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Michael J. Marrero - Luis Rinaldini 1. MIAMI BEACPI 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. Marrero Michael J. NAME OF LOBBYIST: (Last) (First) (M.1) Bercow Radell & Fernandez, PA 200 South Biscayne Blvd., Suite 850 Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 (305) 377-6222 mmarrero(d)brzoninglaw.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: Luis Rinaldini NAME OF PRINCIPAUCLIENT: Groton Partners 640 Fifth Avenue New York New York 10019 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) _(212) 430-1801 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL:(Optional) C-11 Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: Development Board Approvals 1150 8th Street, Miami Beach, Florida Issue to be lobbied(Describe in detail): r: --1 III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED,: Pursuant to City Code Section 2-482(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 Tanning Department and Building Department Staff None X B, HPB, BOA, City Commission, as necessary* None 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 curren,'ty.-corlimissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. �{q Sec 2-482(g)Any Financial, Familial or Professional Relationship None C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration 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) $425 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $425 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 uresent or pending bid for goods.eauioment or ser0 ces. or on a nresent or pending award for goods,eauioment 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 pendina application for a Development Aareement with the City or application &change of zoning map designation or change to the City's Future Land Use Mao2 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 No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: nil EERRI➢ARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER QATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH MI IIJE PRECEDING C EXPENDITURES OR Signature of Lobbyist I do solemnly swear that all of the foregoing fac ar and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Mi eac a all repo requirements. Signature of.Lobbyist: Signature of Principal/Client: 4NZ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: o •a0' PTo roduced ID Produced ID Form of Identification s.st`° Form of Identification c Personally known (Lobbyist) o Personally known(Principal) a,M®o 3 VII. SIGNATURE AND STAMP OF NOTARY A a:01 Q " 3 Pik y (n .�.�a) Cr State of Florida, County of Miami-Dade o 6 State of Florida, County of Miami-Dade o y y Sworn tp nd subscribe foe e N °' Swo and subscribe r me Ch m a This da o Ovar ,2014 A ° Thi 0 day of V ,2014 m 9. CL m m o W� m Signature o ublic Notary—State of Florida Signs re of ublic Notary—State of Florida Notarization f Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ON Y f Annual Registration fee: [ ]Yes[. ]No Amount Paid$ MCR# �. � Date id ( l f Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc F:\CLE istration Form.d6c Revised 04/27/2012 1\A [A "0 1 B IE A%,..o H City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamlbeachfl.gov CHN CLERK Office Rafael E. Granado, City Clerk CityClerkumiamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LO B B Y IS T NAME Michael J. Marrero 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 appealed to the Miami-Dade County Commission on Ethics and Public Trust. o1o�y Sig ature: Date(- C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc i CL CL CL td :: .. .gym N ` ' Y - F - - Exhibit B Name Address %of Stock David B. Dillard 614 she Street,Key West,FL 33040 14.29% Envisioneering Investment Corp. 12430 Tesson Ferry Road 4309, o St.Louis,MO 63128 9.52/0 Howard Kaufman Living Trust 10866 Wilshire Boulevard,#200, o Los Angeles,CA 90024 9.52/ Howard Rose Agency,9460 Melissa Rose Wilshire Blvd,Suite 310, Beverly 9.520 Hills,CA 90212 _ Luis Rinaldini 151 Post Road,Old Westbury, NY 11568 7.14% Gavin J. Parfit 150 East 77th St,Apt 5A, New York, NY 10075 7.14% AWN Holdings 11 LLC 660 Madison Avenue,15 floor, New York,NY 10065 7.14% Howard J. Kapp 1255 Spyglass Ln, Naples, FL a 34102 4.76/0 Arnold E.Spangler 1165 Park Ave,Apt 9B,New York, _ NY 10128 4.76% Annabelle Robbins 3 Hyerdale Court,Goshen,CT 06756 4.76% Judah Schorr 2 River Crest Road, Bronx,NY 10471 4.76% Victor Ozeri 52 East End Ave,Penthouse 3, New York, NY 1028 4.76% Star Navigator Investments Ltd. 6 East 46th St,#300, New York, o NY 10017 4.76/0 Isaac&Judith Koziol,JTWROS 729 Woodson PI, Manakin-Sabot, VA 23103-3162 3.57% Michael& Nancy Koziol,JTWROS 45 26th Street NW,Atlanta, o _ Georgia 30309 2.38/0 Daniel Robbins 207 2nd St 416, Hoboken, NJ 07030 1.19% Total: ,� 100.00%