Justine Velez - ARRP Miami, LLC Rot Ai+en Rocl
MIAMI BE AC H vv.%; e_03.01\-
City of Miami Beach Office of the City Clerk `:` ' ' p
• 1700 Convention Center Drive,'Miami Beach, FL 33139
20 15 Na Y 2 6 PM 1: 16
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks tolencqurage theAassage,i iefeat 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.
Velez Justine
NAME OF LOBBYIST: (Last) (First) (M.I)
•
Urban Robot Associates 420 Lincoln Road, #406 Miami Beach Florida 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 246-4857 or((o1}�2$5 (1.L3
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 Smith
NAME OF PRINCIPAUCLIENT:
ARRP Miami, LLC and Wells Fargo Bank 2200 Biscayne Blvd. Miami Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374-5700
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: David Smith
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST.See Attached
II.SPECIFIC LOBBY ISSUE:
Development Board Approvals for 1901 Alton Road, Miami Beach, FL
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 Staff, PB, HPB,,BOA, DRB, Commission 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
C:\Users\clerhatlWppData\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) 4,. 2,040 V y,
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): Z 111
.-Fl 0
(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 lobbvina 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 lobbvina on a pendina application for a Development Aareement with the City or application for
chanae of zonina map desianation 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
EQB 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:
„---- - 0
Signature of Principal/Client: 7
-
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Personal) known(Lobbyist) /Personally known(Principal)
pa)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida,County of Miami-Dade State of Florida, C•' . ,
Sworn to and subscribed before me S orn and subscr... t ', -OAVAAIIM ABUTAii
This day of , 2015 �s day • % -6tNo of Flora
r f _%;:_:_ .� WoniFF19814
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_,.,: Ue j�! �,:_ ��� Comm.E>�Irea Mar 16,2019
Signature of Public Notary-State of Florida Signa.,re of'ublic Not PAltrr31:r;1' ' Natal Nobryrt . ■
Notarization of Lobbyist's signature Notar zatio of Principals signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
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) ;At i`k
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): A. �
(REQUIRED). 1`11‘
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 nendina bid for goods.eauipment or services.or on a present or Wending
award for goods.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 Wending application for a Development Aareement with the City or application for
change of zoning man designation or change to the City's Future Land Use Man?,
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 BEACI-
m$ THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD,
flitivpiaatet
Signature of Lobbyist
•
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am - iar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: r h/
Signature of Principal/CI nt:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
c
Produced ID o co Produced ID
Form of Identification z N Form of Identification
/ w LL0
% B �o
N
V Personally known (Lobbyist) E..-.--° Personally known (Principal)
get Eo
VII. SIGNATURE AND STAMP OF NOTARY: •2 0 e
zomu't
State of Flori , County of Miami-Dade • , State of Florida, County of Miami-Dade
Sworn,...-, d sbscribe before me Qom`' Sworn and subscribed before me
This `� I ay of MO, , 2015 o` This day of , 2015
lAi' o„...
Signatu'e of "•ublic Notary—State of Florida Signature of Public Notary—State of Florida
Notariza on of hobbyist's signature Notarization of principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
I F:\CLE istration Form.doc Revised 04/27/2012
/\/\ 1\ 1ANA , BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
I
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerkamiami beach fl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Justine Velez
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-Dade County Commission on Ethics and Public Trust.
r'^n / 5/018./15
Signature: ,l.!( ate:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
SUPPLEMENTARY DISCLOSURE OF INTEREST
Interests in ARRP Miami III, LLC
Percentage of Interest
KGM Equities 2, LLC 95%
2200 Biscayne Blvd.
Miami FL 33137
Beach R Holdings, LLC 5%
2200 Biscayne Blvd.
Miami FL 33137
Interests in KGM Equities 2, LLC
Percentage of Interest
Sonny Kahn 2004 Irrevocable Trust 45%
2200 Biscayne Blvd.
Miami FL 33137
Russell W. Galbut 2004 Irrevocable Trust 45%
2200 Biscayne Blvd.
Miami FL 33137
Bruce A. Menin 2004 Irrevocable Trust 10%
2200 Biscayne Blvd.
Miami FL 33137
Beneficiaries of Sonny Kahn 2004 Irrevocable Trust
Percentage of Interest
Child of Sonny Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Child of Sonny Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Child of Sonny Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Child of Sonny Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Child of Sonny Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Beneficiaries of Russell W. Galbut 2004 Irrevocable Trust
Percentage of Interest
Child of Russell Galbut 50%
2200 Biscayne Blvd.
Miami FL 33137
Child of Russell Galbut 50%
2200 Biscayne Blvd.
Miami FL 33137
Beneficiaries of Bruce A. Menin 2004 Irrevocable Trust
Percentage of Interest
Child of Bruce Menin 33.33%
2200 Biscayne Blvd.
Miami FL 33137
Child of Bruce Menin 33.33%
2200 Biscayne Blvd.
Miami FL 33137
Child of Bruce Menin 33.33%
2200 Biscayne Blvd.
Miami FL 33137
Interests in Beach R Holdings, LLC
Percentage of Interest
Tomer Bitton 100%
2200 Biscayne Blvd.
Miami FL 33137
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(THIS INFORMATION MUST BE COMPLETED) . • Office of Finance Director
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ARRP Miami, LLC
Check Number: 00578
To: City of Miami Beach 03555 Date: 05/21/2015
Invoice Number Date Description Amount Discount Paid Amount
052115 May 21,2015 Lobbyist Reg Chad Oppenheim $850.00 $0.00 $850.00
TOTALS: $850.00 $0.00 $850.00
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