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Alyssa Kriplen - PPF MBL Portfolio, LLC LiVICOIA Ko ck a A. A I A RECEIVED /AAA 1 .rtoffice of the City Clerk •1700 Convention Center Drive NOV -6 2019 Miami Btach, FL 33139 305.673.7411 CITY OF MIAMI BEACH LOBBYIST REGISTRATION FORM OFFICE OF THE CITY CLERK Lobbyist means all persons employed,or retained, whether paid or not, by a priacipal Who seeks to encourage the passage,.defeat or modification of any ordinance, resolution, action or decision of any commissioner; any:aotion, 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. InatrUctiOns:' Please complete all sections of this form and submit the.corripleted form,with the applicable fee,to the Office of the City Clerk. If you-needmore 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 "Na" 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 andamend 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: Alyaaa Itripleh NAME OF LOBBYIST (Last) (First) • (Middle Name) 2455 st4 27th Aye, Suite 220 Miami, FL 33145 LOBByIST BUSINEss NAME AND ADDRESS (Number arid Street) (CO) (State) (Zip.Code) 305.310,2602 e1yssa@makwork cora LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS IL PRINCIPAL,INFORMATION': .PPE" MSt.Portfolio, LLC NAME OF"PRINCIPAL 0..ast) (First) (Middle Name) 801 4,rthuz Godfrey Rd, Suite 600, Miami. Beach, PL 33140 PRINCIPAL BUSINESS NAME AND ADDRESS •(Nurnber and Street) (City) '(State) (Zip Code) :305.635.8700 PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS If the principal' 15 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):. Stephen R. aitteX, Manager • 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); NA 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. HP19-0342, HP Board Application to modify exterior of 801 Lincoln Rd • 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 Debbie Tackett,Chief, Historic Preservation 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): no additional compensation Page 2 of 5 The following six(6)goestion$MUST be.answered; 1) Pursuant to City:Code Section 2488,.entitled-Prohibited Campaign:Contributions By Lobbyists On Procurement Issues".: Yes.x No: Are You lobbying on a present or pending::bid:.for..goods,.equipment or services, or on.a present or pendingaward for goods,:eQupment or service?• 2) Pursuant to City Code Section 2-490; entitled"Prohibited Campaign.Contributions By Lobbyists On.Real Estate:Development lssues"t — Are' Yee 4 'Noyou Iobbvinq:Onn:a pending abglicatiotflOra DeVelbOment AgreeMent with the Citi Or application • • • • • • - • • for change ofzoning Map designation Or change to the City's Future Use Map? 3): Pursuant CO City Code Section 2,482(h), any person (except those exempt from the definition of lobbyist'- as' set forth in Section 2481):who only appears as.a representative of a not-for-profit corporation-crantity without:special compensation or. reimbursement theappearan co,whether direct or indirect to.express support Of or opposition to any item,shall register with the city olerle..es,-reguired by this section,'but Shell riot be Uiredto.pay -registration fees, _yes. MO: Are You representing, a :not4ot=ptofit• corporation or entity without. special compensation or reimbursement? 4) Pursuant to City Code Section 248:1, the term"lobbyist' Spedifically excludes the following persons:!Expert witnesses who provide only SCientifie,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 fortheappeatente. _yesx No: .Are, you providing only scientific, technical or other;specialized .informationappearing as a tePtesentative of.a neighborhood .association without special: Compensation reimbursement or representing .a• not-for-profit based:organization for thepUrpOse of iregUeSting.a. grant without special compensation or reimbursement? 