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Monika Entin - 1787 Normandy Drive LLC • • �1 JiOrMc.,,,al, (� • RECEIVED Office of the City Clerk . DEC 11 1700 Convention Center Drive 2020 Miami Beach, Ft 33139 305.673.7411 G�17Y OF N11/1M1 F�FrQ�f�: OFFICE T`9EC]YCLERK LOBBYIST REGISTRATION FORM . . . . Lobbyist means all persons employed or'retained,whether paidor not, by a principal who seeks to encourage thepassage, 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 orcommittee; 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 'hone" or h/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 representedon each specific issue. I. LOBBYIST INFORMATION: Entin Monika - NAME OF LOBBYIST (Last) (First) (Middle Name) MHE Law PA 633 S. Andrews Ave., Suite 500 Ft. Lauderdale, FL 33301 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) .• (City) . (State) (Zip Code) 305-542-3445 305=542-3445 • Monika(a),MHElawpa.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS . II PRINCIPAL INFORMATION: • Lahsen Patricio. NAME OF PRINCIPAL' (Last) (First) (Middle Name) 1787 Normandy Drive, LLC 755 Crandon Blvd. Key Biscayne FL. 33149 PRINCIPAL BUSINESS,NAME AND ADDRESS (Number and Street) (City) .. ;_ (State) ., :_ (Zip Code) c/o plahsen.xojmail.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER. EMAIL ADDRESS S rsitant t e e ectidh 2-482(h)(1 (a). A o i o.l ° any corporation partnership . , t . °,appears 3"r1 lobby ist CtillItagc2'tha entity,' special compensation co reimbursement or -°e-. . direct indirect Jcontingent, e Plea pp° Cfl° •apposition n -n°gr ill cegiste MD. 0- ° e . . uir. e o 31 e e n ell a e e e ttol Ray any gis °a If the principal is'a. Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code.Section 2-482(c): Patricio Lahsen;.Manager • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): • 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 Exhibit 'A" 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 Design Review Board, Planning Board, Board of Adjustment, Land Use and Sustainability Committee, City Commission, any City Workshops or Committees, and City Departments, if necessary relating to the property located at 1787 Normandy 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 Title of Person to be Lobbied Staff for the Planning Department, Building Department None. X Public Works, and City Administration, PB, DRB, BOA None. X 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): None. 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): $450.00 per hour Page 2 of 5 • 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 XNo: Are you-lobbying on a pending application fora 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 2482(h), any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481)whoonly 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: Expertwitnesses 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.oropposition 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 organisation for the purpose of requesting a grant 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 theswearing in of anyelected 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: -Ito; Yes XNo: Ifiyes,has itlbeennde'ss thanb112 monthsssinceiihelelected'offreial(sitwhom yo.0 provided campaign . consulttnq serulces Awa sworm�iinf? i 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 ata public meeting. _Yes XN0: . 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: er" 5F.}�j» ' <a. _i'- :.i" ., r v d.i: L a`4-�'sE: i�r :. . 0 '.`4 'T1W- .,-5:.. .. .. Yes_No: f yes, were yo.0 promised oradid ivousreceive economic'consideration.in exchange for'campaign onsultinq ser,ui'comes TO BE COMPLETED BY CITY CLERK'S STAFF ONLY ... . Annual Registration fee: [ ]Yes trINo Amount•Paid$::- ° G MCR# -1 L-1 Date Paid . Lobbyist Registration Form received and verified by fkc'J J:rs) F;•\CLER\$ALL\aF,ORMS\LOBBYIST FORMS\Lobbyist,Registration Form Revised 09-20-18 REG.doe :. .:. Revised 09/20/2018 Page3of5 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__©.-STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION- TIRING THE RE ORTING PERIOD.1 Signature of Lobbyist: ) Date q I 115 •C10-0 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,p.rovi ons ained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all rep • g requirements. Signature of Lobbyist: Date a / /a U 0-c) Vic= G1 ^lam-1 we.". / t / Z c7—0 Signature of Principal: % p- Date VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL Florida Florida state of state of County of: CNMO-R+l t..) 'Y_ County of: Micwiri1— wae. Sworn to (or affirmed) and subscribed before me, Sworn to (or affirmed) and subscribed before me, by means of 0 physical presence by means ofll physical presence or 0:online notarization or 0 online notarization,this k\/'day of this \�'' day of September , 2020, by Septermber 2020 by Patricio Lahsen, Manager of 1787 Normandy Monika Entin Drive, LLC. NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known X Personally Known 4kUlja-COLJ`kb Signature of Notary Public, Signaturef Notary Public ... LAURA CANO ,0-vim - ` Va..)R4 e. Na rygpt;lyp c F Ott F Fi�3t• ped Name of Notary, Typed, Printed or Stamped Commission#HH 3 2 '' y Comm.Expires May 26,2024 (No adYthrough National Notary,Assn, (NOTARY SEAL) - I MARY-EVE VENDRYES „.,..;;;;74,:_„,,-•� : Notary Public-State of Florida uiii Commission#GO 063066 1 i My Comm.Expires Jun 17,2021 I The term"lobbyist"specifically excludes the following persons: 4 aFP ° Bondedthrough National Notary Assn. 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 MIAMIBEACH . 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;305.673.741 1, Fax: 305.673.7254 Monika Entin NAME OF LOBBYIST: 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 thatmay 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) tofile 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 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 shallimmediately 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 p rrant-to--Section 2-482 of the Miami Beach City Code. 1ff _s � , 2020 C � Signa ure df Lobby! Date. F:\CLER\SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page5of5 . EXHIBIT - A DISCLOSURE OF INTEREST CORPORATION,PARTNERSHIP OR LIMITED LIABILITY COMPANY If the properly that is the subject of the application is owned or leased by a corporation, partnership or limited liability company,list ALL of the owners,shareholders,partners,managers and/or members,and the percentage of ownership held by each.If the owners consist of one or more corporations, partnerships,trusts, partnerships or other corporate entities,the applicant shall further disclose the identity of the individual(s) (natural persons)having the ultimate ownership interest in the entity. 1787 Normandy Drive, LLC NAME OF CORPORATE ENTITY NAME AND ADDRESS New Alhambra Holdings, Corp. 100% 755 Crandon Blvd. Key Biscayne, FL 33149 New Alhambra Holdings Corp. NAME OF CORPORATE ENTITY NAME AND ADDRESS Vizcaya Investing Ltd. 100% British Virgin Islands Vizcaya Investing Ltd. • NAME OF CORPORATE ENTITY 'NAME AND ADDRESS Patricio Lahsen 100% 755 Crandon Blvd. Key Biscayne, FL 33149 { Miscellaneous Cash Receipt CITY OF MIAMI BEACH _ , No, 427201 C Cash` ►Credit Card Check# /f. ;` ,- d 2Q tJ F I1V041 Of 4-,kI t IC. ✓ t r ". IO t1`, i Miscel aneousf•IvtE.,t.-2U21.1 - nIj -,,,I,,')20'd 10.?3l}k, /: ,,, 3 !u I1 ., fft,,,, . , ,#. J G%"1 if 1 1 „ a} `' Riiiii.OPEN(MG '55"t k Payor , A mount: 700.00 a' 427201 _; f' (This IMPORMATPON MUST RE COMPLETED) df4ico of 0t11anaa'Wei ctor Account Number 0 LI. -5 ��t� . . 1 , ' t ti'1 e ri 0 .. .11 . x --) .C''` t-,v� e d • I i