The URL can be used to link to this page

Jennifer McConney - Washington Squared Owner, LLC. AAIAMI BEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 07e� ,e'.' 14- 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. McConney Jennifer NAME OF LOBBYIST: (Last) (First) (M.1) Kobi Karp Architecture& Interior Design, Inc. 2915 Biscayne Blvd., Suite 200 Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 573-1818 (305) 573-3766 imcconnevQkobikarp.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: Washinaton Sauared 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) ai(d)-turnbridgeeguities.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(g)Any Financial, Familial or Professional Relationship None FACLER\$ALL\aFORMS\LOBBYISTFORMS\LobbyistRegistration Form.doc DO i At L j IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION.(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) 25— our B) PRINCIPALS DISCLOS R�E�F LOBBYIST COMPENSATION): (REQUIRED). $ J (/ '/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 lobbvina on a present or pending bid for goods,equipment or services. or on a present or aendina award for goods.eauioment 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 for change of zoning man 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 E STATEMENT SHALL BE FILED EYEN IF THERE HAV9 E EXPENDITURES OR COMPENSATION DURING THE REP I Signa re of Lobbyi t I do solemnly swear that all of th oing is are true and c and that/ave read familiar with the provisions contained in Section 2-482 of the Mia eac t od and a uirements. 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 NOTARY: ( - `. � Le 6L'?�; MONICA KARROUM State of Florida, County of Miami-Dade ounty Sworn to and.subscribed before me :*S MY COMMISSION#EE0373T ubscribed before me�' EXPIRES October 25,2014 ay f j vet. 201_ This day of_ 201 •,,or;N�.� �. (407)398-0153 FloridallotaryService.com Y, Signature bf Pu lic Notary—State of Florida Signatu of Public Notary—State of:r�iW'r'" Notarization of Lobbyist's signature Nota nation of Principal's signature TO BE COMPLETED B )CITY CLERK'S STAFjF Lyi / Annual Registration fee: [ ]Yes[ ]No Amount Paid$ (� MCR# (p & Date Paid Lobbyist Registration Form received and verified by: _Revised 01122/2014 F:ICLERI$Al-,[-';a FORM S!LOBBYIS TF0RMS 1LobbyistRegistration Form,doc r 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: 305.673.7411, 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, 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. __ r---7, -7/j/� Si ature: Date: FACLER\$ALL\aFORMS\LOBBYISTFORMS\LobbyistRegistration Form.doc r NO CV `W _ - .. r0. a .,� Nl,-. rx sl ED _ .ti qtr IL a TN ILU ca Wus Z wo- lZI �. LL. g. z Z a E' LL.