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Jennifer McConney - 6030 Alton, LLC 60014-1-6 �t4�avY+i t�jecacki1 MIAMI BEACH 69 7... ° City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 2015 NAY 76 PM 2: ( 2 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 Blvd, Suite 200, Miami, Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)573-1818 (305) 573-3766 imcconneu(alkobikarp.corn TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: Massimo Nicastro NAME OF PRINCIPAUCLIENT: 6030 Alton, LLC 8301 NW 197th Street Miami FL 33015 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-481-2233 nicastro000hotrnail.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:Massimo Nicastro 100% • IDENTIFY ALL PERSONS HOLDING,D)I ECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ,/v/r ILSPECIFIC LOBBY ISSUE: Development Approvals and Permitting Issues, including, but not limited to the Design Review Board, Planning Board, Board of Adjustment, Land Use Development Committee, City Commission, and any City Workshops or Committees, if necessary, relating to the pronertu located at 6030 Alton Road.Miami Beach.Florida, Issue to be lobbied(Describe in detail): Ill. 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 None_ None_ None. C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc r IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required)$ #(55-b B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $ 3Sb (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)(No: Are you lobbying on a present or pending bid for goods.eauipment or services.or on a present or pending 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)(No: Are you lobbvi na on a oendina application for a Development Aareement with the City or application for chance of zoning map designation or change to the City's Future Land Use Mao? 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 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 OATH. LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI BEACH _ -' , 1__►! : _II_►., . ..__ _ I EVEN IF THERE HAVE BEEN NO EXPENDITURES OlF •i i - ► : • ►. • ► . : 0: = -I . • Signature of L/.•byist I do solemnly swear that all o the fore••' c -- •- `':'-or 4- nd th:t I have ead •:-am familiar with the provisions contained in Section 2-482 of • iami Bea.• f_.• Code -nd all repo •-g req •e ' n .. Signature of Lobbyist: Signature of Principal/Client: 1 ca.-,11-La VI. LOBBYIST IDENTIFICA ION: PRINCIPAL IDENTIFICATION: ;'.,5 ' ;o•-.. : ,,,,:;af.:Produced ID LL1'j /}U2 ��� ..1 �-O Produced ID DL... i.7- ` �•'' Form of Identifi.. tion N a Form of Identification "1/•/:.°.�� magi ens _Personally known(Lobbyist) __ w i l t Personally known(Principal) 3 IQ In as VII. SIGNATURE AND STAMP OF N' ts.' M R , 5 i a 1^ 4a tA� State of Florida, County of Miami-Dade O. C State of Florida, County of Miami-Dade ;a a T Sworn • ..d subscrib efore me o Sworn and subscrib-d before me o Th. �. •=. •f ,2015 a v •;s ue'--:y of 1 , I .. .1 2015 °"!01 N I • L r,..4..: A • ° % l .A/��2. A °0 Signature of Public Notary State of Flori• :. ' '4'%' �. _ . g ry- £�rj _.��,.: Signat.re of P►1�►�:- �-State of Florida Notarization of Lobbyist's signature #,g,0 g Notarization of signature ■ - •i‘,• r ED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ I Yes[ No Amount Pald$ SO erg MGR# —(a�-1 t C' Date Paid S Lobbyist Registration Form receiv d and verified by: ��� (I " r , MIAMI 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: 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 automaticall suspended from lobbying until all fines are paid, unless the fine has been appea •th- Mi-mi-Dade Co i Commission on Ethics and Public Trust. 4.5/ i IS Signature: Dat : C:\Users\clerhatlWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc ---,,-..,,,,..'„:,.-.1,'•':i,;.•,;:•.., -,:ii:I.•,--,;-,:-., '.,.--'•''',..•:;- ?,..',i:'".•;T::!•,;:•.:',.-:''4,;;i ;:,•::,-;.. 1.,:.M,.7,,,-:-.:•-if;•:::.i.,-.. :-.;7-::;R::.i, ':::::',.."t1.'z,',.,.t,...::.f.:..11 ...„--,:f.,,‘... :7::, ,;7•ti:--,i1...7-i..9.--'-'.....-)...-''',4314:.:IY:1'-';::;•':,. :..'-'',,,-.-....;'1,..'1'::-.E':k."'::'-{!-6.,,4,t':',9-:=::::- '4;Y:=1; - i' 7,-4.4:::-'''.:47:P;!-1,;.4.-.-.:-?:./4..!'i'-'liti,:4:-/:: .::%::,;'_,:;-::i ':',...:::;:i'.'i::.‘-,-,-.1-: . 14,.'t. ;i:::i;I:il*I: -1 .2„,i-!::A.- ., ,- 'I.,:-,;'::c-T,i:,lt '' PiY . -.;.P:'J::,:"':=Z--,';..;-_:k;','-':,'.;7;,'-.,i.:''':'':;,''':.- i,,Y:l'..;:.::,''--:_:.:-':-:::-0".-.T.,.-:-::,--,..1:::':: ::. _,..-;-'- ':',,r:4 -.900.;')Y.:!.*;;7,-;?.'!...'''.:',,':::',.--",::,..-.,_',7::.?"!:', iiip..::,--. : :, :::A.4:::I.,.-1.,::--4:::,:::it,;;;-!,•(*.0-.;;jx,',,-,;:'•?.--,'..:.?:.:::::::-.. ..:-.:1 ,, ,,-.!.,:. 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