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Robert S. Fine - Green Comet, LLC M Am EAchi (k_ep-d City of Miami Beach Office of the City Clerk REC P V E► 1700 Convention Center Drive, Miami Beach, FL 33139 2011 OCT - Aft { LOBBYIST REGISTRATION FORM �• Q 7 Y , � Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the p ge , {e t: 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. Fine' Robert S. NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig 333 Avenue of the / mercias, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 - 579 -0826 305 - 961 -5826 finer @gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e address. I. LOBBYIST RETAINED BY: S ESN/ 6tr hfhtchei NAME OF PRINCIPAUCLIENT: Green Comet, LLC 350 Ocean Drive Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) g iIl out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: s 8 • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE• the Wave, 35' ace,* Pti Planning & Zoning, Historic Preservation, Building, Floodplain and Fire Codes, Public Works and Associated Approvals Issue to be lobbied (Describe in detail): lll. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2- 482(ax4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered into any 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. 1 Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied City Attorney, City Manager office, Building Official and desig, x Planning Director and desig, Fire Marshal and desig X Public Works Director and desig. X 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 None , IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) MN) nPr hntir B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). shh() nPr hnur 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 ® 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 ": 1 ❑ Yes ® No: Are you bbbvina on a pending application for a Development Agreement with the City or applicati on 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 IA No: Are you representing a not- for - profit corporation or entity without special compensation or reimbursement . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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 d all r din r • Signature of Lobbyist: , �.... •' c Signature of Principal /Client: 4.4 411k, VI. LOBBYIST IDENTIF ' TION: PRINCIPAL IDENTIFICATION: ❑ Produced ID 0 Produced ID Form of Identification Form of Identification Personally known (Lobbyist) Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Da •,-- State of Florida, County of Miami -Dade 'a and bscrib before me �°' °W* Notary Public State of Florida Sworn and subscrib d before me This This v • ay of , 2 t . Sergio Fernandez This la day of ` .i , 2011 % 1 , , Q oR a My Commi / 13/2015 - � ` s E A E* 07 � `i `�' PuN Signature of l ublic Notary – State of Florida i • ature of Public Notary – S ' d %ergid F ernan d ez ic State of Florida Notarization of Lobbyist's signature Notarization of Principal's si - - I My Coremiss(on EE112059 i J or aX Expires' 07/13/2015 TO BE COMPLETED BY C TY CLERK'S STAFF ONLY A Annual Registration fee: : es [ ] No Amount Paid : V , ar MCR : :Ilk I a • Date Paid 101171 ZO // Lobbyist Registration Fo received and verified by: ; :r7� e F: \CLER \$ALL\aFORMS \LOBBYIST FORMS \Lobbyist Annual Registration Form.doc Revised 1/11/2011 Exhibit A The property which is subject of the application is owned by GREEN COMET, L.L.C., a Limited liability company existing under the laws of the State of Florida, 350 Ocean Drive, Miami Beach, FL 33139 Managed by: Alessandro Ferretti, 300 South Pointe Dr., Miami Beach FL 33139 Diego Ferreyra, 350 Ocean Drive, Miami Beach FL 33139 Mateo Salinas, 350 Ocean Drive, Miami Beach FL 33139 Members of Green Comet LLC are: GREEN COMET `a?, L.L.C., a Limited liability company existing under the laws of the State of Florida, 350 Ocean Drive, Miami Beach, FL 33139 46.67% whose partners are: - Ferfour Inc., a Florida corporation 2039% of GCII = 9.51% of GC 350 Ocean Drive, Miami Beach, FL 33139 President, Secretary, Treasurer, Alessandro Ferretti Owned by: Alessandro Ferretti, 300 South Pointe Dr., Miami Beach - Aquire USA Inc., a Florida corporation 38.47% of GCII = 17.95% of GC 350 Ocean Drive, Miami Beach, FL 33139 President, Secretary, Treasurer Roberto Bianchi Owned by: Aquisitio S.p.a., an Italian Company Ultimate ownership interest: Roberto Bianchi Via Ansperto 10, Milano -Italy - Dryshore Inc., a Florida corporation 25.01% of GCII = 11.67% of GC 350 Ocean Drive, Miami Beach, FL 33139 ► President Andrea Secco; Secretary, Treasurer Lorenzo Secco Owned by: Andrea Secco and Lorenzo Secco Via Guizzetti 73, Dosson di Casier, Treviso, Italy -Prospecto International Inc., a Florida corporation 16.13% ofGCII = 7.52% of GC 119 Washington avenue Suite 101, Miami Beach, FL 33139 President Renato Rangoni; Secretary Daniel Goldstein; Treasurer Fulvio Tettamanti Lifin S.A., a Luxembourg Company 8 Rue Dicks, L1417 Luxembourg Ultimate ownership interest: Rento Rangoni 8 Rue Dicks, L1417 Luxembourg And ETSA HOLDINGS 1, L.L.C., a Limited liability company existing under the laws of the State of Florida, 350 Ocean Drive, Miami Beach, FL 33139 53 .33% whose beneficiary owners are: Diego Ferreyra, 350 Ocean Drive, Miami Beach FL 33139 Mateo Salinas, 350 Ocean Drive, Miami Beach FL 33139 26.67% of GC 26.67% of GC e MIAMIBEACH - 1 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Robert S. Fine, Esq. 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. ClAr Lo ll Signature: Date: