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Kobi Karp - 1600 Collins Avenue LLC i V 1� /\A I A t B H V � ;zck. City of Miami.Beach Office of the City Cler 1700 Convention Center Drive, Miami Beach,tH M3fb PM 2s :I 2 LOBBYIST REGISTRATION FORM CITYy ``LEF%" ` . Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeKS to encourigP�he Jssage, 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.I) 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)kobikarD.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: 1600 Collins Avenue LLC NAME OF PRINCIPAUCLIENT: 1065 Kane Concourse, Suite 201 Bay Harbor Islands FL 33154 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)866-7555 (305)866-7515 robert(cDfinvarb.com 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: Robert Finvarb • 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 aDDrovals and Dermittina issues for one hotel Droiect located at 1600 Collins Avenue, Miami Beach. 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 NO title of person to be lobbied Staff of Planning Department,Building Department,and Public Works None X De artment PB, HPB,BOA,FP,City Commission,as necessary* None X Pursuant to City Code Section 2-482(8)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 Any Financial, Familial or Professional Relationship Nonp- *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 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) t. I 3�0 0 0 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): �0.(REQUIRED). ti 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 uresent or nendina had for goods.eauinment or services.or on_a®resent or pending 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 lobby on a pending application for a Development Agreement with the City or application for chance of zoning map desianation or change to the CitVs 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 representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON EEBRUARY 28th OF EACH XEA11- EACH WOUXISTSHALL 5UB 1 HE CITY CLERK A SIGNED STATEMENT UNDER EQB EXPENDITURES OR COMPENSATION DURING THE M IN ignature of L /anthat I do solemnly swear that all o e foregoin s e true nd rrect I have read or am familiar with the provisions contained in Section 2-482 of the Miami ode ep ing requir . Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFIC ION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification /Person y ",jLobbyi"VANA MARKHOFF Personally known �!:4 ` = Notary Public State of Florida : •; : • My Comm.Expires Apr 3.2013 • (Principal)VII. _ SIGNATURE AND STAMP OF Commission#EE 179221 NOTARY: %%;F.;;;;�•, Bonded Through National Notary Assn. State of Florida, County of Miami-Dade State of Florida,County of Miami-Dade Sworn to and subscribed fore me SWpm and subscribed before me d° This Tday o ,201 is day of 2012 Signature of Foic Notary—State of Florida Sig ur o ub is Notary—State of Florida Notarization of Lgbbvist's signature Notarize of Princes signature w Annual Registration fee: [ ]Yes["}No Amount Paid$ 350 •yy MCR# ��"r 1 Date Paid V y /\AIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 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 2-485 (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 automaticall ed from lobbying until all fines are paid, unless the fine has been appeale o the Miami-Da County Commission on Ethics and Public Trust. I `7 2� 1 Signature: Date: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc