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Neisen Kasdin - Caton Owner, LLC VLAA Bow-J. ii\A I AM I k f k City of Miami Beach Office of the City Clerk F; e 1700 Convention Center Drive, Miami Beach, FL 33139 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 Ordinance 2004-3435. Kasdin Neisen NAME OF LOBBYIST: (Last) (First) (M.I) Akerman, LLP 98 SE 7 St,Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-982-5629 305-374-5095 neisen.kasdin @akerman.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact inforthation:changes:address; hone;:ore-mail address. -. I. LOBBYIST RETAINED BY: Mendy Boymeigreen NAME OF PRINCIPAUCLIENT: Caton Owner, LLC 3921 Alton Road Miami Beach FL 33140 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section If principal is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Ste A` _chec{ • IDENTIFY ALL PERSONS HOLDING,Dilt� CT LY QR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Ste_q+ II.SPECIFIC:LOBBY-ISSUE:; $ite plan filing fora conditional use and Design Review Board approval. 9k n;n� Issue to be lobbied(Describe in detail): 3 Lies 4`+ f STi iii.CITY AGENCIES/INDIVIDUALS'TQ BE LOBBiE:D: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied Design Review Board N/A X Planning Board N/A 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. Sec 2-482(g)Any Financial,Familial or Professional Relationship N/A F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc X• sv' City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Neisen Kasdin I understand that no later than February 28 of each year, I must file the following form, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) LOBBYIST EXPENDITURE AND COMPENSATION FORM Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist(or principal) who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) 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 sus ended from lobbying until all fines are paid, unless the fine has been appealed to t , .lami-Dade County Commission on Ethics and Public Trust. • ,12_1(1c Signature: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc Disclosure of Ownership • Caton Owner LLC is solel y by owned b Caton Mezz LLC • Caton Mezz LLC has 3 individual owners: 1. Chen Lamdan 8 Hamelacha St. Ind.Zone Lod Israel, 71100 2. Sarah Boymelgreen 1286 President Street, Brooklyn,NY 11213 3. Shmuel Boymelgreen 535 Dean Street, Brooklyn, NY 11238. • Miscellaneous Cash Receipt - ri CITY OF MIAMI BEACH - tki 409143 1:1 Cash 0 Credit Card tCheck# 304)11 I I)u $ 5 0 00 C)-3. 26 Received of N Address 5 5f' ' UA 41. 3 Si 31 For I55vc'E- — MAR 2 1 2016 V A Y MI • (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director By 'CIO 0, - Account Number itiSS CITV I, t '? r Dept: - r Err: -J 1 I Preparer. , 4 • •