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Ralph Choeff - Peter R. Kassabovr to MIAMI BEACH Office of the City �1 City of Miami Beac h O y 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. Choeff Ralph NAME OF LOBBYIST: (Last) (First) (M.1) Choeff+Levy P.A., 8425 Biscayne Boulevard, Suite 201, Miami FL 33138 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-892-6262 x 11 rchoe[E&hoefflevU.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: Peter R. Kassabov NAME OF PRINCIPAUCLIENT: 851 Virginia Drive Winter Park FL 32789 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (407) 467-5688 peter(;*assabov.net 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: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: Development Approvals and Permitting Issues, including, but not limited to Design Review Board, Planning Board, Board of Adjustment, Land Use Development Committee, and City Commission, if necessary, relating to the property located at 721 East Dilido Drive, Miami Beach, Florida. 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 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 Planning Staff, City Commission, Development None. Boards, Land Use Development Committee None. land Commission as necessary None. 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 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) /hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). /hour 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)CNo: Are you lobbying on a present or pending bid for goods.eauioment or services.or on a present or pending award for goods.eguipment or service? 2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes XNo: Are you lobbying on a pending application for a Development_Aareement with the City or application for Ghnange of zoning map desianation 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 XNo• Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: =ti 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 EM 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: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) X Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida, County of Orange Sworn to and subscribed before me Sworn and subscribed before me This day of ,2014 This.AZth day of April ,2014 Signature of Public Notary—State of Florida Signatur f Public Notary—St at Florida Notarization of Lobbyist's signature Notariz ion of :.►. " CHEPvt, ,t; BRANSFORD TO BE COMPLETED BY CITY CLERK'S STAFF O LY MY r.;(`tpytr;;:.;,::+;'lN#EE194170 Annual Registration fee: Yes No Amount Paid$ MCR# !° ate 9� I'--l I ] Lobbyist Registration Form received and verified by: ; % 14M lostg3 rvSEfvlCe COm i f' r IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required)SJ11 S/hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED)] Cnhour 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 vending bid for aoods.equipment or services.or on a present or oendina award for aoods,eauipment or service? 2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes)No: Are you lobbvina on a oendina agoiication for a DeveloomentAareement with the City or anolication for change gf zoning man designation or change to the City's Future Land Use Maul 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)No: Are you representina a not-for-profit coruoration 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 EM THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR A AL Signature of Lobbyi 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 Bea ity Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: TOW VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification \\,,,,, SO�`,,, Form of Identification Personally known(Lobbyist) �,, : �Uns 'rte .0� Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTAMP:V /�•�1 �l State of Florida, C m 'y of Miami-Dade �;•; y° ` State of Florida, County of Miami-Dade Sworn to and sub ribed before me '//i�� �•.;•,.••°°* Sworn and subscribed before me This d y of , 2014 ��0®Beo©FROAM-�#\ This day of ,2014 Signature blic Notary—State of Florida Signature of Public Notary—State of Florida Notarizatpon of Lobb3d st's signature Notarization of Prnal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual RaglQtration fees- r I Yes I I Nn Amount Paid$ MCR It natts Paw Lobbyist Registration Form received and verified by: /\AIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.nilamlbeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Ralph Choeff 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. Igor—,"&In Signature: D e: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc L. IL tN' CL LU s : Gi r f LU -a LL LL wo cc _.4 p CL es a IL - J I ) 1 3ra Nllo Salvatore, Jason T rtrr. From: Ralph Choefi<rchoeff @clfarchitects.com> Sent: Thursday, August 18, 2016 12:06 PM To: Salvatore, Jason Cc: CLF Architects Subject: Ralph Choeff lobbyist letter received Attachments: Ralph Choeff Lobbyist.pdf Dear Jason, In your letter dated 7/29/2016 you ask what compensation was received or will be received for the following projects: 1. 114 3rd Dilido Terrace Principal: Florian Depenthal Cindy Melk 2. 835 E. Dilido Drive Principal: AML Investment IX LLC / Andrew Lessman 3. 721 E. Dilido Drive Principal: Peter R. Kassabov I have and will not receive any compensation for these projects in regards to lobbying. Thanks, Ralph Choeff Principal CHOEFF LEVY FISCHMAN A R C 1=I I T E C `r U R E + D E S U G N 8425 Biscayne Blvd.Suite 201 Miami, FL 33138 (t)305.434.8338, Ext. 111 (f)305.892.5292 rchoefflnclfarchitects.com www.clfarchitects.com • 1