Neisen O. Kasdin - 3420 Collins Ave, LLC . t
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MIAMI BEACH.
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 recommendatlon 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.
Kesdin Nelsen O.
NAME OF LOBBYIST: (Last) (First) (M.I)
Alterman LLP One BE Third Ave,25th Floor Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
306.374.6600 306.374.5095 nelsen.kosdln®akerman.wm
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact Information changes:address,phone,or e-mail address.
I. LOBBYIST RETAINED BY:
3420 Collins Avenue,LLC
NAME OF PRINCIPAUCLIENT:
3201 Collins Avenue Miami Beach FL 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-535-3009 sjatife®faenegroup.com
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section If principal is a Corporation,Partnership or Trust[Section 2482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: N/A
• IDENTIFY ALL PERSONS HOLDING,DIREC INDI A ° RMQPE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
ii.SPECIFIC LOBBY ISSUE: , .,
Seeking approval of certificate of appropriateness for demolldon a d V/� �' A8 &`
Issue to be lobbied(Describe In detail):=jkpCK i t%XJ �-Vpfto4j foil ,r j Tp-_ Of rt hC A #10 iC beA& .
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
Planning Department Staff, Historic Preservation Board n/a
Pursuant to City Code Section 2.482(8)Every registrant shall be required to state the extent of any business,financial,familial or pcffesslonab
relationship,or other relationship giving rise to an appearance of an Impropriety,with any current city commissioner or city personnel whops'
sought to be lobbied as Identified on the lobbyist registration form tiled. -•- -� i1
Sec 2-482 Any Financial,Familial or Professional Relationship
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) 9 Sn�� e
h-rV B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED).w45h4
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❑✓No: Are you lobbving on a present or pending bid for goods,eaulpment or services,or on a present or pending
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✓]No: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning may 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 2481 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[]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/40 THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENsAILONAECEIVED. IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILWIEVIEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lob yist
I do solemnly swear that all of the foregoing facts are true c rrect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all r quirements.
Signature of Lobbyist:
Signature of Principal/Cliental
VI. LOBBYIST IDENTIFICAT PRINCIPAL IDENTIFICATION.
Produced ID Produced ID ci vtr$ �
Fo ti WOYPUBLIC ERE��6ATA Form of Identification
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a STATE OF FLORIDA
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6/8/2015 VII. SIGNATURE AND ST I OF f &kW MY COMMISSION#EE134®14
EXPIRES Septe bMOWN%State of F orida,County of Miami-Dade coof Flo' de
Sworn f4o bnd subscri fo me wor
This d f ,20 OJ� This day of tNeoli 20�
Signature of Pul5lic try—State of Florida Si a re of Public Notary—Stat f Florida
Notarization of Lob is signature Notarization of Principal's signa ure
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ No Amount Paid$ a MCR# ate Paid
Lobbyist Registration Form received and verified by: i Q„no_ L�
F:%CLER\$ALL\aFORMS\LOBBYIST,FORMSkLobbylst Annual Registration Form.doc Revised 11/18/2013
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/\AIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granada,City Clerk CityClerk @miamibeachfl.gov
Tel:305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: Neisen O. Kasdin
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 2-455(d),the City Clerk shall notify any lobbyist(or principal)who
falls 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) flied after the due date. The City Clerk shalt 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 30, shall be automatically
suspended from t ving until all fines are paid, unless the fine has been appealed to
the Miaml-Dade C Commission on Ethics and Public Trust.
Signature Date
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Disclosure of Interest
3420 Corans Ayenuo,llC
PARTNERSHIP Of LIMITED PARTN£RSHM NAME
NAME AND ADDRESS %OF STOCK
—MOM BkvaWl.730 S*Memo.Nair Yore.NY 10019 100
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Miscellaneous Cash Rec eipt
CITY OF MIAMI BEACH
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