Kobi Karp - CG Sunny Isles, LLC MIAMI BEACH No��
City of Miami Beach Office of the City Clerk IQ
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.
Karp Kobi
NAME OF LOBBYIST: (Last) (First) (M.1)
Kobi Karp Architecture 2915 Biscayne Blvd, Suite 200, Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 573-1818 (305) 573-3766 info(d)kobikarn.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
CG Sunny Isles, LLC. CG Sunny Isles 1. LLC. & CG Sunny Isles II. LLC—Joseph Chetrit& Meyer Chetrit. Manaoers
NAME OF PRINCIPAUCLIENT:
Same 2915 Biscayne Blvd, Suite 300, Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 747-6408
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: Joseph Chetrit and Meyer Chetrit,Managers and Authorized Signatories
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached.
II.SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for one hotel project located at 2000 &2030 Park Ave, 2035 Washington
Ave. 425 &435 20t Street. and 430 215' Street
Issue to be lobbied(Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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 I NO
title of person to be lobbied
Staff of Planning Department, Building Department,and Public Works None X
Department
PB, HPB,BOA,City Commission,as necessary* None X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business;finpneial,far "41-pl pro a tonal
relationship,or other relationship giving rise to an appearance of an impropriety,with any current city comi»issioner'or city-pe'rsori I� ho is
sought to be lobbied as identified on the lobbyist registration form filed.
CO
Sec 2-482(g)Any Financial, Familial or Professional Relationship
None
*Unless an Issue Is legislative In nature,PB,HPB,BOA,&City Commission members are not lobbied outside of a public hearing setting.
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) #
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): TO6 � / Dom`
(REQUIRED). y9' 7 A
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes X No: Are you lobbying on a present o mendi ng hid fns goods eauipment or services or on a present or Pending
award for goods,eauipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbying on a pendina anolication for a Development Agreement with the City or application for
chance of zoning map designation or chanty_to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2-482(h)Any person(except those exempt from the definition of"lobbyist'as set
forth in Section 2481 above) 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 clerk as required by this section but,shall not be required to pay any registration
fees.
_Yes X Noe Are you representing a not-for-profit corporation or entity without special compensation or reimbursement
V. SIGNATURE UNDER OATH:
FEBRUARY ON 8O C 08YIST SHALL SUBMIT TO SIGNED
LISTING OMPENAMM RECEIV C OF MIAMI BEACH
Fes(•$ THE PRECEDING CALENDAR yEAg. A STATEMENT LL BE L BEEN N2
EXPENDITURES OR COMPENSATION
Signature of Lobbyist
I do solemnly swea hat all of the foregoing are t e and correct an at I h read or am familiar with the provisions contained
In Section 2-482 of a Miami Beac amity C -en porting requireme,ts.
Signature of Lobbyist:
Signature of Principal/Cl nt:
VI. LOBBYIST DENTIFI 1011riOr PRINCIPAL IDENTIFICATION:
_Produced Notary Public State of Florida -_Produced ID
Form of Id t Mercy Marques Form of Identification
My Commission EE139146
_Personally known(Lobbylst Expires 10117/2015
Y—Personally known(Principal)
VII. SIGNATURE AND STAMP OF DT 1
Y � late of Florida,County of Miami-Dade
� JEANINE RODRIGUEZ
State of Florida,Count of Miami-Dade :* �•-
Sworn 'and su "cribed fore me o Notary Public-State of Florida wo nd subscribed before me
This }� ay f Q. ,2012 = , �,=My Comm.Expires Jan 14,2013 his day of gut-.,2012
' F..F. .•' Commission#DD 851762
Siglfature,kf Public otary–State of Florida Signature of Public Notary–Slate of Florida
Notariza on of s s signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r
Annual Registration fee: [ ]Yes[ ]No Arnount Paid$ M C R# Date Paid
Lobbyist Registration Form received ancl verified y:
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) '
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
$,��(REQUIRED).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes X No: Are you lobby*na on a present or nendina bid for goods,eauiioment or services.or on a present or oendina
award for aoods.eauipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbvina on a nendina application for a Development Aareement with the City or application for
chance of zonina map desianation or chanae to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2-482(h)Any person (except those exempt from the definition of"lobbyist"as set
forth in Section 2-481 above) 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 clerk as required by this section but, shall not be required to pay any registration
fees.
Yes X No: Are you representina a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
-f-Dr klab I
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
XSignature of Principal/Client:
VI. LOBBYIST IDENTIFICATIO PRINCIPAL IDENTIFICATION:
_Produced ID _Produced ID
Form of Identification Form of Identification
_Personally known(Lobbyist) personally known(Principal)
VII. SIGNATURE AND STAMP OF T
State of Florida, County of Miami-Dade ;'-,P`;� JEANINE RODRIGUEZ tate of Florida, County of Miami-Dade
y
Notar Public•State of Florida worn nd subscribed before me
Sworn to and subscribed before me ' A
This day of 2012 =°9j o-c�c My Comm. Expires Jan 14,2013 his day of�.,2012
Commission#DD 851762
•1111 I
Signature of Public Notary—State of Florida Signature of Public Notary—Slate of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified y:
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F:1CLE Isb-ation Form.doc Revised 04/2712012
AAAAA] BEACH
City or Miami Bench, 1700 Convention Center Drive, Miami Beach, Florida 33139, «�vtiv.miamibcachll.gcv
CITY CLERK Office
Rafael E.Granado,City,Clerk CilyClerk(a,�miamibeachfl.gov
Tcl:305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: Kobi Karp
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 2-185 (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, 2012, shall be
automaticallv sus ended from lobbying until all .fines are paid, unless the fine has been
app to the Miami- County Commission on Ethics and Public Trust.
6 12-711�
Signatu Date:
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EXHIBIT B
DISCLOSURE OF INTEREST
NAME OF INTEREST HOLDER % INTEREST
1. CG Sunny Isles,LLC, a Florida Limited Liability Corporation 51%
3200 Stirling Rd
Hollywood,FL 33021
Judah Chetrit, Manager 100%
3200 Stirling Rd
Hollywood, FL 33021
2. CG Sunny Isles I,LLC,a Florida Limited Liability Corporation 20%
3200 Stirling Rd
Hollywood,FL 33021
Joseph Chetrit,Manager 100%
3200 Stirling Rd
Hollywood,FL 33021
3. CG Sunny Isles H,LLC,a Florida Limited Liability Corporation 29%
3200 Stirling Rd
Hollywood,FL 33021
Meyer Chetrit,Manager 100%
3200 Stirling Rd
Hollywood, FL 33021
TOTAL for Applicant 100%