Jennifer McConney - 3925 Collins Avenue~~ MIAMI BEACH ~ ,
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Ci of Miami Be ch fF C
ty a 0 ce of the Gty 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.
McConney Jennifer
NAME OF LOBBYIST: (Last) (First) (M.I)
i
Kobi Karp Architecture & Interior Design, Inc. 2915 Biscayne Blvd., Suite 200 Miami Florida ; 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER:
I. LOBBYIST RETAINED BY:
EMAIL:
Beta Epsilon/Cadillac, LLC, contact: Dan Economos
NAME OF PRINCIPAL/CLIENT: ~
Beta Eosilon/Cadillac. LLC 4000 N Federal Hiahwav Suite 206 Boca Raton Florida 33431
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
361-3918
TELEPHONE NUMBER:
361-3945
NUMBER: (Optional)
EMAIL:
out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] ~
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Nicholas Economos, Manager
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: See Exhibit B
7i_ cDFrrGrr ~ nnnv rcc~ ~c.
New ground floor addition, inclu
Issue to be lobbied (Describe in
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title i
B) Any Financial, Familial or Professional Relationship
Planning Department Staff, HPB, BOA, Planning Board and
City Commission* ~
None
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I
* Unless an issues is lanidative in n~riiro unc enn ei.....,.... e___~ _ '
- ~ ---~-~ -••- -.., _,,...,,,.,,,..., ...~..~,.~~~ a~~ ~~~~ iwuicu ~wwe cn a puonc nearing settingD
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mechanical parking, at the Cadillac Hotel located at 3925 Collins Ave
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
` FLAT RATE OR OTHERf j
A) LOBBYIST DISCLOSURE: (Required) ~ 350.00 oer hour
I
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 350.00 oer hour ~
The following information must be answered:
i
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
present or nendina award for goods. equipment 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 nendina application for a Development Agreement with the Ciri or
Mau?
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 anot-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 requiredjby this
section but, shall not be required to pay any registration fees.
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 EXPEND , WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR T CEDING ACEI R YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO PENDITURE O P NSATION DURING THE
REPORTING PERIOD. ~'
SignatuyC of Lobbyist
I do solemnly swear that all of the foregoing facts are tru an orrect and th~~have read j or am
familiar with the provisions c~p>~iSectio~n 2~-,482 of the iami BeachACity Code and all reporting
requirements. / //
Signature of Lobbyi
Signature of Principa lient: N `~~~ CCono~n•5 - ~^^°~-~--
~.e !~ ~ ~ Imo. ~~a,l ~`,
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscrib befor e
This day of ~ 20 JG
My Comm. Expires ADr 3, 2013
Produced ID
~ LG
of Identification
~ia~n~ ~ DEBRAA WNV(iSTON
Personally known (Principal) * * MYCOMMISSIONiDD667i32ii
EXPIRES: Mayy~13, 2011
9~OF ~~`~C BOIIE6d TMu BUdgB-.^"°'7 SBfYICBS
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This ~_day of I 20 d
/ ~ /
Signature o Public Notary -State of Flori ~ '''T'^\/J
Notarization of Principal's signature
'~ -~'' %°~ ~ ~°'~ nded 1flr~u h National Na~R9!a RK'S U E ONLY g
Annual Registration ~~ee:..[ _ .Yes.{-- :~de % MCR # ~/ ~ Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\¢ALL\MARIA-M\Lobbylst\LOBBYISr FORM OS.da
By:
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Revised 12/08/04
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.741 1 ,fax: 305.673.7254
Acknowledgement of fines/suspension from lobbying for failure to
comply with City of Miami Beach lobbying Laws
LOBBYIST NAME: h n ~~ t r c
I understand that no later .than October 1st of each year, lobbyists subject to lobl
registration requirements shall submit to the city. clerk a signed statement under.
listing all lobbying expenditures, as well as compensation received, for the precet
calendar year with regard to the .specific issue on which the lobbyist has been enga
to lobby. A statement shall be filed even if there have been no .expenditure:
compensation during the reporting period.. The statement shall list, in detail, e
expenditure by category, including food and beverage, entertainment, resea
communication, media advertising, publications, travel, lodging and special events.
FAILURE TO TIMELY FILE THE EXPENDITURE AND FEE DISCLOSURE REPI
WILL RESULT IN A FINE OF $50.00 PER DAY. ANY LOBBYIST WHO F~
TO FILE THE REQUIRED EXPENDITURE REPORT BY DECEMBER 1, SH
AUTOMATICALLY BE SUSPENDED FROM LOBBYING UNTIL ALL FINES
PAID, UNLESS THE FINE HAS BEEN APPEALED TO THE MIAMI-DADE COUP
COMMISSION ON .ETHICS AND PUBLIC TRUST. In the event a lobbyist fail
either file the report and/or pay the assessed fines, the Clerk shall notify the Miami-D
County Commission on Ethics and Public Trust.
IN ADDITION, ONCE AN ISSUE (HAVE- REGISTERED TO LOBBY ON H
BEEN RESOLVED, 1 AM REQUIRED TO IMMEDIATELY. NOTIFY THE C
CLERK'S OFFICE OF LOB,~YIST WITHDRAWAL IN WRITING.
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Signatu Date:
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EXHIBIT B
DISCLOSURE OF INTEREST
for
Beta Epsilon/Cadillac, LLC
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
NAME OF INTEREST HOLDER
1. Stanley Daniel Economos
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
2. Nicholas Economos
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
3. Alexandra Yessios
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
4. Chris Yessios
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
5. George Bavelis
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
6. Beta Epsilon/Cadillac, Inc. a Florida Corporation
. 4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
a. Nick Economos 100%
4000 N. Federal Highway, Suite 206
Boca Raton, Florida 33431
TOTAL for Beta Epsilon/Cadillac, Inc. 100%
TOTAL for Beta Epsilon/Cadillac, LLC
24.75%
24.75%
35.00%
7.50%
7.50%
0.50%
100.00%