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Jason Nunez - North Bay Owner, LLC ,23I$ -.2,31-(o 4ve iv-\IA/V\1 BEy b.�s, Office of the CityClerk #� „� . 1700 Convention Center:Drive : - Miami Beach, FL 33139. 71311N0v 21. PM 12: 59. 305:673.7411fziTy J ff i LOBBYIST REGISTRATION FORM ;> j," r ;1 i' Lobbyist means all persons employed.or retained;whether paid or not, by a principal who seeksto 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 recommendationof 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:Theterm Lobbyists has specific exclusions: Please refer to City.Code Chapter 2,Article VII, Division3,:entitled "Lobbyists," for additional information.: Jnstructions: Please complete all sections:ofthis 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:havenothing to report in a particular section, you must write "none" or "n/a" in that section. Any:change to any information originally filed, orany 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 theperiod that the lobbying occurs: Separate registration forms shall be required for each principal represented on each specific issue: 1:. LOBBYIST INFORMATION: Nunez Jason • . NAME OF LOBBYIST (Last) (First). • (Middle Name) : Fernando.Wong Outdoor.Living Design/1504 Bay Rd., Suite 2705, Miami Beach, FL 33139 LOBBYIST BUSINESS:NAME.AND ADDRESS: ` (Number and Street) `..(City) " (State) (Zip Code) 305-604-0003 jason@fernandowongold.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER. EMAIL ADDRESS II, PRINCIPAL INFORMATION North::Bay Owner, L.L.0 . .: . NAME OF PRINCIPAL• (Last) (First)` : : .`` (Middle Name) 1601 Washington Avenue,:Suite 800, Miami Beach, FL 33.1.39 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) •' (State) (Zip Code) 305-695-5452 .1-1 awley@star.wood.:cbm: PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER H. 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): SEE ATTACHED EXHIBIT "A" NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,_write:N/A): C VIZZ NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,'A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): ��R�.. / Gl►Z� Page 1 of 5 MIAMI 6025.791.1 83551/86181 • III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specificdescription where applicable of a pending request for proposal, invitationto bid, or public hearing number. Development of property located at 2318-2340.Collins Avenue 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 ofservice 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 Plannina Boardand staff x Historic Preservation Board &Staff x Board of Adjustment &Staff X. . City.Commission . 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(if none,write N/A): n/a 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): /c) _ Page 2 of 5 MIAMI 6025791.1.83551/86181 • The following six(6)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()ending bid for goods:equipment or services. or on a ()resent or pending award for•aoods:eauioment or service? 2) Pursuant to City Code Section 2-490 entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues" Yes.00: Are you Jobbyin9pn a oendvig application for a Development Aareement with the City or application for chance of•zoninaman desianation:or change to the City's Future Land Use Mao? 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 anot-for-profif 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. .)No Are you providing only 'scientific: technical or- other specialized 'information apoearina as-a • representative of a neiahborhood association without special compensation or reimbursement or representing*a, not-for-profit based oraanization for the purpose of reauestina a arant'without special compensation or'reimbursement? 5) :. Pursuant to City Code Section 2-491(1), no campaign consultant shall.lobby the City Commission for a period of:12 months • . . following the..swearing in of any elected officials) for whom the campaign'consultant provided campaign consulting services within the past election cycle. See Section 2-491'for more information: Yes XNo: J-lave you'provided camoaian consulting services to an incumbent member of the City Commission within the bast cycle? If yest•p tlease list the incumbent member(sl of the City Commission:' Yes No f yes, has it been less than 12 months since the elected offrcial.(s�) whom you provided campaign. — : cod or su tinw g ervices as sworn in'O : 6) Pursuant to City Code Section 2-482(a)(4)a.; a lobbyist who has within the past election cycle provided campaign consulting services:to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section 2491) shall disclose such.particular service onhis/her lobbyist registration formand shall orally disclose such particular service before lobbying:the City Commission at a public meeting, Yes.:XNo: pave'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(s1 of the City Commissions Yes • No.. : If yes, were you promised or did you receive economic consideration in exchange for campaign c`on rltingTserv'aEM` TO BE COMPLETED BY CITY CLERK'S STAFF 7F ONLY / CI Annual Registration fee: iL }Yes�( J!No rAmount Paid$ €1 SO°C 4 MCR.#' L� L O Date Paid° .l /-,' ,! 7 1.D Lobbyist Registration•F.orm received end�verified by: --a � lca-CA., E". Fr;\E_LER}\$@LL\aFORMSALOBBYZISTIFO ISALobbyist(Registration:Form Revised of-01 18 REG dpc Revised 01/01/2018 Page 3 of MIAMI 6025791.1 83551/86181 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. JtEcEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS•BEEN ENGAGED TO LOBBY. A STATEMENT SHALL B FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR CO PEN ATION DURING THE REPORTING PERIOD, Signature of Lobbyist: Date l dJcol leb 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 Codiab.. all reporting requirements: Signature of Lobbyist: NKrI' A� Date 1 2(p I t. /Signature of Principal: : Date I / 2) /)I VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of : 0 ( State of qo�i©/�- County.of 04 .C.6/14 12 � : C Pr. County of: d v'1/4/.1 ' E Sworn to(or affirmed)and subscribed.before mea. Sworn to.(or affirmed)and subscribed before me this y day of U rJ 20/V by : this .27day of A)cDv 3 cam- 20k16-by nn /J NAME OrLOBBYIST NAME OF PRINCIPAL _Produced:ID ���d.rr if--�Lr C f� Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known - _Personally Known Signature of No ry.P yblic S. ature of Notary Public Name of Notary,Typed, Printed or Stamped : Name of Notary,Typed,.Printed or Stamped r.Civ Poe, RAUL CHAVARRIA -: 3o MY COMMISSION#FF 962231 A .,n, , {NOTARY SEAL) . _--£t.��, * (NOTARY SEA ,*��s.:t'''•• JASONSALVATORE mr �. EXPIRES:March 6.2020 � MY COMMISSION#GG 030527 '6'OF FLO• Borrdw TTrtr Budget Notary Services . . .. E#; Irina .��.�. EXPIRES:September 14,2020 %:;os�.4P.••Bonded Thru Notary Public Underwriters The term+'lobbyist"specifically excludes the following persons: Expert witnesseswho 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 asa representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the.appearance. Page4of5 MIAMI 6025791.1 83551/86181 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.rniarnibeachfl.goV Office of the City Clerk Rafael E. Granado, City Clerk Cityalerk@miarnibeachfl.gby Tel 395.673.7411, Fax 305.673.7254 NAME OF LOBBYIST: Jason Nunez 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 lobbyistexpenditures, 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. I 1 .g3 Sign . e of Lobbyist - Date FACLER1SALL1aFORMSILOBBYIST FORMStobbyist Registration Form Revised 01-01-18 REG doc Page of 5 MIAMI 6025791.1 83551/86181 • EXHIBIT "A" North Bay Owner, L.L.C. • North Bay Owner Holdings, L.L.C. 100% North Bay Owner Holdings, L.L.C. Barry Sternlicht 100% • • Page 6 of 5 MIAMI 6025 805.1 83 551/86181 Miscellaneous Cash Receipt CITY OF MIAMI BEACH No. 422709 Cash 0 Credit Card ,b Check# / 03 C`r) $ 11.,) .) c-)- 0 ) f )7 i ,, Roi iFred of 4. -?..%,r,..,\,)),‘, .r',�:.)Ij I )Ic I f ic(--17-14 V :.y A h1 A-i, t pnJ ellaneous-MCR-2019yl f J f FOI?1CR OPEN(MCR) P ,NJ A;-L ii C (27S 4 S !_c ul :) �•` c� , •� e/ ) l~,-�c�.9 . < Payment Amount: 4,250.00 81 MCR 122700 , (THIS INFORMATION MUST SE COMPLETED) Office of Finance Director>>`.:'. B Account Number: 011 1 5000. 3(�.,9 '1' /-00 :5 1y :-.5- 5.(4 • (:O oc). c:0 Preparers` �ti�� !� Dept: c_ Exr:� C,� f