Kobi Karp - 2912 Collins Avenue, LLC MIA/\Al BE H
City of Miami Beach Office of the City Clerk
V
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.
Kam Kobi
NAME OF LOBBYIST: (Last) (First) (M.I)
Kobi Karp Architecture&Interior Design, Inc., 2915 Biscayne Boulevard, Suite 200, Miami, Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-573-1818 305-573-3766 kobikaronakobikaro.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:
2912 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 (3051866-7515 robejjgLnvarb.corn
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] I
l
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Robert Finvarb g
• 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, including, but not limited to Historic Preservation Board, Planning and Board of
Adiustment approvals for the proyertu located at 2912 Collins Avenue, Miami Beach,FL
Issue to be lobbied(Describe in detail):
Ill. 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,st ting 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
Planning Department and Building Department Staff None
B, DRB, HPB, BOA, City Commission, and Land Use None
IDevelopment Committee, as necessary None
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
Nnne
None
None
I
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required):_$550, QQ/h r
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):_$ -5 50. 00 n r
(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 oresent or Dendina bid for goods.eauiDment or services.or on a present or
DIGAWg award for goods.equipment 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 pending application for a Development Agreement with the City or application
f&[c•hanae of zoning map designation or change to the Gitv'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 On Are you representing a not-for-profit corporation or entity without special comoensation or reimbursement.
V. SIGNATURE UNDER OATH:
nil FFR13U RX 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH_ i ISTiNr 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 COOdPEbISATION DURING THE REEOBTIN n!!�
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have 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 IDENWrCATIONilr PRINCIPAL IDENTIFICATION:
_Produced ID _Produced ID
Form of Identification g'°4 Form of Identification
.Personally nown(Lobbyist) � Personal) known(Principal) w
Y ( Y� ) Y ( P ) �fto CN
VII. SIGNATURE AND STAMP OF NOT 1t 45 W�Uj'Pu
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State of Florida, County of Miami- F F State of Florida,County of Miami-Dade S.
Sworn to and subscribed b e me FE Sworn and subscribed before me U11 v m
This 2g7i day of ,2013 g� This _ ,2013 ,.••`"�i:'�;dyo,
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=�e�Pu is tary—S of FI Signature of Public Notary—State of Florida *ll •t •
sig nature` =1�*•+,, Notarization of Prince signature
TO WtVaPLETED BY CITY CLERK'S STAFF ONLY /J
Lobbyist Registration Form ceived and verified by: /
1
F:\CLE istration Form.doc (Revised 04/27/2012
MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachf.gov
CITY CLERK Office
Rafael E.Granado, City Clerk 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
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.
Signature Date
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1.CORPORATION
If the property which is the subject of the application is owned or leased by a CORPORATION, list the principal
stockholders and the percentage of stock owned by each. Where the principal officers or stockholders consist of
another corporation(s), trustee(s), partnership(s) or other similar entity, further disclosure shall be required which
discloses the Identity of the Individual(s)(natural persons)having the ultimate ownership interest in the entity).*
2912 Collins Avenue,LLC,a Delaware Company
1065 Kane Concourse,Suite 201,Bau Harbor Islands.FL 33154
CORPORATION NAME and ADDRESS
NAME,ADDRESS,AND OFFICE %OF STOCK
RIF 2912,LLC 100°,b
1065 Kane Concourse,Suite 201
Bau Harbor Islands,FL 33154
REF 2912 LLC
1065 Kane Concourse,Suite 201,Bay Harbor Islands,FL 33154
Robert Flinvarb Familu Investments 100%
1065 Kane Concourse,Suite 201
Bau Harbor Islands,FL 33154
Robert FYnvarb Family Investments
1065 Kane Concourse,Suite 201.Bau Harbor Islands,FL 33154
Robert and Rochelle PYn.varb,Manaaina Members 100%as
1065 Kane Concourse,Suite 201 tenants bu the entiretu
Bay Harbor Islands,FL 33154
Seville Acquisition,LLC
10400 Fernwood Road,Bethesda,Maruland 20817
Courtyard.Marriott Corporation 100%
10400 Fernwood Road
Bethesda,MD 20817
Courtward Marriott Corporation
Marriott International.Inc. 100%
10400 Fernwood Road
Bethesda,MD 20817
Marriott International,Inc.
Marriott International.Inc. IOO;b
Marriott International,Inc. is a publicly traded
companu under the symbol MAR on the New York
Stack Exchange.
IF THEREAREADDMONAL CORPORATIONS,LIST OTHERS,INCLUDING CORP.NAME(S)AND EACH INDIVIDUAL S
NAME,ADDRESS, OFP7CEAND PERCENTAGE OFST0LX, ONA SEPARATEPAGE.
NOTE.•Notarized signature required an page 8
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