Les Beilingson - 1790 Alton Holdings, LLC •
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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.
Beilinson Les
NAME OF LOBBYIST: (Last) (First) (M.I)
Beilinson Gomez Architects, PA 8101 Biscayne Blvd, Suite 309 Miami Florida 33138
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 559 -1250 (305) 551 -1740 idbt&beilinsonarchitectspa.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
I. LOBBYIST RETAINED BY:
1790 Alton Holdings, LLC — Nathanael Cohen, Manager
NAME OF PRINCIPAL/CLIENT:
1790 Alton Holdings, LLC 2337 NW 5"' Avenue Miami Florida 33127
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
•
(800) 606-7319 (866) 836-5751
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
ctso
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2 -482 (c)} i L.
C7 —
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Nathanael Cohen, Manager f"— T
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH 1
CORPORATION, PARTNERSHIP OR TRUST: Nathanael Cohen (33.33 %); Yonef Fellous (33.33 %); and Steve W. Athea 0 77
(33.33 %). CI i
C)
II. SPECIFIC LOBBY ISSUE: r rn
Development approvals and permitting issues for property located at 1790 Alton Road. CD W
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2- 482(a)(4) include the commissioner of personnel sought to be lobbied, and whether the lobbyist
has entered into contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding
such person's commencement of service with the city to the present date, stating the general nature of the subject contractual
relationship.
Sec 2482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES I NO
title of person to be lobbied
Planning Department and Building Department None X
Staff
DRB, BOA, City Commission, as necessary* None X
I j
Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or
professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner
or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2- 482(g) Any Financial, Familial or Professional Relationship I •None.
* Unless an issue is legislative in nature, DRB, BOA, & City Commission members are not Lobbied outside of a public hearing setting.
i
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATEOR
OTHER)
°
A) LOBBYIST DISCLOSURE: (Required) $ L-.
co
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 2 5
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2 - 488 Entitled "Prohibited Campaign Contributions By Lobbyists On
Procurement Issues ":
L Yes X No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or
pending 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 lobbying on a pending application for a Development Agreement with the City or application
for change of zoning map designation or change to the City's Future Land Use Map?
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 a not - 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 required by this section but, shall not be required to pay any registration fees..
[1 Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or
reimbursement
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF
MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN
NO EXPENDITURES OR COMPENSATION DURING T • 0 NG PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the
provisions contained in Se 14 - 'of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
V At
Signature of Principal /Client:
VI, LOBBYIST IDENTIFICATION: iPRINCIPAL IDENTIFICATION:
Produced ID ° o •roduced ID a•“.ir l \CDUL IJ_ -•
Form of Identifiicati. > F ,. Form of Identification
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'
Vii( Personally known (Lobbyist) ° z 3E `,, *y .0
,., ° • Personally known (Principal) , ;: WErsYs ion SANDOVAL # EE 68807.
> ,n = ` Commiss
VII. SIGNATURE AND STAMP OF NOT $ i � My Commission Expires
,u ' r % ? °F February 28, 2015
CC Cf.
State of Florida, County of Miami -Dade < o E 1- tate of Florida, County of Miami -Dade
Sworn to and subscribed before me '° c Sworn and subscribed before me
This 1th day of 3Ucj , 2011 z a $ is R- day - ki 2 J t
A 51C4 ;>�
Signature of Public Notary — State of orida r' _ � l g Signature of ublic Notary — fat of Florida
Notarization of Lobbyist's signs re .;" . 4i Notarizatio of Principat signature
FOR E • K'S USE ONLY. 7 • •
Annual Registration fee: [ ] Yes [ ` ] No Amount Paif�, 3 510 MCR # ? f/ Date Paid + J F
Lobbyist Registration Form received and verified by: . .71 / / � Entered By: �r.� z-R / '
Reined 1/11/2011
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER)
A) LOBBYIST DISCLOSURE: (Required) $ 23.15
00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ �
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2 -488 Entitled "Prohibited Campaign Contributions By Lobbyists On
Procurement Issues ":
❑ Yes X No: Are you lobbying on a present or pending bid for goods. equipment or services, or on a present or
pending 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 lobbying on a pending application for a Development Agreement with the City or application
for change of zoning map designation or change to the City's Future Land Use Map?
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 a not - 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 required by this section but, shall not be required to pay any registration fees..
❑ Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT
UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF
MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN
NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the
provisions contained in Section 2 -482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal /Client: A ill . 911111 .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID L- Produced ID _D civar \AP( 2_
Form of Identification Form of Identification
Personally known (Lobbyist) Personally known (Principal) � WENDY SANDOVAL
4 0,1 *� Commission # EE 68802
,�; My Commission Expires
VII. SIGNATURE AND STAMP OF NOTARY: February 28, 2015
State of Florida, County of Miami -Dade State of Florida, County of Miami -Dade
Sworn to and subscribed before me Sworn and subscribed before me
This day of , 20_ This T- day _ 20 l
Signature of Public Notary — State of Florida Signature of ublic Notary —736t; of Florida
Notarization of Lobbyist's signature Notarizatio of Principal�stgnature
FOR CLERK'S USE ONLY r Y
Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # // Z/ Date Paid
Lobbyist Registration Form received and verified by: Entered By: "2--z{
Revised 1/11/2011
City of Miami Beach, 1700 Convention Center Drive, Miamr Beach, Florida 33139 www.miamEbeacnf! yov
CITY CLERK Office CiryCierk @miamibeachfi gov
Tel- 305 673 741 i , Fax 305 673.7254
LOBBYIST NAME: Les f' l w Tcsn
understand that no later than February 28th of each year, I must file the following form, pursuant
to Section 2 - 485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying
issues.
1) Lobbyist Expenditure and Compensation Form
Failure to file these forms on a timely basis will result in my name being transmitted to 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, i am required to
immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
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Signature: Date: