Jennifer McConney - 1600 Collins Avenue, LLC 'n•'„VVVV���� 4,� Y
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City of Miami Beach Office of the 6ity Clerk r° 0 0
1700 Convention Center Drive, MiggjggRqc�b F� 13 $
LOBBYIST REGISTRATIQ ..FORM
Lobbyist means all persons employed or retained, whether paid or not, by a princip t se�e �`tb��iourage 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.
McConnev Jennifer
NAME OF LOBBYIST: (Last) (First) (M.I)
Kobi Karp Architecture 2915 Biscayne Blvd, Suite 200, Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)573-1818 (305) 573-3766 imcconney(cDkobikarp.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:
1600 Collins Avenue, LLC
NAME OF PRINCIPAUCLIENT:
1065 Kane Concourse, Suite 201 Bay'Harbor Islands FL 33154
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)866-7555 (305)866-7515 robertCaD-finvarb.com
TELEPHONE NUMBER: FAX NUMBER`.(Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Robert Finvarb
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached
II.SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for one hotel project located at 1600 Collins Avenue, Miami Beach.
Issue to be lobbied(Describe in detail):
lll. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2482(a)(4)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.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Staff of Planning Department, Building Department,and Public Works None X
De artment
PB, HPB, BOA,FP,City Commission,as necessary* None X
Pursuant to City Code Section 2-482(8)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 Any Financial, Familial or Professional Relationship
None
*Unless an issue is legislative in nature,PB,HPB,BOA,&City Commission members are not lobbied outside of a public hearing setting.
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Formrevised 5-30-2012.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): a
(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 oresent or ognding bid for goods.eguipment or services.or on a present or pending
awa_goods,eguioment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbying on a oending application for a Develooment Agreement with the Citv_or application for
change of zoning mao designation or change to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2-482(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 Non Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON EEBR1 ARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
QA111 1LIajj1NG LQBBYING EXPENDITURES, AS WELL AS COMPEN EIMED. IN THE CITY OF MIAMI BEACH
FM JHE PRECEDINQ CALEbj12AR XEAR. __A S I BE FILED EVEN IE THERE HAVE BEEN NO
EXPENDITURES OR rgObdPENjJAjIObj DURIbIG TIJE rG &
Signature of obbyents.
1 do solemnly swear that all of a fore g g fa s re true and correcthat I h e,.-d or am familiar with the provisions contained
in Section 2-482 of the Miami B ach C' Co e d all re requir
Signature of Lobby t: `
Signature of Principal/ n
VI. LOBBYIST IDENTIFI ION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
P o N 9own(Ldb fttrjkkKr1UFF Personally known
Notary Public
State of Florida
VI •: »•= My Comm.Expires Apr 3,201? SIGNATURE AND STAMP OF
Commission # EE 179221 CAW-
(Principal)
NOTARY: F °' Bonded Through National Notary a�°
State of Florida,County of Miami-Dade State of Florida, County of Miami-Dade a
Sworn to_ and subscrib before me Sworn and subsc ' ed before me
Thi da of 2012
This day o ,20? y
IW)yn ,P
fit
Signature of lic Notary—State of Florida Signs re o lic Notary—State of Florida
Notarization of Lsignature Notar zatio Prin®signature
Annual Registration fee: [ ]Yes ]No Amount Paid$�V '00 MCR � r y Date Paid
/\AIAMI BEACH
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: Jennifer McConney
I understand that no later than February 28 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, or I am no longer
lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's
Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who
fails to timely file a Statement and in addition to any other penalties which may be
imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appeals a ami-D de County Commission on Ethics and Public Trust.
ignature: Date:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
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