on a separate page attached to tius form.
4. Please describe the nature of the consideration.
5. Describe what is being requested in exchange for the consideration.
ACKNOWLEDGEMENT OF COMPLIANCE
I hereby acknovvIedge 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 KM':
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 I * expiratio •eriod f one year after the
nullification of the application or o 'er.
1
PERSON SUBMITTING DISCLOSURE:
signature
Spencer Crowley
Print Name
SII OM to and subscribed before me this day of . 2 . The fiffegohig
instiument ilas acknoHledged before the by Spencer Crowle , who has produced
a,s identification and Or LS personally knoirn to me awl w 10 did/did not take an oath.
STATE OF FLORIDA
CITY ' MIA66, perez_Gata -
.....t
M r...%-- '''' .f SkielliARY PUBLIC fary
E -1 ' ' STATE OF FLORIDA
-' 10414V -0 '.-- Comm# FF233833
• ,......• -. Print Name
•Fnclo,11:"°" sV Expires 5/8/2019
Doe No '86543 Page 2