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Jennifer McConney S&S Properties 1 ..A„,,' r e1I q th) B ot ( MANI L.,mv4..... f ' Apr ' ' ik A I ' 11: A ife". . i , 1.--wki Nur , )e )44°1 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, 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) Kobi Karp Architecture 2915 Biscayne Blvd, Suite 200 Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 573 -1818 (305) 573 -3766 kobikarpkobikarp.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: S & S Properties; contact: Avraham Sibony, managing partner NAME OF PRINCIPAL /CLIENT: S & S Properties 12501 Coastal Highway Ocean City Maryland 21842 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (410) 250 -8200 (410) 250 -8274 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: Avraham Sibony, managing partner • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Partners: Avraham Sibony (25 %); David Sibony (25 %); Prosper Sibony (25 %); and Yaron Sibony (25 %). II. SPECIFIC LOBBY ISSUE: Development approvals for renovation and partial demolition of, and addition to the 1- and 2 -story buildings on the west side of 919 Collins Avenue for a retail establishment Issue to be lobbied (Describe in detail): III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual /Title B) Any Financial, Familial or Professional Relationship Planning Department Staff, HPB, BOA, Planning Board and City Commission* None 33W0 S. 313 Ain IS 'iWJ IN VI1�Z 03A13038 * Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a public hearing setting. • . 2 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, � ` FLAT RATE OR OTHER): DISCLOSURE: (Required) a' F144 A) LOBBYIST ( q ) $ B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ X 000 Fidget / The following information must be answered: • 1) Pursuant to Miami Beach City Code Section n 2 -488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ■y- X N.: Ar- • o.. . n. •n�• •r _ en or _ - n � .in. bi• f•r .O• .s e•ui.m-n •r ervi es or on - � _ � o -n •r ! -n•in .war. fr is.. e. i•m - n- •rs e. 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues ": _ . - li - . i • n f • r a Develo • ment Agreement with the City or ❑Y N•: Ar- • I•b• in. •n . n in a application f • r change of zoning map designation or change to the City's Future Land Use p 9 Map? Any person (except those exempt from the definition of 3) Pursuant to Miami Beach City Code 2 -484 (h ) Y p of snot- for - profit corporation representative "lobbyist" as set forth in Section 2 -481 above) who only appears as a re p whether direct, or indirect, to express support of o r opposition or entity without special compensation or reimbursement for the appearance, b this to any item, shall register with the clerk as required y section but, shall not be required to pay any registration fees.. • not-for-profit corporation ❑ Yes X No: Are you representing snot- for -prof t oration or entity without special compensation p or reimbursement. V. SIGNATURE UNDER OATH: s�' EACH LOBBYIST SHALL SUB ON OCTOBER 1 OF EACH YEAR, EAC SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE STATEMENT E CITY OF MIAMI BEACH FOR THE PRECEDING CALEN 0 AR Y . R. A _ SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURE • ' - C ! ' E ■ TION DURING THE REPORTING PERIOD. Signatur; of Lobb ; st -� d that - ' _ � � -ve read or am I do solemnly swear that all of the foregoing facts are true and correct familiar with the provisions familiar ' ' ns cos - • in - ction 2 -482 of the Miami Beac City Code and all reporting requirements. , AO/ Signature of Lobb ist: , , Pi' _ i gnature of Principal ' - : r VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: P ID ❑ Produce! , *,. . ❑ o� � mofI Form of Identification ��•►..••••••••...,• Etaoui s oy *r w :. . HOTA PUBL Personally known er` allr rinci► t e r Co V Pe y (Lobbyist) C �\ s`%o OTARY: pu State of Maryland SIGNATURE AND STAMP OF N �•• M� Comm; on Expires VII. �u,► _ on�aa1 v 2011 State of Florida, County of Miami-Dade State of Maryland, County of orce r Sworn to and subscribed before - Swim an subscribed before me S --� %� May of 12 E e-- , 20�. 0 5 11 - This �, � day of - 13 _ ry pub1l • state c1/49 t 3 - - a X I les : • ig ture of Public Notary — State of Maryland • . ure • P c Not K.,.:,......1pritk* ..� co ,� rn . E p 8 ,. .;; • - of Principal's signature Notari t' - of Lobbyis 1: r .U :;, ; • , _ My �s�on *NB" . ization nature r. o p 9 14 t o C °m s ��,h N�t�ona, Notary, � ''�•.,°rtit: ' ' , - ERK'S USE ONLY II • � C� MCR # _ ©� ► � Date P- id 1 �- Annual Registration fee: [ �] - o Amount Paid `�. ,, ;. / , Registration Form received and verified R Lobb � � � —' ! Entered 6 : � - ' ,,.t Lobbyist egistrfied by: : . �_� y . = ` " y F: \CLER \$ALL \MARIA -M \Lobbyist \LOBBYIST fORM 05.doc Revised 12/08/.4 ... 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 LOBBYIST NN i f I NAME: I understand that no later than February 28th of each year, I must file the foliowing form !y Y � , pursuant P to Section 2 -485 of the Miami Beach' City Code, with the City lerk's Office for all active Iobbying � issues. 1) Lobbyist Ex and. Compensation Form Expenditure p Failure to file these forms on a timely basis will result in my name being transmitted to th y y the Miami Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, l g y o ved, l am required to immediately notify the City Clerk's Office of . Iobbyist withdrawal in writin g Sig s ure: Da e.