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Conrad Martin - Northpoint Properties II, LLC - D-, I f` § '„/ BEACH Office of the City Clerk 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 Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City 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: MARTIN CONRAD NAME OF LOBBYIST (Last) (First) (Middle Name) 109 HATFIELD STREET GARDENS, CAPE TOWN, SOUTH AFRICA 8001 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) +27 (0)21 468-4400 +27 (0)79 503-5320 CONRADM@SAOTA.COM LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: NORTHPOINT PROPERTIES II, LLC NAME OF PRINCIPAL (Last) (First) (Middle Name) 2767 SUNSET DRIVE, MIAMI BEACH, FLORIDA 33140 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) +1 (323) 899-7181 SHANE@CRUCIAL51.CO.ZA 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: SHANE THOMSON • NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A 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. Architectural Services for Northpoint Properties II. LLC related tb DRB File No. 17-133toncerning the property located at 28 W. DiLido Drive,Miami Beach, Florida. 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 Design Review Board Title of Person to be Lobbied None x Historic Preservation Board None x Planning Board None x Zoning Board of Adjustment None x City Attorney's Office ,None x Planning Staff None x Mayor's Office None x COanager's Office 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. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety: None V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee is prohibited pursuant to City Code Sec. 2-485.3): $1,630/day 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": _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 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 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 X No: 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. No: Are you providing only scientific, technical or other specialized information; appearing as a g•ee., representative of a neighborhood association without special compensation or reimbursement or n, - .�9 representing a not-for-profit based organization for the purpose of requesting a grant without �/ 1-4044, 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. _Yes XNo: 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.'- Signature of , { C/Iir Date OC D 2i 2.0( 7 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. ji___) Signature off, -z Date OS/a,2 i '017 Signature of Principal: Date `' )4' �v1--? VII. NOTARY *.-.------*--.-- -----/-----E AND SEAL: . Yin: \ PRINCIPAL State of f I© r c� A State of FL-(3°--r43' County of: N`{�t ri, - 6A pe County of: MI-N.-A t D Ao c Sworn to(or affirmed) and subscribed before me Sworn to (or affirmed) and subscribed before me this Ur day of fA 4 ,2OR, by this t%.1, day of tvi p,,. , 20 17 by C oNv tD !U A R(I N 3 H cwt w0,642-E-.J t r, o••-Z G•J NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID yr,iQ✓ S L-tc ✓Produced ID PASSPORT FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Kn-,• _Personally Known SignaturelIof Notary •u�1ic Signature of Notary Public di €rllvt `l'_0LP t`A-6 C__.1 -0--10-5pAG+-PG •:., NWEIVAticROMIMPorNM Stamped Name of Notary, Typ-=, • .- -- _ - -:,:- "= MY COMMISSION#FF974743P.r po ' - 9 S PARDO -.,' • `4 s� Notary Public,State of Florida ,' p, Y �FjES March 23,2020 (NOTARY SEAL) z A < My Comm.Expires March 9,2019 (dd7�988 u{83 FIoAdallof�r8Nrbe.odn '� -+ Q .35.0.00 Eti• Commission No.FF198810 TO BE COMPLETE BCITY CLERK'S STAFF ONLY Bonded through National Notary Assoc. Annual Registration fee: [ ]Yes[y]N _ � o Amount Paid$ MCR# . .: 1bQS Date Paid ( .S`3)- 17 Lobbyist Registration Form receiv d verified by: .e'- v *?- A- 61) F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 08-18-16 REG.docs,,�,.1: R-vised 08/18/2016 1 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. M, „A V \ I 3EALA City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E. Granado, City Clerk CiyClerk@miamibeachfl.gov Tel: 305.673.741 1, Fax: 305.673.7254 NAME OF LOBBYIST: CONRAD MARTIN 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 pursuant to Section 2-482 of the Miami Beach City Code. ) 0; 1G 2 1 Qp Signature of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 08-18-16 REG.doc Salvatore, Jason From: Ernesto Reyes - KHR Law Offices <ereyes@Khrlawoffices.com> Sent: Tuesday, May 30, 2017 2:42 PM To: Salvatore,Jason; Granado, Rafael Cc: Kent Harrison Robbins - KHR Law Offices; Clerk- KHR Law Offices;Assistant - KHR Law Offices Subject: Thomson - DRB File No. 17-133 (28 W. Dilido) Supplement