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Ralph Choeff - Robun Transport M, IAMI BEACH 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. Choeff Ralph NAME OF LOBBYIST: (Last) (First) (M.I) Choeff+Levy P.A., 8425 Biscayne Boulevard, Suite 201, Miami FL 33138 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-434-8338 x 111 rchoeffii)choefflevu.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: Robun Transport Vice President of Lost and Found Production. LLC NAME OF PRINCIPAL/CLIENT: 810 Seventh Avenue, 7th Floor New York New York 10019 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (212)275-1525 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:Ken Lerer, 100%Owner • 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, Board of Adjustment, Planning Board, Land Use Development Committee, and City Commission, if necessary, relating to the property located at 33 E. DiLido Drive, Miami Beach, Florida. Issue to be lobbied(Describe in detail): iii. CITY AGENCIESANDIVIDUALS 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,st ting 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, Building and Public Works staff None. PB, DRB, BOA, City Commission, and Land Use None. Development Committee, as necessary Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial gurofessional relationship,or other relationship giving rise to an appearance of an Impropriety,with any current city commissioner or city pe sonnel who Is sought to be lobbied as identified on the lobbyist registration form filed. r Sec 2-482(g)Any Financial, Familial or Professional Relationship -_ IVone- None. 71 -_. . � a C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Restration Formrevised 5-30-2012.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OFF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) 1,-1 ! /hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): y /hour (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_XNo: Are You lobbying on a present or pending bid for aoods.equipment or services.or on a present or oendina award for goods.equipment 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 lobbAno on a nendino-application for a Deyelor[2rraen+Agree_Ment with the City or application for change of zoning map designation or change to the City's Future Land Use Map2 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 representina 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 E92 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 IDENTIFIC�TION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification —Personally known(Lobbyist) P r so n I ly known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida,County of Miami-Dade State of. a, County of Sworn to and subscribed before me Sworn a Vbscribe before me This day of .12013 Thi Way of v t , 20# A Z'J��Y\\'-, Signature of Public Notary—State of Florida Si f Pu is Nota —State Notarization of Lobbyist's signature Notariza ion of Principal's signature TO BE COMPLETED BY CITY CLERK' STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Dgte Pai Lobbyist Registration Form received and verified by: v BARBARA ROTH .Notary No.01,R06065076gew York Qualified In Nassau County Commission Expires October 29, 20 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required)$ 11 '5 _/hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $__1 1 hour (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)C4o: Are you lobbying on a present or nendina bid for goods,eauipment or services_or on a present or nendina award for goods,equipment 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 lobbying on a uen=n0lication for a Development Agreement with the City or a0l2lication for change of zoning map 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 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, C� Z ENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE r%%,f 54*W.11 %-A PERIOD, Sign Sure 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 B 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) Personally known(Principal) VII. SIGNATURE AND STA ..•;�` 1,,, State of Florida, County of Miami °s STEPHEN PARKA Not,ry Public-State of Florida State of Florida,County of Miami-Dade Sworn to and subscribed before My Comm.Expires Jul 9.2018 Sworn and subscribed before me This r day of ✓ Commission ar FF 140358 This day of ,2013 hp ios Signature jof Pbblit Notary-State of Florida Signature of Public Notary-State of Florida Notarization of Lobbyist's signature Notarization of Prin=signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# -' Date P id Lobbyist Rec listration Form received and verified by: v MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfi.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. e-ci Zo L j Si ature: ate: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc n CL amok tv P - - 4 ti- w Cl i 3 CeA - �17 1