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Antoine Chaava - Terra Group .r C� Am' BE H City of Miami Beach Office of the City Clerk �p 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. Chaava Antoine NAME OF LOBBYIST: (Last) (First) (M.I) 56e ATTAci--1-ED BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address,phone, or e-mail address. I. LOBBYIST RETAINED BY: David Martin s NAME OF PRINCIPAUCLIENT: Terra Group 26 5 S. Bayshore Drive Miami Florida 33133 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 416-4556 (305) 777-3040 DMartin(c�terraaroup.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: 01-tiC it n 4 �` • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MO OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: 4et ILSPECIFIC LOBBY ISSUE: Land Development Approvals for 8701 Collins Avenue, Miami Beach. Florida 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 Planning Department and Building Department Staff None X PB, 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 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) x1/ $ AdiY-c-e n2.t- B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (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 lobbyina on a present or pending bid for goods.eauipment or services. or on a present or pending award for aoods.eauipment 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 oendina application for a Development Agreement with the City or application fa change of zoning map desianation or chanae 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 BEACF( EQ$ .._ C I . . C:•__►_ _:. T• Al .. L BE Fl ED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE RE'•-. ► ,I PM" Signature A►::"Iy I do solemnly swear that all . t e for-•,•ing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Mia i a• ��'y Code and all reporting requirements. Signature of Lobbyist: tri 4 Signature of Principal/Client. 9 VI. LOBBYIST IDENTIFICATIO : PRINCIPAL IDENTIFICATION: • Produced ID .115.NOl Produced ID o�, "o% Form of Identification g n Form of Identification r , Personally known (Lobbyist) a Personally known(Principal) X g o 0 m�C7Z C/ d• VII. SIGNATURE AND STAMP OF NOTARY: 0 m A 3 (7).- C1 Q oa ;pc off 3 a. km mg -0 State of Florida, County of Miami-Dade o T.o N Sta of Florida, County of Miami-Dade m 0 Sworn • and sub i efo e me ; N m Swor .nd subscribed bef re me o This i,►i day •� , 2015 ` `" o This / day of , 2015 N � 111/ N •' � V c Signature'o Publi, Notary—State of Florida • SignaTr- of "ublic Notary—State of Florida Notarization of_• • ' signature -r Notari-ation 'f Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: ]Yes[ No Amount Paid$__ ( '�� MCR# 40)14.0 *,4041(34I Date Paid 3 51�� Lobbyist Registration Form received and verified by: cio,,� � C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc IF:\CLE istration Form.doc Revised 04/27/2012 M 1AM BEACH; • City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Rafael E.Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Antoine Chaava 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- de County Commission on Ethics and Public Trust.5()_/(i ,.............,„ Signature: IFF f Date: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc Camm, Patrick To: Francisco Canestri Subject: RE: Lobbyist Profile Information Original Message rom: Francisco Canestri [mailto:fcanestri @terragroup.com] Sent:Thursday, April 16, 2015 2:14 PM To: Camm, Patrick Subject: RE: Lobbyist Profile Information Thank you for contacting me back, I need the following information for Antoine Chaava. Please email me the information below so I can attach the information to his profile. -Business Name Renzo Piano Building Workshop -Business Address 34 Rue des Archives, Paris 75004, France -Telephone Number +33-1-4461-4920 -Work Email achaaya @rpbw.com Regards, Patrick Camm,Administrative Aide I OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411/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. Original Message From: Francisco Canestri [mailto:fcanestri @terragroup.com] Sent: Wednesday,April 15, 2015 1:32 PM To: Camm, Patrick Cc: Graham Penn; Michael Patrizio; David Martin Subject: RE: Lobbyist Profile Information Patrick Please let me know the information you need from me Thanks, Francisco Canestri Project Manager