Jennifer McConney - 2912 Collins Avenue, LLC MIAMI -BEACH
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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.
McConneu Jennifer
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 kobikarp(Rkobikam.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 1�
� 1
Collins Avenue LC
NAME OF PRINCIPAUCLIENT: S
1065 Kane Concourse, Suite 201 Ba,,y Harbor Islands FL 33154
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 866-7555 0051866-7515 robertna.finvarb.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 Approvals and Permitting Issues, including, but not limited to Historic Preservation Board, Planning and Board of
Adiustmentxwi2rovals or the provertli located at 2912 Collins Avenue Miami Beach FL
Issue to be lobbied(Describe in detail):
lll. 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
evelopment Committee, as necessary one
Puirsuant 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
lVone
None-
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required):_$ ,/�s o
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). V,
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 pending bid for goods.equipment or services.or on a present or
Blogjpg award for aoods.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 amending application for a Development Aareement with the City or application
I"change of zonina map designation or change 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 o: Are you reoresentina 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
OA11J. Ll§jlblG LOBBYING EXPENDITURES. AS WELL AS COMPENSATION R cr% IN THE CITY OF MIAMI BEACH
EXPENDITURES OR
Signature of Lob ist
I do solemnly swear that all of the goi facts ar a and correct an aye re d or a famili with the provisions contained
in Section 2-482 of the Mi ' eac o all rting requirements.
Signature of Lobbyist: oll
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
—Produced ID o°o Produced ID
Form of Identificatio W o N^ Form of Identification
W
Personally known(Lobbyist) c o Personally known(Principal)
W L1
m W
VII. SIGNATURE AND STAMP OF NOT R15 d e E
Wc90
State of Florida,Count Z ;" State of Florida, County of Miami-Dade
Sworn to and subsc ' ed b fore me �• og Sworn and subscri ed befor e
This ?_Q]b da of ,2013 ;.•�,c • bo;,, This o ,2013
V-
e o is Notary-Sta nda "'°ti • SSp�,� Signature of Public Notary-State of Florida
of signature Notarization of Prin=signature
Anniml ReglaStrafoon fee- j I Ypq[ I Nn AMonnt Paid$ mCR#— natp PaDd /
TO BE COMPLETE B CITY CLERK'S STAF 0 -7 2j
Lobbyist Registration Form received and verified by. , ✓
F:\CLE istration Form.doc Revised 04/27/2012
MIA.MIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.mimnibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax:305.673.7254
LOBBYIST NAME: Jennifer McConney
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/-- -7/ � 2 //3
Sig ture 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
RIP 2912,LLC 100%
1065 Kane Concourse,Suite 201
Bau Harbor Islands,FL 33154
RLP 2912 LLC
1065 Kane Concourse,Suite 201,Bay Harbor Islands:FL 33154
Robert Firwarb Familu Investments 100;b
1065 Kane Concourse,Suite 201
Bau Harbor Islands,FL 33154
Robert Flinvarb Family Investments
1065 Kane Concourse,Suite 201,Bau Harbor Islands,FL 33154
Robert and Rochelle Ffnvarb,Managing 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
Courtuard Marriott Comomtion 100%
10400 Femwood Road
Bethesda,MD 20817
Court ward Marriott Corvoration
Marriott International,Inc. 1001%
10400 Fernwood Road
Bethesda.MD 20817
Marriott International.Inc.
Marriott International,Inc. 100;0
Marriott International.Inc.is a nubliclu traded
comvanu under the sumboI MAR on the New York
Stock Exchanae,
IF 7HEREAREADDMONAL CORPORA77ONS,LLST OTHERS,INCLUDING CORP.NAME(S)AND EACH INDMDUAL S
NAME ADDRESS, OFFICE AND PERCENTAGE OFSTOCIC, ON SEPARATE PAGE.
NOTE.•Notarized signature required on page 8
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