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Kobi Karp - CG Tides, LLC lao o MlM BEAC Office of the City Clerk tk r'`15 6 1700 Convention Center Drive Miami Beach, FL 33139 305.673.7411 . 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 City Code Chapter 2, Article VII, Division 3, entitled "Lobbyists," for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City section, , you need morees"none" rcomplete"n/ ainn that section. Any separate changehtotany inpaper. forrmationyou originally filed, oor report add additional particular City section, you must Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Karp Kobi NAME OF LOBBYIST (Last) (First) (Middle Name) Kobi Karp Architecture & Interior Design, Inc. 2915 Biscayne Blvd, Suite 200, Miami, F zip C 3137 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) de) (305) 573-1818 KobiKarp@KobiKarp.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: CG Tides. LLC (First) (Middle Name) NAME OF PRINCIPAL (Last) 2915 Biscayne Blvd, Suite 300 Miami, FL (State) 33137 Code) PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (305) 747-6408 ari.pearl@gmail.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: See attached. • NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached. III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number. for properties located at'f elerettm, IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship(paid or unpaid)with said City Commissioner or City personnel from 12 months preceding such commencement of service with the City to the present date, stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship(If yes,explain) YES NO Title of Person to be Lobbied X Planning Staff, City Development Boards, None. Land Use Development Committee None. XX and 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. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety: N/A V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fete is prohibit pursuant to City Code Sec. 2-485.3): Y 200 h oor The following five(5)questions MUST be answered: 1) Pursuant to City Code Section 2-488, entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": YesX_No: 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 City Code Section 2-490, entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _YesX No: 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 City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481) 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 city 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? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. _Yes XNo: Are you providing only scientific, technical or other specialized information; appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-482(a)(4), a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. _YesXNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle? If yes,please list the incumbent member(s)of the City Commission: If yes,you must also orally disclose such particular service before lobbying the City Commission at a public meeting. VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD). A,Signature of Lobbyist: V ----) Date S"(eq/i I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct, and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting requirements. __AirSignature of Lobbyist: l Date 4q1,7 ..., Signature of Principal: A Date 40 fr.--- VII. r/VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of �-'/o r'd am�c— State of \l1Q 001-- County JLCounty of: ri,A vo• (--e-, County of: aV1,Q.AX)S Sworn to(or affirmec,i) and subscribed before me Swor�(or affirmed) and subscribed before me this 7 day of c;,/ , 2012, by this_day of onaC , 204, by Ccs e• Le,r P `V .Q.r _,\11,e-v NAME OF LOBBYIST NAME O INCIPAL //� \/ 6.(t„j Produced ID Produced ID t �o° ��• ��' �t — FORM OF IDENTIFICATION FORM OF IDENTIFICATION —PersonallylKnown ._.` ”Personally Known _ Cits.CJt )---- J7 Notary nature 'kJ/nature of Notary Public Signature Public -Is- • k • ____.-7_---.-_7 ----- •tamped Name of Notary, Typed, Prirtttt}( g tANCHEZ F-- ; v.. RAMON SEBASTIAN QUEZADA Notary Public,State of New York c; , 4:YmSE01141SsiON0GO030524 (NOTARY SEAL) NO.01HU5042516 EXPIRES:September 14,2020 auallfied In QueensCourrty ,(� i "'' »` Bonded Thru Notary Pubic Underwriters bion Expires 24,7O.j - -- —" • BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[VI No Amount Paid$Joy' MCR# Cj,6'n -L Date Paid /fliti Lobbyist Registration Form received and verified by: 41,vete vt • F:\CLER\BALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 08-18-16 REG.doc Revised 08/18/2016 The term"lobbyist"specifically excludes the following persons: Expert witnesses who provide only scientific, technical or other specialized information or testimony in public meetings; any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. MAMBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E. Granada, City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.741 1, Fax: 305.673.7254 NAME OF LOBBYIST: Kobi Karp 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 appealed to the Miami-Dade County Commission on Ethics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period commencing October 1 of each year, and the fee for such annual registration shall be $500.00 pursuanat -482 of the Miami Beach City Code. s q (cr Signature of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 08-18-16 REG doc Disclosure of Interest 1220 Ocean Drive CG Tides, LLC 2915 Biscayne Blvd Suite 300 Miami, FL 33137 I 100% JCMC Tides, LLC 512 Seventh Avenue 15th Floor New York, NY 10018 29.7% 70.3% Joseph Chetrit Meyer Chetrit 512 Seventh Avenue 512 Seventh Avenue 15th Floor 15th Floor New York, NY 10018 New York, NY 10018 1 Disclosure of Interest 1201, 1221 &1225 Collins Avenue CG Tides Village,LLC CG Tides Village I,LLC 2915 Biscayne Blvd 2915 Biscayne Blvd Suite 300 Suite 300 Miami,FL 33137 Miami,FL 33137 100% 100% 392 Fifth,LLC 392 Fifth, LLC 512 Seventh Avenue 512 Seventh Avenue 15th Floor 15th Floor New York, NY 10018 New York,NY 10018 100% I 100% Joseph Chetrit Joseph Chetrit 512 Seventh Avenue 512 Seventh Avenue 15th Floor 15th Floor New York, NY 10018 New York, NY 10018 CG Tides Village II,LLC 2915 Biscayne Blvd Suite 300 Miami, FL 33137 50% 50% Meyer Chetrit Juda Chetrit 512 Seventh Avenue 512 Seventh Avenue 15th Floor 15th Floor New York, NY 10018 New York, NY 10018 2 Miscellaneous Cash Recelp CJ - OF MIAMI BEACH No. 41 G022 � Cacti: redit Card p 1, a Check# S' 4120%'x ._ City of Miami Beach ,. ,,,,/ � 7 if N►iscel �►614�(Df-2 'f 1� 00132� ah 05/Q9J20 )0:3 MCR OPEN{ R) ie � f1 Pa .. ... .. ±.1.-+1` C MCR416022 Yrile Office of Finan ce Dirac_ (THIS INFORMATION MUST BE COMPLETED} �` By �- f Aacoun€Number: �ll � -.1 6- 1 Preparers 4,409 � Dept: / 'I FXT /f_ ;