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Andrew Resnick - Washington Squared Owner, LLC. S- H City of Miami Beach Office of the City Clerk 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. Resnick Andrew NAME OF LOBBYIST: (Last) (First) (M.1) Washington Squared Owner, LLC 425 Northwest 26th Street, Miami Florida 33127 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) andrewresnick21(d)amail.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: Washington Squared Owner. LLC (contact: Andrew Joblon) NAME OF PRINCIPAUCLIENT: Same 425 Northwest 26th Street Miami FL 33127 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) ait—turnbridgeeauities.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: Andrew Joblon • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: 100% Washington Squared, LLC,Managing Member—50%Turnbridge Miami, LLC(47.5%Andrew Joblon, 47.5%Ryan Nelson and 5%Andrew Resnick)&50%PG Washington Squared Owner, LLC(50%Jarrett Posner and 50%Sean Posner) Referendum and Ordinance concerning development regulations for Washington Avenue corridor between 6th and 17th Streets and development approvals and permitting issues for the 600 block on the east side of Washington Avenue 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 Department None. X B,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(8)Any Financial, Familial or Professional Relationship None I J._i I,.1 F:\CLER\$ALL\aFORMS\LOBBYISTFORMS\LobbyistRegistrationForm.doc ' ' IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Re -red). $ ., /hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). /hour 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,equipment or services.or on a Dresent or Dendina award for goods,eauipment or service? 2) Pursuant to Miami Beach Code Section 2-490 Entitled "Prohibited Campaign..Contributions By Lobbyists On Real Estate Development Issues": _Yes X No: Are you lobbvina on a pending application for a Development Aareement with the City or application for change of zoning 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 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 FOR THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE 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: G Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form.of Identification Form Identification Personally known (Lobbyist) Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: � ��,� Sardh Nr�`�®rk- New Yomy � Cat Zano State of Ffefta, County o State of Florida, Count of Miami-Dade Sworn to and subscribed efore me cc a COMMISSION#FF127075 Sworn� subscribed before me This 1 d J , 201 EXPIRES: 2$, 8 Tda of , 201_ �� ► R Y.COMI - - S n ure of Pub VNa —St to of F rida Signatur of Public Notary—State oW-fm CT1VeA4Y � , No ation of signat Notari ation of Principal's signature TO BE COMPLETED BY CITY CLERK'S ST Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# 6 Date Paid Lobbyist Registration Form received and verified by: Revised 01122/2 4 F.\CLER\ AI_L\aFORMS\LOBBYISTFORMS\LobbyistReg islra.iiotiForm.doc AAIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfi.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.1411, Fax: 305.673.7254 LOBBYIST NAME Andrew Resnick 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, 2014, 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: FACLER\$ALL\aFORMS\LOBBYISTFORMS\LobbyistRegistration Form.doc ^ D CL ❑ wow CL ■„, { f rr ❑ m.. O CL F ny n cD CD Id Za NJ V �-"� - '. _ - -•.+..;, - � _ 11111 _ Prieto, Silvia From: Prieto, Silvia Sent: Wednesday,July 09, 2014 10:25 AM To: 'andrewresnick2l @gmail.com' Cc: 'aj @turnbridgeeguities.com' Subject: Lobbyist Registration Dear Mr. Resnick, We are in receipt of your Lobbyist Registration on "Washington Squared Owner, LLC", however, on the 2"d page of the application the hourly rate amount was left out, please send us the amount, in order for us to conclude the processing of your application. Thank you so much, MIAMI BEACH Silvia Prieto,Administrative Aide I CITY CLERK'S OFFICE 1700 Convention Center Drive,Miami Beach,FL 33139 Phone: 305-673-7000 ext.6269/ Fax:305-673-7254 www.miamibeachfi.gov We are committed to providing excellent public service and safety to all who live,work and play in our vibrant,tropical,historic community. 1 Prieto, Silvia From: Andrew Resnick <andrewresnick2l @gmail.com> Sent: Wednesday,July 09, 2014 10:27 AM To: Prieto, Silvia Cc: aj @turnbridgeeguities.com Subject: Re: Lobbyist Registration $0.Thanks Sent from my iPhone On Jul 9, 2014,at 10:25 AM, "Prieto,Silvia" <SilviaPrieto @miamibeachfl.gov>wrote: Dear Mr. Resnick, We are in receipt of your Lobbyist Registration on "Washington Squared Owner, LLC", however,on the 2nd page of the application ' the hourly rate amount was left out, please send us the amount, in order for us to conclude the processing of your application. Thank you so much, - MIAMI BEACH Silvia Prieto,Administrative Aide I CITY CLERK'S OFFICE 1700 Convention Center Drive, Miami Beach,FL 33139 Phone:305-673-7000 ext.6269/ Fax:305-673-7254 www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live,work and play in our vibrant,tropical,historic community. 1