5) pin:tont.to..City Code Section .2491(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.servioes. within the past election cycle.See Section 2-491:for:more information, Yes ki No: Have You provided:CamPaignOonsulting services to an inturnbenttnettber Of the City Commission •• • .:..„ within the past election Ovoid?If yes please list the inetntbeht.tri6rribef(t)of the.City•Coriimisicitn. . . . . . . . „ . . . . . . . . . • • • •• • • • • - • . • • • • . • • • .• • . • • • , • Yes No; ItietAida4Vbeetilesilitaii:421tiontbieiriceAbielecteirciffibiat(e);.44.1icirfileauliravide&carritieiiiri- , . ••• • • •, tonsUltinoServiceavastWornin? ...• •"... .." •. 6) Pursuant:to.City'Code Section.2482(e)(4)0,, a lobbyist who:hes:.within the-pest: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 ptiblionneeting,. Yoe x NO; 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 hivinfierklit ........... ........ ... Oxchanqe for campaign . .. toitsultioity'terVide0_' . . 'TO.BE COMPLETED BY CITY CLERK'S.STAFF ONLY Annual Registration fee Yes No Amount Paid$ 5O MCR# q$(I' i 1 15 ) b Date Paid It c ' •:..„Lobbyist,Registratiomfonnxeceived:Andmenfierttyli'6.:g,,„ Page:.1..:of 5. VISIGNATURES UNDER OATH: ON FEBRUARY 25 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 COMPE ION DURING THE REPORTING PERIOD. Signature of Lobbyist: Date a- 0 6- ( i I do solemnly swear or affirm that ail of the foregoing facts, Statements,-and disclosures in this form are true and correct, and that I have read or am fan4lar with the provisions contained in Chapter 2, Art. VII, Division 3,, entitled 'Lobbyists' of the Miami Beach City COde a reportingrequirementS. -_,, Date IL 0 Signature of Lobbyist:: _ T.4,.a. ....0. .raibir..."..ti.21.,.4.1.,..4... r+T4ratligTille4==== Signature of Principal: ''''''',.' , N- ritL...- Date 13-•519 jee, 044-4-ke LA VII. NOTARY SIGNATURE AND:SEAL: LOBBYIST: PRINCIPAL State'of fuob,IziAr State of r Imiceta. COurtty of: tA I A-AA1-k)fkIDE '17ade. County of: 114(e2 ;id,i. Sworn;to (or affirmed),, iand pubstribecl before me Sworn to(or affirmcd)and subs‘9ribed before-Me this b N.day of' OV ,20A by this day of Npveafq fr./ , 206, by ..- 4k15SoL krFbi-lbil . 01 rn efti iri&r.i art/ NAME OF LOBBYIST NAME OF PRINCIPAL (PrOthiCed 11) Fl-- 76 L Produced ID .._ FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personal, no g ____PA;nally Know- v r /Ito iJY, 'ii' Sigpure of Notary Public 4071 7-ature of Not. •Public 40 Name of Notary,Typed, Printed or Stamped Name of Notary, 'Typed,.Printed or Stamped T„gy pc, es,;k•MiiN JASON SALVATORE 01, Sandra Schatzel (NOTARY SEA 4.1 fit 1,,Ti MY COMMISSION#GG 030527 (NOTARY SEALy .11-i., Notary Put:lite-State of Florida EXPIRES:September 14,2020 . 03444.,,:,7,- Commission#PP 940827 Bonded Thru Notary Public Underwriters 487;1231' Expires 0W1912020 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 A AI A A ' b --1: A (--- kt t v t V \ ' 1.,.7 t iA,\ . .6 k - 2 e,/, .44,1( V ,,,,Ae` .. P qty of Miamj.Bedch, 1700 conVention Ceoter Prive,Mimi Beachifjoriclo ?•.1..9,Nrvw.rn1ornibeachfLgov Office of the City Clerk Rofoel.E.'QrarlddO,'City Clerk Citi/Clerlarniathibeadhfl.gov Tel:: 3Q5.673:7411) Fox:3n6737254 NAME.OF LOE3BYIST:. . Alyssa. Xrj,plen 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. 21. LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, 1 shall immediately file a Notice of Withdrawal with the Office of theCity Clerk. 3): ANNUAL LOBBYIST REQISTRATION 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 $501.00 pursuant to Section 2-482 of the Miami Beach City.Code. , . Si - 4 rejof bbyist Date FACLERISALL1aFGRIAMLOBBYIST FORMSlobbyist Registration Form Revised 01.01-18 REG.dbc Page 5 of 5. DIVISION OF CORPORATIONS yf Pt iiarc)r,f,0,14gitOrg C RCP,LY it rcilkB f f �. rare aaj hair 5!W1 1JJ Lrldlts ss.