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HomeMy WebLinkAboutTab A9 - Disclosure of Consideration to support or withhold objectionCITY OFMIAMI DISCLOSURE O*F CONSIDERATION PROVIDED OR COMMITTED FORAGREEMENT TO V, . . . . . . . SUPPORT OR WITH14OLD OBJECTION The City of Miarni requires any person or entity requestmig approval relief or other action from the City Conumission or any of its boards, authorities, agencies, councils or committees, to disclose at the con-mienceinent (or continuance) 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, paynient, contribution, donation, fee, commission, p I romise or grant of any money, property, service, credit or financial assistance of any kind or value; whether direct of 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 forth. N,Ad\4E: Thomas Spencer Crowley (First Name) (Middle) (Last Name) 1-10ME AJ)DRESS: 98 SE 7 Street, Suite 1100 (Address Line 1) (Address Line 2) CITY: Miami STATE: Florida 711"- 33131 EONIEPHONE, 305-374-5600 CELL PHONE: FAX: EMAIL: spencer.crowley@akerman.com BUSSINTESS or.,,.kPPLlCANTT or FNTITY NAME Tobacco Road Property Holdings, LLC BUSINESS ADDRESS, 21 SE 1 Avenue, Floor 10 (Address Line i) Miami, FL 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. An amendment to the Brickell CitV Centre Special Area Plan 2. Has any consideration been provided or committed, directly or on y I your behalf, to any entity or person for an agreement to support or withhold objection to the requested approval, relief or action? [:] YES [X1 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 isVes, please answer questions 3, 4 & 5 and read and execute the Acknowledgement. Nu -'86543 3. Please provide the name, address and phone number of the person(s) or entities to whom consideration has been provided or committed. 'Natzte Address Phone# a. b C, Additional names cant be placed on a separate Page attached to this form. 4. Please describe the nature of the consideration. 5. Describe what is being requested in exchange for the consideration.. ACKNOWLEDGEMENT OF CC IN11?LIANCE I hereby acknowledge that it is unlawful to employ any device, scherne, or artifice to circumvent the disclosure requirements of Ordinance .1.29183 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 Citi` Commission that the foregoing disclosure requirement was not fully and tirncly s4dified the following Wray 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) untilexpiratio a peri of one year after the nullification of the application o r. PERSO'N'SUBMITTING DISCLOSURE: igna ure 0/7 Spencer Crowley Print Name. .Siwrn to and subsct-ibed bef6r e rrre this - (Zv ref _ LL �� � 2Q _. The frac-egoing irrstr trra rrl was rrck)�cr� I elYcfd b fc�rE� n by Spencer Crowley _ F ivhr has produced (xs idc tttfflicttdoll alwkl )r is personrdly k-11011=17 to rnc: roma who d0411d not take dil 047th, STATE OF FLORIDA CITY OF 1f1:1 Diana Perez -Gats #S'i� C NOTARY PUBLlC �°i EXPI STATE OF FLORIDA i °' Conan# FF233833 Print atre Enclosure{s} Expires 8/83/2(}19 Doc. No.:86543 Page 2 All CITY OFMIA DISCLOSURE OF CONSIDERATION PROVIDED OR CO?sIMITTED FOR AGREEMENT TO SUPPORT OR WITHHOLD OBJECTION The City of Marni 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 c.orinnencement (or continuance) of the bearing(s) on the .issue, any consideration provided or committed, directly or on its behalf, to ,my entity or person. for an agreement to support or withhold objection to t I he requested approval, relief or Action. "Consideration" includes any gift, payment, contribution, donation, fee, commission, promise ' I 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 futtire. Individuals retained or employed by a principal as a lobbyist as defined in Sec. 2-053, 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 mvfters' legal representative are not required to fill out this forma. N. -A -ME: Thomas Spencer Crowley (First Name) (Middle) (Last Name) 1-1.0,MB ADDRESS; 98 SE 7 Street, Suite 1100 (Address [Eg I (Address Line 2) CITY: Miami STATE: Florida ZIP: 33131 HOMEPHON' : 305-374-5600 CELL PlIONT: E -MMU spencer.crowley@akerman.com BUSSINIESS or.A.PPUCANIT or :E. N -AME 2 Indian Creek Holdings, LLC BUSINESS ADDRESS: 21 SE 1 Avenue, Floor 10 (Address Line 1) Miami. FL 33131 (Address Line 2) FAX: 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. An amendment to the Brickell City Centre Special Area Plan (SAP). 