Steven Tyler Nielsen - Collins & 72nd Developers, LLC MIAMI BEACH Office ofthe City Clerk RECEIk-+•
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1700 Convention Center Drive 2018MAY I S PM 3 JO
Miami Beach, FL 33139
305.673.7411 ())i :npl;; 3 ,CH
LOBBYIST REGISTRATION FORM - INE Cii Y CLEF",
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 City Code Chapter 2,Article VII, Division 3, entitled "Lobbyists"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "Na" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Nielsen Steven Tyler
NAME OF LOBBYIST (Last) (First) (Middle Name)
Nielsen Landscape Architects, LLC 357 Cypress Drive, Suite 10 Tequesta Florida 33469
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
561.402.9414 303.909.7192 Tyler@nielsenlandarch.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION: T
-See-Attached. i t u tf 7-,Z ' )r=' '(Le f _C-
NAME OF PRINCIPAL (Last) (First) (Middle Name)
C\ 57 14* tiAz, cspy& posbc 'L 3-5) S4
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PRINCIPAL BUSINESS NAME AND ADDRESS Number and S reet) (City) (State) (Zip Code)
CSo ) 4 ; 7 — C3HUJ
PRINCIPAL BUSINESS TELEPHONE NUMBER CEL LAR ELEPHONE NUMBER EMAIL ADDRESS
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,write N/A): See Attached.} IU('rt
of
• NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A): See Attached.
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
The development of hotel at 7140 Collins.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship(If yes,explain) YES NO
Title of Person to be Lobbied
Planning Board ✓
Design Review Board V
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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
NA
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$150.00 l HR
Page 2 of 5
The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488,entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues
_Yes VNo: Are you lobbying on a present or pending bid for goods. eauipment or services, or on a present or
pending award for goods,equipment or service?
2) Pursuant to City Code Section 2-490. entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
_Yes , 4c): 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 City Code Section 2482(h), any person (except those exempt from the definition of "lobbyist" as set forth in
Section 2-481)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 city 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?
4) Pursuant to City Code Section 2481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific, technical or other specialized information or testimony in public meetings; any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-far-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
_Yes 1/1o: Are you providing only scientific, technical or other specialized information: appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services
within the past election cycle. See Section 2-491 for more information.
_Yes 1/111o: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
_Yes yNo: If yes. has it been less than 12 months since the elected official(s) whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service an his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
_Yes i/Flo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(sl of the City Commission:
_Yes X140: If yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETEDLEBY CITY CLERK'S STAFF ONLY�I c.
Annual Registration fee: )Nf]Yes[ ]No Amount Paid St L.T5` 'pbSA-UV/Si-to
' MCR# ✓12' 0 (C4 Date Paid '7751 I p 4a
Lobbyist Registration Formreceivedand verified by:_ ` 400 A-L W Vt
F:\CLER\SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 01-01-18 REG.doc Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH. LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSAT URING THE REPORTING PERIOD.1
Signature of Lobbyist:( 4 - Date Or /y aye
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code a sling requirements. ,J
Signature of Lobbyists Date 4157 /7• dtvg
•
Signature of Principal: .4_, .,d, e ./ i1.«/ Date OS /,S (.29/ i
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of F)orl dc1 State of [70/e." "-
County of: kin tllotc,hCounty of: fv ell
Sworn tq(or affirmed)and subscribed before mea., Sworn to (or affirmed)and subscribed before me
this ) '-1 day of mM,1 20Th by this _day of 20 , by
Sit viN T-VUt dpieCIS(r1) s, l u r a- Ga /f&_ e
NAME OF LOBBYISTII NAME OF PRINCIPAL
Produced ID -R ) z (. _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
‘iiyPeri onally Known // Perso ally Known
V tn
Sig to = •f otary Pu Ic Signatu a of N,ary Public
fiifeN �rkA!Or\J L. + J AAs
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
(NOTnI KAREN L.aAflKALOW (NOTARY SEALJANET HQYOS
Notary Fubllc.Stale of FlOride t r, LAZA SSION#F14 21045
CommsxpieGG 61251 My GONA9 232019
_ „ses„res Jan.10,2021 ExMRES SppndM
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1 The term'9i a y excludes the following persons: rwn99M19+w
Expert witnesses who provide only scientific, technical or other specialized information or testimony in public meetings; any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
3EAC -I
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.mlomibeachfl.gav
Office of the City Clerk
Rafael E. Granada, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.741 1, Fan: 305.673.7254
NAME OF LOBBYIST: S7Wr 714-M2.
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 Miami-Dade County Commission on Ethics and Public Trust.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
cis--ill -30/¢
ature of Lobbyist Date
FICLER$ALL\aFORMSLOSBYIST FORMS\Lobbyist Registrabon Form Revised Cl 01-18 REG clot
Page 5 of 5
Discolosure of Ownership for Collins and 72nd Developers,LLC
%hMesed %Internt d Collins
Member 1NME Individual Member 72nd Developers LLC
Transacta 72nd,LLC,9357 Harding Ave,Surfside,FL 33154 Silvia Sabates Coltrane,Manager 10000% 35.59%
AOMA Investments,LLC(Delaware LLC),730 Sth Avenue,20th
Alex Blavatnik,Manager 100.00% 4.07%
Floor,New York,NY 10019
Silvia Sabates Coltrane,Manager 83.37%
Collins and 72nd Holdings,LLC,9357 Harding Ave,Surfside,FL Raquel Bender Rabinovich as Co- 5.545%
33154 Trustee 24.44%
Jacob Bender Krayser as Co-Trustee 5.545%
Cynthia A.MacPherson 2.77%
Derek and Ashley Norred 2.77%
Contemporary Hotel Partners,LLC.(Delaware LLC),18305 Jacques Bessoudo,Manager 50.00%
Oiscyane Blvd,Suite 402,Aventura,FL 33160 31.51%
Jordan Kavana,Manager 50.00%
Gold Bird Road Properties,LLC(Florida LLC),1177 Kane Salomon Gold,Manager 50.00%
Concourse, Suite 218,Bay Harbor Islands,FL 33154 3.39%
David Gold,Manager 50.00%
TOTAL 100% 100%
^ AAM BEACH
City of Miami Beach RECEIVED
1700 Convention Center Drive 1018 MAY i 8 PM 4 46
Miami Beach, Florida 33139
www.miamibeachfl.gov 1.2ty : i, i C4C11
City Clerk's Office ' E C; Y CLEAT
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Steven Tyler Nielsen, ASLA
Business Name: Nielsen Landscape Architects, LLC
Address: 357 Cypress Drive, Suite 10
Office Telephone Number: 561.402.9414
Cellular Telephone Number: 303.909.7192
Email Address: Tyler@nielsenlandarch.com
If more than one lobbyist, please list:
1)
2)
3)
4)
5)
6)
7)
Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
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For City Clerk's Office Use Only
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