Terra Group 305.416.4556(t) 305.777.3040(f) 2665 S. Bayshore Dr.Ste 1020 Coconut Grove, FL 33133 fcanestri @terragroup.com The content of this e-mail is intended solely for the use of the individual or entity to which it is addressed. If you have received this communication in error, be aware that forwarding it,copying it,or in any way disclosing its content to any other person, is strictly prohibited. If you have received this communication in error, please notify the author by replying to this e-mail immediately. Please consider the environment before printing this e-mail. P Original Message From: David Martin Sent: Wednesday,April 15, 2015 12:46 PM To: Camm, Patrick Cc: Graham Penn; Francisco Canestri; Michael Patrizio Subject: Re: Lobbyist Profile Information FRANCISCO please provide this information ASAP. On Apr 15, 2015, at 11:26 AM, Camm, Patrick<PatrickCamm @miamibeachfl.gov>wrote: This message cannot be displayed because of the way it is formatted. Ask the sender to send it again using a different format or email program. message/rfc822 ExchangeDefender Message Security: Click below to verify authenticity https://admin.exchangedefender.com/verify.php?id=t3FHVpe1002085&from=fcanestri @terragroup.com ExchangeDefender Message Security: Click below to verify authenticity https://admin.exchangedefender.com/verify.php?id=t3GIEX9c008892&from=fcanestri @terragroup.com 2 Ao- i f SUPPLEMENTARY DISCLOSURE OF INTEREST Interests in 8701 Collins Development, LLC Percentage of Interest 8701 Collins Avenue, LLC 100% c/o Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in 8701 Collins Avenue, LLC Percentage of Interest Terra 8701 Investments, LLC 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 8701 Associates 2, LLC 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in Terra 8701 Investments, LLC • Percentage of Interest NV Collins, LLC 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Terra 8701 Investments Holdings, LLC 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in NV Collins, LLC Percentage of Interest New Valley, LLC 100% c/o Terra Group 2665 South Bayshore Drive, Suite 1020 • Miami FL 33133 New Valley, LLC is 100% owned by Vector Group, Ltd., which is a publicly traded corporation. Interests in Terra 8701 Investments Holdings, LLC Percentage of Interest Terra 8701 IH Holdings, LLC 100% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in Terra 8701 IH Holdings, LLC Percentage of Interest Pedro Martin 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 David Martin 50% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in 8701 Associates, LLC Percentage of Interest 8701 Associates 2, LLC 100% c/o Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 Interests in 8701 Associates 2, LLC Percentage of Interest Stephen Della Sala 100% do Terra Group 2665 South Bayshore Drive, Suite 1020 Miami FL 33133 S :'. WelkedERNPMWONINFOSPIAW NinitaiiMESESSEBSENIOICUMEN Sr City of Miami Beach-Florida Finance Department 1 City Hall 1506213-1 03/03/2015 BR1 T118 Tue Mar03,2015 09:33AM Trans#7-7 7 $350.00 MCRMISC - NCR;- • Miscellaneous * MCR#: 402721 1 ITEM(S): TOTAL: $350.00 Check (002064) PAID $350.00 Have a nice day! Duplicate S1 Miscellaneous Cash Receipt < <� r YY.�f {} , CITY OF-MIAMI BEACH a 4 _ 0 Cash O Credit Card e2 Check# .t( r, Received of � - I "S r . - ,� . c 1> j Address —Po .)) 3 30 • For S 'J y f; (THIS INFORMATION MUST BE COMPLETED) Oficc e of Financ e ®tractor r • By • Account Dept �, . EXT. - ;, .y .i`� -� e`..� �}1's _h_.;f _,.�Fh�',.,.Y F� r-, t 0 City of Miami Beach-Florida Finance Department 1 City Hall 1506213-1 03/03/2015 BR1 T118 Tue Mar03,2015 09:34AM Trans#8-8 . 8 $500.00 MCRMISC - MCR - .' Miscellaneous * MCR#: 402720 1 ITEM(S): TOTAL: $500.00 Check (002065) PAID $500.00 Have a nice day! Miscellaneous Cash Receipt t ii-a: -- $:a ., i i Erin.:.. 402120 20 $5t;U.0; CITY OF MIAMI BEACH 4-02720 0 Cash O Credit Card Check# -' '� $ '' _ 1 . 20 I\ Received of 7o i 6, 11 11}ii .. . L L Address 0 ` -/ ' .°("° 4i fr"` - ter.•-, . a .,. 3 - 2 33 For Anti v&-- t 4- (L-' 6 -c✓ '... .� 1-1F . `An _�. hc. o va j 5--s s .. 7 Q 1 C.) U U , ,.a A t ,,,., 6 -, i -1 (THIS INFORMATION MUST BE COMPLETED) : Office of Finance Director By Account Number 0(I. 00• 3( . � • C -�� Lam-. --N... CL EXT: 2( I Preparer. Dept. � �.r