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Ari Pearl - CG Sunny Isles, LLC 'G r MIAMI BEAct 7-010 -60 t � l City of Miami Beach Office of the City Clerk Q, 3S S �� 1700 Convention Center Drive, Miami Beach, FL 33139 03 S D LOBBYIST REGISTRATION FORM �y 'elk O OR Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks!to encourage the--pas , defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendati of t City Manager or any city board or committee; or any action, decision or recommendation of any city personnel during tl)e.time-period' entire decision-making process on such action, decision or recommendation that foreseeably will be heard OF revfe*ed°by the city commission, or a city board or committee. The term specifically includes the principal as well as any employe&ngage.d in lobbying activities. The term "Lobbyists"has specific exclusions. Please refer to Ordinance 2004-3435. Pearl Ari =9 NAME OF LOBBYIST: (Last) (First) (M.I) N 2915 Biscayne Blvd, Suite 200, Miami FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) ' (305) 747-6408 ari.gearl@kobikarp.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: i i CG Sunny Isles, LLC, CG Sunny Isles I. LLC. &CG Sunny Isles II. LLC—Joseph Chetrit& Meyer Chetrit, Managers 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: Meyer Chetrit,Managing Member of CG Sunny Isles,LLC&CG Sunny Isles II, , LLC and authorized signatory for CG Sunny Isles I,LLC j 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 20` Street. and 430 2151 Street Issue to be lobbied(Describe in detail): III. CITY AGENCIESIINDIVIDUALS 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 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,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 None *Unless an Issue Is legislative In nature,PB,HPB,BOA,&City Commission members are not lobbied outside of a public hearing setting. C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc Jill I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) D, 6y B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): b (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 lobbvina on a present or aendina bid for goods,eauinment or services,or on a present or aendina 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": i Yes X No: Are yglj lobbying on a aendina application for g Pevelonment Agreement with the City or application for change of zoning man designation or change to the City's Future Land Use Map? l 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. i _Yes X No: Are you representing 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 EM THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR CQMPgNSAIIQN DURINC2 ILIE RTMG PERIO0--, I Signa ure of Lobbyist i 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 h City C d all reporting requirements. I Signature of Lobbyist: leo :�,a°<* ��;�w JEANINE RODRIGUEZ i Signature of Principal/Client: :.• ,: Notary Public-State of Florida S P My Comm.Expires Jan 14,2013 Vl. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIF A ° Commission#DD 851762 I Produced ID Produced ID s Form of Iden' caip�s�. JEANINE RODRIGUEZ Form of Identification :rr S Notary Public--State of Florida I � " 'eE My Comm.Expires Jan 14,2013 .� A/Personally known(Lobbyist) %4 ersonall known(Principal) commission#DO 851762 y ( p ) fall VII. SIGNATURE AND STAMP OF State of Florida, County of Miami-Dade State of Florida,County of Miami-Dade Sworn to and subscribed bpfore me Sworn 2W subscribed before me This I day of QX-�t_ .2012 This I --'day of OL-tot ,2012 r Signature of Public Notary-Stak of Florida §ignatfire of Public Notary-State of lorida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY.(;ITY CLERK'S STAFF ONLY Annual Registration fee: Yes[ j No Amount Paid$'950-O V MCR# 31 Date Paid 2� ZV IZ Cobbyist Registration Forni received and verified y: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Tempora Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) �a co B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): �0.00 (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 lobbying on a present or pending bid for goods.eauipment or services.or on a present or pending award for goods.eguioment 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: Ara you lobbying on a pending application fora Awelopment Agreement with the City or application for change of zoning map designation or change to the City's Futljre 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 representing a not-for-profit corporation or entity without special compensation or reimbursement, V. SIGNATURE UNDER OATH: QN 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 EM THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE H__AVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 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: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) Personally known(Principal) VII. SIGNATURE AND STAMP OF N ,p,,, r A�e�0 JEANINE RODRIGUEZ State of Florida, County of Miami-Dade ' Notary Public-State of Florid to of Florida,County of Miami-Dade and subscribed before me f,Ay Comm.Expires Jan 14,20 m a d subscribed before me Sworn to a This day of ,2012 ",tit;; Commission#00 851762 day of O ClbW,2012 a Signature of Public Notary—State of Florida Signa r of Public Not ry—State of Florida Notarization of Lobbysignature 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 by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc F:\Ct F istration Form.doc Revised 04/27/2012 M . I- ((y(if Miami Bc,ich, 1700 Convention Center Drive, \limni Beach. Florida 33139, miamiheachtl. o%, ('I1 Y CLERK Office Rafael F.Granado, City Clerk Cit�Clerk�rintiatnibcachll.�o Tel:305.673.7411 ,Fax:305.673.7254 LOBBYIST NAME: Ari Pearl 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, 2012, 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�z Signature: Date: C:\Userslclerhatl\AppData\Local\MicrosofllWindows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc ® EXHIEIT is 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 0 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 II,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%