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Michael Marrero - 320 South Hibiscus Drive, LLC f_ 2C33 4-1�/I`sc,45 rl✓G m Ami BEAc H h 4 - Office of the City Clerk ntgawf � �" 11: 32 1700 Convention Center Drive ``f" 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: Marrero Michael J. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez &Larkin, PLLC 200 South Biscayne Blvd., #850 Miami, Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 mmarrero@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Karpov Ilya NAME OF PRINCIPAL (Last) (First) (Middle Name) 320 South Hibiscus Drive,LLC 2201 Collins Avenue, Unit UPH-6 Miami Beach, Florida 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 448-5898 PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant in City Code Section 2! 82(g1) ): A prin`eipal of g corporation, part eerstii.,ca other entity who appears(MO list CTd behalf of that en ity,with-o t spacial compensation CI?reimbursement for RD appearareappearance =intrdtimIL indirect,CJi'con ingent,ft)ex a ress .a® (510p o a aosition to an item shall register thh1th Clerk as requiMalI y"ftliis subsectioglbut shelf not be required to aay any registration fees. 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(if none,write N/A): Ilya Karpov • 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): See Attached Page 1 of 5 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. Development Approvals and Permitting Issues,including,but not limited to the Historic Preservation Board, Design Review Board, Planning Board, Board of Adjustment, Land Use Development Committee,City Commission,and any City Workshops or Committees,if necessary,relating to the property located at 320 South Hibiscus Drive in 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 Title of Person to be Lobbied Staff for the Planning Department,Building Department None X Public Works and City Administration,PB,HPB,BOA None X DRB,City Commission,and Mayor as necessary 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(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): $490.00 per hour Page 2 of 5 • 1 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 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 2iNo: 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 r 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 official(s)for whom the campaign consultant provided campaign consulting services within the past election cycle. See Section 2-491 for more information. - _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: Yes XNo: f es has it been less than 12 months since the elected official s whom ou 'rovided c•mrai>n. onsultinq services was sworn 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 2-491) 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: YesX No: f yes, were you promised or did you receive economic consideration in exchange for campaign, consulting services?. _ _ ____ TO BE COMPLETED BY CITY CLERK'S STAFF ONLY �! Registration fee: [ ]Yes[ ^)No Amount Paid$ MCR# L�2 77 I Date.Paid-21- Annual _f c� Lobbyist Registration Form received and verified by: I 3.1 vTLt _. F:\CLER.\$A1L\aFORMS\LOBBYIST FORMS\Lobbyist Registration Forma Revised 09-20-18,REG.doc Revised 09/20/2018 Page 3 of 5 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 URING TH E REPORTING PERIOD.1 j .. Signature of Lobbyist: ;��'' Date lit_V oZa 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 pro 4sions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all rep• i e•uir-••ejnts: Signature of Lobbyist: Date Za"II- Signature of Principal: ,. Date / Aar 4 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of ft 6-64 State of 0-060 County of: UiOlµ( vb4t / County of: R\Akam I P, C Sworn to (or affirmed) arid subscribed before me y Sworn to (or affirm d) and s •scribed before this 2 p day of N a'Jem , 2016, by this 21 day of NtN 2011 by ( try( Ua-M-ciJ A KarY0V NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID A _Produced ID 4111 / FOM 0F IDENTIFICATION / F IDENTIFICATION ,Personall \ f 'Persona n 4 Signature of No'ary Public Signature of No ary Public Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SEA r; err vos Notary Public State of Florida (NOTARY SL A I 'oe Notary Public State of Florida :9lt�; Diana Ramos ? �; Diana Ramos• c' a My Commission FF 207719 y ,I My Commission FF 207719 3 cr tion Expires 04/10/2019 v4 4,toyExpires 04/10/2019 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. Page 4 of 5 . * I MIAMI BEACH 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 CityClerk@miamibeachfl.gov Tel:305.673.7411,Fax:305.673.7254 NAME OF LOBBYIST: Michael J. Marrero 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 Se '•n 2-482 of the Miami Beach City Code. r j l� �O/ b Signature of Lobbyist Date( g Y F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 Miscellaneous Cash Receipt ?''. CITY OF MIAMI BEACH No. 422717 0.S ic D Cash C1 Credit Card 17CheCk# Q —7 - $ /O--'0 p c 20 ReUdIved of Pic c\A A \ JA-0(1 C_P3 , '1-0;\c Il A0,,Iii,"\ ("7 t(2 rs t/-�t v C7:01/'1 'e 1‘1 Miscellaneous"=we: - 01.9 7 l l Liz/7 f� ACNE 408V Adrian .. F93 2s- +� 11) t/t.,t,' -'-'° ,�`l(),4 t t :,.? '1'3 f -)i I 6' . F+DIIACR OPEN(M„ iR) f 5.5k-gl; - c-t1 ..�> t�•13 <, C v.", 1)t I C9 ,, ;t'(I itt 1 rt .. !5 1, Payment Amount: 1,050.00 1 MCR422717 • (THIS INFORMATION MUST BE COMPLETED) Office of.Finance Director By Account Number 011 ' %0003 Ic 3 LI!led. 00• '' `7 . J'I � 1?,r•,0. a Preparers CA. D g;., ) (u Cr ,Preparers -----)CA. Dept: {i .". EXT: `19 I.1 • 4 EXHIBIT"B" MEMBERSHIP OWENER FOR 320 South Hibiscus Drive,LLC,a Florida limited liability company } - I MEMBER: ANDREY ISAEV OWNERSHIP 100% l ' f 1� q7T Y r J r, �� C c y. i ,,1411141,404'.1): y ` '+ ) 77 A Vj8682673 POWER OF ATTORNEY Moscow,August second,two thousand eighteenth. I,Mr.ANDREY ALEKSEYEVICH ISAEV,born June 28, 1966,place of birth:city of Murom,Vladimir region,citizenship:Russian Federation,sex:male,passport 45 11 174280 issued by the Division of the Federal Migration Service Administration of Russia for the city of Moscow for the Shchukin district on July 6,2011,subdivision code 770-098,foreign passport of Russian Federation citizen 71 9961489 issued by Federal Migration Service 77811 on June 29,2012,valid until February 10,2022,registered as residing at address:32(thirty-two)Marshal Biryuzov street,building 1(one),apartment 108(one hundred eight),Moscow, do hereby empower Mr.ILYA KARPOV,born June 2, 1972,place of birth:Moscow,citizenship:Russian Federation,sex:male,foreign passport of Russian Federation citizen 71 1216279,document issued by Federal Migration Service 50030 on July 2,2010,valid until July 2,2020, to act on my behalf,specifically he is hereby granted the rights and powers to draw up and perform any documents concerning the following matters: (1)to submit applications to any state or municipal bodies,public organizations and other governmental,private or public organizations, state or federal institutions,and/or state companies or to any other parties,and also to sign applications and permits issued by the aforesaid bodies or parties;and (2)to obtain licenses and permits,and for the'performance of this power of attorney to sign any-applications,documents or application forms to obtain permits,to request consents or permits from the government of the city of Miami Beach,including but not limited to,the Planning Board,the Commission on Review of Design Documentation,to sign any agreements or declarations permitting the construction of individual residential buildings in the Territory, (3)to sign contracts for design and construction with architects,designers,contractors,subcontractors,consultants and independent executors,to sign notices of start of work,and also any other documents necessary for the development of the territory indicated below: land lots 11,12 and 13,section 1,HIBISCUS ISLAND,pursuant to the plan and entries in Boundary Book 84211 page 7 of the Public Archive ofFlorida. TOGETHER with a piece of land 20 feet wide adjacent to the coastline of lots 11,12 and 13 of section 1 of HIBISCUS ISLAND,which was conveyed per Biscayne Bay Island Company in a transaction with authorized agents of the Regional Development Fund(Internal Improvement