°f alx Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Limited Liability Company PPF MBL PORTFOLIO, LLC Filing Information Document Number L14000122267 FEI/EIN Number 47-1509574 Date Filed 08/04/2014 State FL Status ACTIVE Principal Address 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Mailing Address 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Registered Agent Name&Address Fitzgerald, Scott 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Name Changed: 02/08/2018 Address Changed: 02/08/2018 Authorized Person(s)Detail Name&Address Title Manager of Lincoln Road MM, LLC, the Manager of PPF Lincoln Road Venture,which is the sole member of PPF MBL Portfolio Bittel, Stephen H 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Annual Reports Report Year Filed Date 2017 01/16/2017 2018 02/08/2018 2019 04/01/2019 • Document Images 04/01/2019--ANNUAL REPORT i View image in PDF format 02/08/2018—ANNUAL REPORT View image in PDF format 01/16/2017--ANNUAL REPORT View image in PDF format 03/03/2016—ANNUAL REPORT View image in PDF format J 03/18/2015--ANNUAL REPORT View image in PDF format 08/04/2014--Florida Limited Liability View image in PDF format Florida Del/Ott/add of Stair:•,Division of Corporations DIVISION OF CORPORATIONS S'f _`T)FVI 1Ol`i of $6rrry of F!oridu Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Limited Liability Company LINCOLN ROAD MM, LLC Filing Information Document Number L14000121976 FEI/EIN Number N/A Date Filed 08/04/2014 State FL Status ACTIVE Principal Address 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Mailing Address 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Registered Agent Name&Address Fitzgerald, Scott 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Name Changed: 02/08/2018 Address Changed:02/08/2018 Authorized Person(s)Detail Name&Address Title Member Bittel, Stephen H 801 ARTHUR GODFREY ROAD, SUITE 600 MIAMI BEACH, FL 33140 Title Authorized Representative Mcllroy, Mindy M. 801 ARTHUR GODFREY ROAD STE 600 MIAMI BEACH, FL 33140 ft.�n..�l Dnni..4n ru InuaI I Report Year Filed Date 2017 01/16/2017 2018 02/08/2018 2019 02/08/2019 Document Images 02/08/2019--ANNUAL REPORT View image in PDF format 02/08/2018—ANNUAL REPORT View image in PDF format 01/16/2017--ANNUAL REPORT View image in PDF format 03/03/2016—ANNUAL REPORT View image in PDF format 03/19/2015--ANNUAL REPORT View image in PDF format 08/04/2014—Florida Limited Liability, View image in PDF format Florida Department of State,Oivsion of Corporations Miscellaneous Cash Receipt 1 CITY OF MIAMI BEACH No, 425115 1 p;. 0 Cash 0 Credit Card Gfi Check# I 1 -7 $ ..'�? O - 0v zi i i F 06 20 gg ; M 4$eceived of j4°t \rcr-p. 1(tC"r 0 )- , :1 I Miscellaneous-MCR-2020 "? 004iTSll�6qUT A c.�LM1�t' { "]) 1 G ('1 r� 60i: ( 3311-1 . MCOPEN(MCR) I i55 N..%.t,.. :. cf.)O ��...i 0( r•I ,1 I I r Payment Amount: 350.00 k: MCR49i11F l• 1 c'< I` (THIS INFORMATION MUST SE COMPLETED) Office of Finance Director I,' N (711 ' c")c)° ' -(icILji 00 ' 30' y5cd(-1. (7.0- 'ciz 1 Account umber: Preparers —) OAd ,h-z.„‘ r`F _,c.-- Dept t 4---- EXT: 7:4"i 1 I 1 t. Miscellaneous Cash Receipt 'CITY OF MIAMI BEACH , i. t No. 425116 , C-7 i 1 6 rm Cash Credit Card Check# ‘ .0 $ r r , --) IF.: I 0 .' 20 Vi , 11: Retitived of i lc -,,-s. ailliveous-MCR-2020.;',/t LI 55 -.---:33 RI C 1 , 004011-01i0gAarran ... iiiabizui9 09.14AM '' 1 FOCR OPEN(MCR) 1 Payment Amount: 500.00 I: MCR125116 I, ' ',.. • I l, (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director , A I" By [ Account Number Or / ' 7' 000 - 3k-r-i LI ilLi_ (Do_ -5(7)--7, 5 co ei . (,-,) c,,: :. Lf. Eli ----- A-)D 1\1 .1)/0' l„:L..,-,, C. . rreparer: Dept: C (— OCT: / Li L --)