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Gregory See - Zilkatur, LLC 20 (AIM 5 Avem LA-e- MIAMI BEA H 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 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. SEE GREGORY NAME OF LOBBYIST: (Last) (First) (M.I) DIVERSIFIED CONSULTING AND MANAGEMENT INC. 601 N.E. 36TH STREET, MIAMI FLORIDA 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 712-7168 GREG @DCM-MIAMI .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: ZILKATUR, LLC NAME OF PRINCIPAL/CLIENT: ZILKATUR, LLC 2000 COLLINS AVENUE, MIAMI BEACH, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (512) 732-2650 TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) r,• Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:MISCHA DEETER • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SEE EXHIBIT "B" II:SPECIFIC'LOBBY'ISSUE' CHANGE OF OWNER/OPERATOR FOR VARIANCE AND CONDITIONAL USE PERMIT-UNDER-BOA-FILE-NO. 3554 AND PB FILE NO. 2042 AND ANY AND ALL OTHER LAND USE, ZONING, AND LICENSING MATTERS RELATED TO THE PROPERTY AT 2000 COLLINS AVENUE Issue to be lobbied(Describe in detail): III.ECITY 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 DIRECTOR AND STAFF X BOARD OF ADJUSTMENT X PLANNING BOARD X Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or p. fessional 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. Cji Sec 2-482(g)Any Financial, Familial or Professional Relationship NONE F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc -` - PC' IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) NO ADDITIONAL COMPENSATION B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). NO ADDITIONAL COMPENSATION 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 XNo: Are you lobbying on a present or pending bid for goods,equipment 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 XNo: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map 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. YesXNo: 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 YEAR. A STATEMENT SHALL BE FILED EVEN IF THE VE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. • r L , Signature of o yiat I do solemnly swear that all of the foregoing facts are try- :ud correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Mia•"' :-. ity Code and all re•i di g re•uir-is-I s. Signature of Lobbyist: til Signature of Principal/Client: �`! _ �P VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: f Produced ID F1 • °river, l,ccnJe NO. 0 Produced ID Dip.F.:4 I Form of Identification syq M ,r, Form of Identification 0 E 5 0 0 0-19 0- 1 t- L30-0 '` s;•o+��'''� CC 0.tte Personally known(Lobbyist) ! , r.Personally known (Principal) J N II g —i vevc,5 \--ic,415 3:VII. SIGNATURE AND STAMP OF NOTARY: a State of Florida,County of Miami-Dade State of Perida, County of Miami-Bee?e Sworn to and subscribed before me Sworn and subscribed before me -Q This 11 t h day of 'Jun E ,201S ;II$ This 11.51. day of Sv"y ,201 . -kw'. faiRF- -__ o (API/W7,-,....4...,- Signature of Public Notary State of Florida Signature of Public Notary—State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature y 9 p g TO BE COMPLETED YYTY CLERK'S STAFF ONLY Annual Registration fee: [ Yes[ ]No Amount Paid$ MCR# $044 g Li I Date Paid 1 4 t( Lobbyist Registration Form received and verified by: !^-1 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Regis 6tib . o Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 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: GREGORY SEE 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 of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miam' = . ..e County Commission on Ethics and Public Trust. A � c_4 r Sign- I -. /Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc p. EXHIBIT"B" DISCLOSURE OF INTEREST ZILKATUR,LLC CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1.CORPORATION If the property which is the subject of the application is owned or leased by a CORPORATION,list ALL of the stockholders,and the percentage of stock owned by each. Where the stockholders consist of another corporation(s),trustee(s),partnership(s)or other similar entity,further disclosure shall be required which discloses the identity of the individual(s)(natural persons)having the ultimate ownership interest in the entity. ZILKATUR,LLC CORPORATION NAME Name and Address %of Ownership Zilkatur,LLC Red Blue Green Investors,LP 100% 4303 Island Avenue Austin,TX 78731 Red Blue Green Investors,LP OFG Investors,LP 10% 4303 Island Avenue Austin,TX 