Charles H Benson - MBeach1, LLP vijio 111 )()
r r,„I V
City of Miami Beach Office of the City Clerk \ %2 a (t, PC
1700 Convention Center Drive, Miami Beach, FL 33139 b
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.
Benson Charles H.
11..8ft/lE OF LOBBYIST: (Last) (First) (M.I)
Charles 1-i .Benson &Associates,
Architects,P.A. 1665 Washington Avenue,2nd Floor,Miami Beach,FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)532-6161 (305) 532-6151 carkitect3 @aol.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:
MBeach l,LLLP
NAME OF PRINCIPAL/CLIENT:
1111 Lincoln Road,Suite 760 Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)538-9320
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:
Robert Wennett
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached Disclosure of Interest
ii.SPECIFIC LOBBY ISSUE: All development issues related to 1111 Lincoln Road, 1665 Alton Road, 1666 Lenox
Avenue.
Issue to be lobbied(Describe in detail):
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/Historic Preservation/Design/Board of Adjsument 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 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 I '
F:ICLER\$ALL1aFORMSILOBBYIST FORMS\Lobbyist Registration Fomm.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $275.00/hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $275.00/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 XNo: 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 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 Agreement with the City or application 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.
YesXNo: 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 C RENS ON C VED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL E FILE E14 Ij
TH RE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
li
Signature of Lobbyist Charles H. Benson
I do solemnly swear that all of th fore oin; f. is are rue and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami B ach C'y Co•Ir,an.. all -••rting requirements.
Signature of Lobbyist: -
Charles H.Benson — �... ------
Signature of Principal/Client: -•- -' °"�
t
Robert Wenne — '
VI. LOBBYIST IDENTIFICATION: G hctf kti . lk ili'°f--" PRINCIPAL IDENTIFICATION:
es I-- F., JR.. w. -■■- e ,•';Produced ID ", —° `"I i' Produced ID a• Y F a' O co *-
Form of Identification = o c m g Form of Identification 2 "
• Z ' W : 00 0
Y is' W m O c O 2,6
✓ Personally known(Lobbyist) �:' =pp, personally known(Principal) Y W
Q .y.- al .Q = ' Q h m f
[t v, C
VII. SIGNATURE AND STAMP OF NOTARY:'„. g d E E ', . W y • ``
.- 0 E a d E i r
State of Florida, County of Miami-Dade o o A State of Florida, County of Miami-Dade a... c
Sworn to and bscribed before me z Sworn and subscribed before me c Ca.3
�.,,,,,,
T.is da f'December 201 4 - lici:lisrotort Aliii 2nd e . of Mcember , 201 4 ' g 2
IMIFIIH*rGAZU.Q.A- • '. la' riLlriel. , ,,,,,,wifk,
Signatu of Public Notary—State of Florida ,o 4 pr 4:�' Signature • Public Notary T State of Florida ;le�:;=�j
a ,
Notarization of Lobbyist's signature Notarization of Principal's signature -,r; �;.
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r ”,
Annual Registration fee: [ ]:Yes[ No Amount Paid$ _'.40 • CO MCR# ,S4oca� I :Date Paid �- d- I .
Lobbyist.Registration Form received and verified by:, f' , M diu /.Y y use �+ .
;c s. t '� ,�a t.. t aya �a rai Revised 01/22/2014
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Fomi.doc
1.
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Charles H. Benson
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 of each year, shall be
• automatically suspended from lobbying until all fines are paid, unless the fine has been
appea) o t -3- • Dade County Commission on Ethics and Public Trust.
t
12/2/2014
Signature: Date:
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
•
CITY OF MAIM! BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
•
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of the application is owned or leased by a CORPORATION, list the
principal stockholders and the percentage of stock owned by each. Where the principal officers or
stockholders consist of another corporation(s), trustee(s), partnership(s) or other similar entity, further
disclosure shall be required which disclosed the identity of the individual9s) (natural persons) having the
ultimate ownership interest in the entity).*
MBEACH1 GP, LLC, a Delaware limited liability company
CORPORATION NAME
NAME,ADDRESS,AND OFFICE %OF STOCK
URBAN INVESTMENTS ADVISORS, LLC, a Delaware limited liability company, 100%
the Sole Member of MBeachl GP, LLC, a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
MBEACH1 INVESTORS GP, LLC, a Delaware limited liability company
CORPORATION NAME
NAME,ADDRESS,AND OFFICE %OF STOCK
URBAN INVESTMENTS ADVISORS, LLC, a Delaware limited liability company, 100%
the Sole Member of MBeachl Investors GP, LLC,
a Delaware limited liability company •
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
URBAN INVESTMENTS ADVISORS, LLC, a Delaware limited liability company
CORPORATION NAME
NAME,ADDRESS,AND OFFICE %OF STOCK
WELLSPRING INVESTMENTS MANAGEMENT I, LLC, a Delaware limited liability 1%
company, the Managing Member of Urban Investments Advisors, LLC, a Delaware
limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
WELLSPRING INVESTMENTS MANAGEMENT Ii, LLC, a Delaware limited liability 99% •
company, the Managing Member of Urban Investments Advisors, LLC,a Delaware
limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
M1AM[963391.1 7613422013 9
09/23/2014
WELLSPRING INVESTMENTS MANAGEMENT I, LLC, a Delaware limited liability company
CORPORATION NAME
NAME,ADDRESS,AND OFFICE %OF STOCK
ROBERT S.WENNETT,TOD ROBERT S.WENNETT REVOCABLE TRUST, 0.5%
.5/o
the Managing Member of Wellspring Investments Management I, LLC,
a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
ROBERT S.WENNETT REVOCABLE TRUST, the Managing Member of 99.00%
Wellspring Investments Management I, LLC, a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
MARIO CADER-FRECH REVOCABLE TRUST, a Member of 0.5%
Wellspring Investments Management I, LLC, a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
WELLSPRING INVESTMENTS MANAGEMENT IIi LLC, a Delaware limited liability company
CORPORATION NAME
NAME,ADDRESS,AND OFFICE %OF STOCK
ROBERT S.WENNETT,TOD ROBERT S.WENNETT REVOCABLE TRUST, 0.5%
the Managing Member of Wellspring Investments Management I, LLC,
a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
ROBERT S. WENNETT REVOCABLE TRUST,the Managing Member of 99.00%
Wellspring Investments Management I, LLC, a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
MARIO CADER-FRECH REVOCABLE TRUST, a Member of 0.5%
Wellspring Investments Management I, LLC, a Delaware limited liability company
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139.