2. Hasany 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? M YES [X] 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. 3, Please provide the name, address and phone number of the persons) 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 this form. 4. Please describe the nature of the consideration. 5. Describe what is being requested in exchange for the consideration. _ACKNOWLEDGEMENT OF Ci?iNI'Ll-ANCE X hereby acknowledge that it is unlawful to employ any device, scheme or. artifice to circumvent the disclosure requirements of Ordinance 12918 and such cire6mvention shall be deemed a violation othe Ordinance; .and that in addition to the criminal or civil penalties that marc be imposed under the City Code, upon determinatlon by the City Commission that the foregoing disclosure requirement was not fully and timely satisfied the following may occur: L (lie 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 boards expiration of a perlo of one near after the nullification of the application rder: PERSON SUIBMITTING DISCLOSURE: signature Spencer Crowley Print Name aSii-earn to and subseribed befbre rare INS d foc (>f _ � 200 The f©regoing instrrrnient was ac:karaiv1er/gvd before me by Spencer Crowle � irha has produced (is identificatian rawt`or is personally knoii rt tci ore sand who (10,`did not take an oath, STATE OF F6i T -Data i RY PUBLIC l §fAq"F FLORIDA C9mm#_FF233833 Expires 6/8/2019 Vk Print teams Endosure(s ) Doc. No.:86543 Page 2 CITY OFMIAMI D L F D D E ISC OSUREO CONSI ERATIONPRONTIDE OR COMMITTED FOR AGREEMENT SUPPORT OR WITHHOLD OBJECTION The- City of Miami requires any person or entity requesting approval relief or other action ftom the City Commission or any of its boards, autborities,, agencies, councils or committees, to disclose at the commencement (or continuance) of the hearing(,-;) 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 I 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 o)xmers' legal representative are not required to fill out this form. N-. A N -f E: Thomas Spencer Crowley ()°irst Name) (Middle) (Last Name) 1.10 -ME ATS )RESS: 98 SE 7 Street, Suite 1100 FAdaieg 069 ) j CITY: Miami BOME PJAONE: 305-374-5600 (Address Line 2) STATE: Florida CELL PHONE: E'N 4 A I L -. spencer.crowley@akerman.com BUSSTNESS or APPLICANT or ENTITY NANIE BCC Road Improvement, LLC BUSWESS ADDRESS: 98 SE 7 Street, Suite 600 (Address Line 1) Miami, FL 33131 (Address Line 2) FAX. 7113: 33131 .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. 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 i0thbold objection to the requested approval, relief or action? R YES X NO If your answer to Question 2 is INTO, 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. 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 Phone# a. b C-1 Additional natives can be placed on a separate pae attached to this forin. 4. Please describe the nature of the consideration. 5. Describe what 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 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 w not Wily and timely satisfied the following .0-Jay 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 he reviest it or considered by the applicable boardsexpiration eriod f one year after the nullification of the application or o e- PERSON SliBMITTING DISCLOSURE: Signature Spencer Crowley Print Name .SSit'xra to and subscribed bee- br•e free this — —dc.Y oaf 2l . The for egoi a instrument i'-as cac?knoti4edged before erre b S e� neer Crowle who has produced --as iderattficxation anderr• is personally ritrolvit to me and 111/70 (INI'tid great take an oath STATE OF FLORIDA CITY . , MIAbJ6 Perez -Data i M SW1RY PUBLIC N tory STATgPF FLORIDA Comm# FF233833 tvnA «i< EC 6/8/2019 p�Q/��9 Print Name ETIC101Mk 5�. xplt+es Q Doc. Irio-,86543 Page 2