Correcting Lobbyist Registration for C. Martin and Fee Attachments: Ltr Supplement Correcting Page 2 of C. Martin Lobbyist Reg 5.30.17.pdf Mr. Salvatore, See attached letter supplementing and correcting Mr. Martin's Lobbyist Registration in response to your below email. A hard copy of this supplement will be hand delivered to the City Clerk's office tomorrow with a check for payment of Mr. Martin's Lobbyist Registration Fees. Thank you, Ernesto V. Reyes Firm Administrator Senior Legal Assistant The Law Offices of Kent Harrison Robbins IT 242 Northeast 27th Street Miami, Florida 33137 Telephone: (305) 532-0500 Facsimile: (305) 531-0150 Email: ereyes a(�khrlawoffices.com From: Kent Harrison Robbins- KHR Law Offices Sent: Friday, May 26, 2017 10:41 AM To:Clerk- KHR Law Offices<clerk@Khrlawoffices.com>; Ernesto Reyes- KHR Law Offices<ereyes@Khrlawoffices.com> Subject: Fwd: US_MIA_28WDILIDO_WSO4_LA_2001_LobbyFee_cm Please locate this lobbyist registration. Kent Harrison Robbins Cell 3056321770 Sent from my iPhone Begin forwarded message: From: "Conrad Martin SAOTA" <conradm@saota.com> To: "Salvatore,Jason" <JasonSalvatore@miamibeachfl.gov> 1 Cc: "'shane@crucial5l.co.za" <shane@crucial51.co.za>, "Kent Harrison Robbins- KHR Law Offices" <khr@Khrlawoffices.com> Subject: US_MIA_28WDILIDO_WSO4_LA_2001_LobbyFee_cm Hi Jason, Please refer queries to Kent Robbins, copied above. From:Salvatore,Jason [mailto:JasonSalvatore@miamibeachfl.gov] Sent: Friday, 26 May 2017 4:31 PM To: Conrad Martin SAOTA<conradm@saota.com> Cc: 'shane@crucial51.co.za' <shane@crucial51.co.za> Subject: Miami Beach Lobbyist Registration-28 W. DiLido Drive Hello Mr. Martin, On the lobbyist registration we received,Section V,Question 4 was marked "yes" but it was also indicated that there is a daily lobbyist compensation$1,630 being received by you. This information is conflicting. Please clarify if you are receiving a compensation directly relating to your lobbying activities with the City of Miami Beach, or if you are not receiving any compensation or reimbursement directly related to your lobbying activity so that we may amend your registration. If you are receiving compensation related to your lobbying activities,then the registration fees will need to be submitted to the City. Thank you, Jason Salvatore - Office Associate I/I Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. Conrad Martin SAOTA M.Arch infosaota.com www.saota.com 2 The Law Offices of Kent Harrison Robbins May 30, 2017 By Email to rgranado(a�miamibeachfl.gov By Email to jasonsalvatoremiamibeachfl.qov By Hand Delivery Rafael E. Granado do Jason Salvatore Clerk of the City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 3139 Re: Supplement correcting page 2 of Conrad Martin's May 18, 2017 Lobbyist Registration for Northpoint Properties II, LLC related to to DRB File No. 17-133 concerning the property located at 28 W. Dilido Drive, Miami Beach, FL. Dear Mr. Granado and Mr. Salvatore: I am the registered lobbyist and authorized agent for Northpoint Properties II, LLC related to DRB File No. 17-133 concerning the property located at 28 W. Dilido Drive, Miami Beach, FL. Pursuant to Mr. Salvatore's email on May 26, 2017, please supplement and correct page 2, section V, item no. 4 of Mr. Martin's (Principal of the project architect) May 18, 2017 Lobbyist Registration as follows (corrected item in bold): 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; 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 for reimbursement for the appearance. _Yes X No 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. 242 Northeast 27th Street Miami,FL 33137 Office:305 532 0500 Ceti:305 6321770 ichrekhriawoffices.com khriawoffices.com Offices: Miami,FL 1 Miami Beach,FL A copy of Mr. Martin's May 18, 2017 Lobbyist Registration with a corrected page 2 reflecting the above change is attached hereto. A hard copy of this letter and corrected Lobbyist Registration as well as a check for Mr. Martin's Lobbyist Registration Fees will be hand-delivered to the City Clerk's office tomorrow morning. Thank you for your prompt attention and courtesy in this matter. Sincer , Kent Harrison Robbins Enclosure 2 . I IiI C- L ,_y,-cgs0_ �. Z rt 0 c r1+ v to 70 I " 0 - ' 1 fp s , :9 I - I 4 . t '. " -, I 3 o - II, P o o ) J v ` o -" ` -a • � Al m)12 .n. ti. r-. m ' 0 - i z _: _ 0 -s .W ''''-w Q 9 O --' ~' L,...:,„.'' _ 0- '� ' ryi ----1- = 2-- 0 - : *. o z Q n A •• a -g 1 : .. _.. m_ o v . I - . . 1 0 ;,oma ii,\I" -_',....-'-:,:',".=--i--'..-..,_-'... p S, ri.,...., ,,,A:,:,,,;,:ti7.,:,:::_,,..„,„,.._ ,,, _ .:. , _ 0 :__.:.,_ _:,.:. _ , _„,.. ..,. ,„.,,,,:__„;_..,..,....._,...,,,:,..3, �'"� 0.