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S)AND
EACH INDIVIDUAL'S NAME,ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE
PAGE.
NOTE:Notarized signature required on page 13
MIAMI 963391.1 7613422013 10
09/23/2014
CITY OF MAIM! BEACH •
DEVELOPMENT REVIEW BOARD APPLICATON
DISCLOSURE OF INTEREST
2. TRUSTEE
If the property which is the subject of the applications owned or leased by a TRUSTEE, list the
beneficiaries of the trust and the percentage of interest held by each. Where the beneficiary/beneficiaries
consist of corporation(s), another trust(s), partnership(s) or other similar entity, further disclosure shall be
required which discloses the identity of the individual(s) (natural person) having the ultimate ownership
interest in the entity.*
ROBERT S.WENNETT REVOCABLE TRUST
TRUST NAME
NAME,ADDRESS AND OFFICE %OF STOCK
ROBERT S.WENNETT TRUSTEE 76,30711%
1111 LINCOLN ROAD,SUITE 760,MIAMI BEACH,FL 33139
MARIO CADER-FRECH REVOCABLE TRUST
TRUST NAME
NAME,ADDRESS AND OFFICE %OF STOCK
MARIO CADER-FRECH TRUSTEE 15.46193%
1111 LINCOLN ROAD,SUITE 760,MIAMI BEACH,FL 33139
3. PARTNERSHIP/LIMITED PARTNERSHIP •
If the property which is the subject of the application is owned or leased by a PARTNERSHIP or LIMITED
PARTNERESHIP, list the principals of the partnership, including general and limited partners. Where the
partner(s) consist of another partnership(s), corporation(s), trust(s) or other similar entity, further
disclosure shall be required which discloses the identity of the individuals) (natural persons) having the
ultimate ownership interest in the entity.*
MBEACHI, LLLP, a Delaware limited liability limited partnership
PARTNERSHIP or LIMITED PARTNERSHHP NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
MBEACH1 GP, LLC, a Delaware limited liability company, the General Partner 0.5%
of MBeachl, LLLP,a Delaware limited liability limited partnership.
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139 •
MBEACHI INVESTORS, LP, a Delaware limited partnership, a Partner 99.5%
of MBeachl, LLLP, a Delaware limited liability limited partnership
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
MIAMI 963391.1 7613422013 11
09/23/2014
MBEACHI INVESTORS, LP,a Delaware limited partnership
PARTNERSHIP or LIMITED PARTNERSIHP NAME
NAME,ADDRESS, AND OFFICE % OF STOCK
MBEACHI Investors GP, LLC, a Delaware limited liability company, 0.5%
the General Partner of MBeachl Investors, LP, a Delaware limited partnership
ROBERT S.WENNETT REVOCABLE TRUST, a Limited Partner
of MBeachl Investors, LP, a Delaware limited partnership 76.30711%
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
MARIO CADER-FRECH REVOCABLE TRUST, a Limited Partner
of MBeachl Investors, LP, a Delaware limited partnership 15.46193%
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
CLAUDE CHANDONNET, a Limited Partner of MBeachl Investors, LP, 7.73. 096%
a Delaware limited partnership
1111 Lincoln Road, Suite 760
Miami Beach, Florida 33139
NOTE: Notarized signature required on page 13
4.
•
5.
6.
7.
8.
MIAMI 963391.1 7613422013 12
09/23/2014
-:4 f,w-,ra ' 1 t .,7*-i 32;x..'2./20/4 g .1..r,.
Miscellaneous Cash Receipt G{=.: i::, j:, L i I:: 36231 $350 p
CITY OF MIAMI BEACH
No. 3 6 2.3
El Cash
)1'
-Credit Card 0 Check# $ 3 ) 6, , c
,": ,v 20 i V
i 1 k Received of i I i .. I ;, ) rJ -
Address i
For L:-.:,v-2,\(-)14 ',-c-: Y .: .v 'FY',. - ., I
Ic.'„,r-,,e,(--A, '-' i(,_-_-),(,-,c--) T‘,,.. k -1,7-,A. ts<1.,(4.. $, ,N,-1,,Li 0 6.....,6 L(.----' t%)(,),)/
(THIS INFORMATION MUST BE COMPLETED) Office of Finance Director
By
Account Number: ', ±► t_ _ ,:.4-1(-1
r. ( r 1 fir~ i F• i r
I {. �, ,
Preparers �_. _ : , - p : �-- f .i EXT:
•