78731 FML,LLC 3.33% 4303 Island Avenue Austin,TX 78731 Raizda Group,LP 13.33% PO Box 6770 Lee's Summit, MO 64064 South Beach Adore, LLC 3.33% 2315 Windward Lane Newport Beach,CA 92660 Kudu Investments,LLC 15% 225 Kingstown Park Road St.Vincent and the Genadines,West Indies OFG Manager,LLC 55.01% 4303 Island Avenue Austin,TX 78731 OFG Investors,LP OFG Manager,LLC 0.25% 4303 Island Avenue Austin,TX 78731 EXHIBIT"B" DISCLOSURE OF INTEREST ZILKATUR,LLC Page 2 of 5 South Beach Adore, LLC 4.94411414982164% 2315 Windward Lane Newport Beach, CA 92660 SBV Miami I, LLC 0.461450653983353% PO Box 6770 Lee's Summit, MO 64064 FML, LLC 6.59215219976219% 4303 Island Avenue Austin,TX 78731 David J.Vittor Revocable Trust 1.64803804994055% 5915 Oak Wood Road Mission Hills, KS 66208 Night Time Ventures, Inc. 1.64803804994055% 54 ST Andrews Gardens Toronto,Ontario M4W 2E1 SOUTHB, LLC 1.31843043995244% 750 Lexington Ave 24th Floor New York, NY 10022 Arcane Group,LLC 0.824019024970274% PO Box 97901 Las Vegas,NV 89193 Atlas Properties, Inc. 0.824019024970274% PO Box 6770 Lee's Summit,MO 64064 SBV Miami I, LLC 0.824019024970274% PO Box 6770 Lee's Summit, MO 64064 Dan Margolin 0.824019024970274% 6253 Glenfield Drive Fairway, Kansas 66205 Garzano Investments,LLC 0.824019024970274% 21055 NW 37th Avenue Apt.410 Aventura, FL 33180 Price Property and Investment,LLC 0.824019024970274% PO Box 12067 Shawnee Mission, KS 66282 SJ Partners,LLC 0.824019024970274% PO Box 7082 Kansas City,MO 64113 / EXHIBIT"B" DISCLOSURE OF INTEREST ZILKATUR,LLC Page 3 of 5 Yann LeLourec 0.527372175980975% 5785 Alton Road Miami Beach FL 33140 Poremi2,LLC 0.164803804994055% 6439 Overbrook Road Mission Hills, KS 66208 Kyle Kinsel 1.67746730083234% 724 Ruthven Street Houston,TX 77019 Brembel South Beach Loan, LLC 37.50% 2315 Windward Lane Newport Beach, CA 92660 FML,LLC 7.50% 4303 Island Avenue Austin,TX 78731 FML,LLC 28.50% 4303 Island Avenue Austin,TX 78731 David J.Vittor Revocable Trust 1.50% 5915 Oak Wood Road Mission Hills,KS 66208 FML,LLC Mischa Deeter 100% 4303 Island Avenue Austin,TX 78731 Raizda Group,LP Amit Raizada 100% PO Box 6770 Lee's Summit,MO 64064 South Beach Adore, LLC David Belfiore 100% 2315 Windward Lane Newport Beach, CA 92660 Kudu Investments,LLC Jake Heimann 100% 225 Kingstown Park Road St.Vincent and the Genadines,West Indies EXHIBIT"B" DISCLOSURE OF INTEREST ZILKATUR,LLC Page 4 of 5 OFG Manager,LLC FML,LLC 33.33333333333333% 4303 Island Avenue Austin,TX 78731 South Beach Adore,LLC 33.33333333333333% 2315 Windward Lane Newport Beach, CA 92660 Spectrum Management, LLC 33.33333333333333% PO Box 6770 Lee's Summit, MO 64064 SBV Miami I, LLC Amit Raizada 100% • PO Box 6770 Lee's Summit,MO 64064 David J.Vittor Revocable Trust Beneficiary:David Vittor 100% 5915 Oak Wood Road Mission Hills, KS 66208 Night Time Ventures, Inc. David McQuaid 100% 54 ST Andrews Gardens Toronto,Ontario M4W 2E1 SOUTHB,LLC Michael Clofine 100% 750 Lexington Ave 24th Floor New York, NY 10022 Arcane Group, LLC Cy Waits 100% PO Box 97901 Las Vegas,NV 89193 Atlas Properties, Inc. Ravi Srivastava 100% PO Box 6770 Lee's Summit, MO 64064 r EXHIBIT"B" DISCLOSURE OF INTEREST ZILKATUR,LLC Page 5 of 5 Garzano Investments, LLC Carlos Garafulic 100% 21055 NW 37th Avenue Apt.410 Aventura,FL 33180 Price Property and Investment,LLC Barry Price 100% PO Box 12067 Shawnee Mission,KS 66282 SJ Partners,LLC Rick Moseley 100% PO Box 7082 Kansas City, MO 64113 Poremi2, LLC David Moseley 100% 6439 Overbrook Road Mission Hills, KS 66208 Brembel South Beach Loan,LLC David Belfiore 100% 2315 Windward Lane Newport Beach, CA 92660 Spectrum Management, LLC Amit Raizada 100% PO Box 6770 Lee's Summit,MO 64064 CITY HALL CASHIER OFFI 1700 CONVENTION CNTR DR MIAMI BEACH, FL 33139 07/06/2015 16:43:59 CREDIT CARD VISA SALE CARD# )000(XXXXXXXXS INVOICE 682 SEQ#: 0001 Batch#: 0001 Approval Code: 001576 Entry Method: 006399 Mode: Swiped Tax Amount: Online I� $0.00 SALE A OUNT $ $ 50,00 CUSTOMER COPY Miscellaneous Cash, R ��,�, ��: � �:�,€s� t� eceipt_ ,_� m.,¢4 5 u lrT� ((//�� !rte Fw( (/��l�Q, �3 7 ti : ;� SCy�t YI ®■ �MIAM��Y�Vf i r ��r,��:`_t _�il i-i_�� , +fi.�l�•'f.�Tf fi T�.�' iq uULi _ - 1"I i ) C.' _• o cash ri Credit Card o t' 1 ck# 73 0 _ • j ` 7._,,,_, -2 L t .. fir,.; e4---)�:^ J 67 .----- - "-_-•.! - '. .- - -- - •- _ 2 am p _ } ' °.� Fit=,� � -- - __ r : 3_._: „, :33..., tF -1TH1S INFORMATION MUtT BE COMPLETED) Oce;r �F anc e• Director- •__ ir - T Account Number: r z (, c, By •1 k` Dept.• / . _t.r.,.,C '" _.r,r" f..,:�, . 1 j4`-' .r L ' t ;7 S_