Fund),pursuant to entries in Transactions Register 151,page 479 of the Public Archive of Dade,Florida(hereinafter the "Territory'). at the address:320 S.Hibiscus Drive,Miami Beach,FL 33139 case No.:02-3232-006-0110 I hereby grant ILYA KARPOV all rights and powers to.perform any and all actions that need to be performed with respect to real estate and which I could perform independently.I hereby approve and confirm any actions that ILYA KARPOV as authorized agent will perform on legal grounds,or whose performance he will effectuate. The power of attorney is issued for a term of three years,with a prohibition on sub granting powers under this power of attorney to other persons. The content of articles 187-189 of the Civil Code of the Russian Federation has been explained to the principal. I,as a participant in the transaction,understand the notary's explanations about the legal consequences of the transaction that is being conducted.The terms of the transaction correspond to my actual intentions. The information established by the Notary from my words is entered faithfully in the text of the transaction. principal: [signature] City of... CERTI I D TRANSLATION PREPARED BY SEVEN LANGUAGES,INC. ...Moscow. • • Russian Federation City ofMoscow • August second,two thousand eighteenth This power of attorney is certified by me,Yalta Vladinirovua Krylova,notary in the city of Moscow. The content of the power of attorney corresponds to the expressed will of the person who granted the power of attorney. The power of attorney was signed in my presence. The identity of the person who signed the power of attorney.was established,•his capacity was verified. Recorded in the register:No. 77/719-n/77-2018-9-1067. State tax collected(at rate):500 rubles 00 kopecks. • Paid for rendering services of a legal and technical nature:1200 rubles 00 kopecks. • Yu.V.Krylova • [signature] [inked round seal] • • • • • • • • • • • • • • • CER M D TRANSLATION PREPARED BY . •SE!EN LANGUAGES,INC, ., CIIIIII ,, SEVEN Elul LAN G V GES T?"A SLA ING SE VICESy Il`tl C o TRANSLATORS • INTERPRETERS Conferences•Depositions• Documents•Translations• Legal •Commercial •Medical•Technical •U.S.Court Certified Interpreters Web site: www.sevenlanguages.com • E-mail: info@sevenlanguages.com CERTIFICATE OF TRANSLATION STATE OF FLORIDA } } COUNTY OF MIAMI-DADE } ' I, ELISE GICHON-STRAUSS, on behalf of SEVEN LANGUAGES TRANSLATING SERVICES,Inc,do certify that the attached translation,consisting of Z pages,is,to the best of my knowledge and belief, a true and accurate rendition into the Et/11161A language of the original written in 11 u551cM . / - L".,,,,LAL4_,_. t ..; , h,,`�4.. ELISE GICHON-STRAUSS '' The foregoing instrument was acknowledged by me on this C6 day of btq►tis-1-' ,20 l g. S 'P ANI S H ELISE GICHON-STRAUSS personally appeared before me at the time of notarization. She is IFP ,E NN. C ,H; personally known to me and produced a driver's license as identification and she did take an oath. - - !I T A ,,L 1 A N HI E IB IR' "E ,i'+ i _� Notary Public State at Fltxid9 -TOIL { moo rT: 8ritirtie M Sanchez . , REO ,L 'E My C,ommtasion GG 237213 : : e M. Sanchez,Not•- ' - • is d� ExplreaO8f0812o2z r.�®1 lU; Tw ;C IHorw j,Y State of Florida at Large PORTU.GUSEI • ,G,'E; IR 'M ;A ;N{ C: H�it 'IN 1E.:S El , The utmost care has been taken to ensure the accuracy of all translations. SEVEN LANGUAGES TRANSLATING SERVICES 'J kA P A N,'E-S E and its employees shall not be liable for any damages due to negligence or error in typing or translation. 0: U S:S; I A 'N SCANDINAVIAN `A S 1 A `N' SL AV I C SEVEN LANGUAGES TRANSLATING SERVICES, INC. 8c ALL OTHER: 1849.5(SOUTHDIXIE HIGHWAY#116, CUTLER BAY, FLORIDA 33157 ,LANG-UAGES DADE (305) 374-6761 • 24 HR. FAX(305) 374-0339 . 1-800.374-6761 Y 4. J. . ' j 5i j1L : aet ` I :, S } i .,., %'---'' - 1l,i S : ',g, U�`Yti-a..C`r'r !,(t T`-1 L 06 _'f 77. A 8 '8682673 ' • _ AOBEPEHHOCTb Fopoo Moczaa,ainopoio aezycnza.daembtcntitl ooceMutadganrozo zoom H, ap.,MCAEB AH,1(PER AIIEKCEE13I3'I,•28 axma,...1966•.rota;powaenHM; Mecro poxcnellmi: rop. 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