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Vanessa Madrid - Jon Perez (da Ait,„-k-c„,,,,_&,,,,stA,,,,, I /�fenV i I B E A C RECEIVE® I V 1 l / '1 Office of the City Clerk 1700 Convention Center Drive JUN -5 2019 Miami Beach, FL 33139 305.673.7411 CITY OF MIAMI BEACH LOBBYIST REGISTRATION FORM OFFICE OF THE CITY CLERK 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 "n/a" 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: Madrid Vanessa NAME OF LOBBYIST (Last) (First) ,?�'ROOT- Holland Name) Holland & Knight LLP 701 Brickell Ave Miami FL 33133 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-789-7453 vanessa.madrid@hklaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Perez Jon P. NAME OF PRINCIPAL (Last) (First) (Middle Name) Miami Beach Port, LLC 315 S Biscayne Blvd Miami FL 33131 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-533-0093 jpperez@retaledgroup.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS -ursuant RAZ @t(1)LaREin2-482(h)(11) a):A principal Gf/eX9 corporation, partnership,C!?o i D .••-, MP lobbyist •n Ia dP the i• special compensation®pi-rei •ursementforP appearance,C - indirect,CQ contingent,to( su••ortCQ®o••ositionR NIMu1E [�lilll al)the@Le3gBre•uiredf�7 iab • - • •it gra D9 KE020 Qn /toil/re.istrationfi 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): Please see attached. • 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): Please see attached. Page 1 of 5 V 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. Development approvals and permitting issues for property located at 120 Macarthur Causeway 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 Members of City Administration and Members City Staff X Members of Planning Board (PB) , Design Review X Board (DRB) and Board of Adjustment (BOA) X City Commission and Mayor 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. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): N/A 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): $425 per hour 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 ✓No: 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) Pur uant_to_City_Code_Section_2-490,_entitled_"Prohibited_Campaign_Contributions_By_Lobbyists_On_Real_Estate_Development_. __ _ Is ues": Yeslo: 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 2-482(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. Utes✓Z o: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, 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-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. DYes_✓ lo: __ 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 2-491(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. O Yes0No: 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: f Yes0No: If yes, has it been months•since the elected offic_ia_I(s) whom you provided campaigr$ consulting services was sworn inr. 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 on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. L1 Yes0No: 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: QYes9No: If yes,°were`you promised"or did you receive economic consideration in exchange for campaig Mu sfltin,gNa viEM TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes 7G]No Amount Paid$ -��-G MCR# /237S Date Paid �{i Lobbyist Registration Form received and verified by: --1�.475.17)4\-) I W}V'->" u F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018 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 COMPENSATIO DURING THE R ORTING PERIOD.' Signature of Lobbyist Date 12 1741 le 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 and all re orting requirements. Signature of Lobbyist: 1/IA Date (42-49 !S Signature of Principal: Date 1,9_1 0- • VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida County of: Miami-Dade County of: Miami-Dade Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me this d- of , 20_, by this 12„day of S)e.c.. , 20‘e, by _ '6 rid _ NAME OF LOBBY':T NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION t...-Personally Known sonally Known 4e, Li_ (01111-k .1 ,01' Signa ure of Not ry`Publi - Sig re of-Notary Public * er L/+r 1/0 61;a �446 Name of Notary, Typed, Printe• e r Stam.-• Name of Notary, Typed, Printed or Stamped PAMELA JACKSON Victoria Delgado • •= pAYCO'MISSION#GG 160789 °S0.RYgsso NOTARY PUBLIC (NOTARY S 'Ls ", *= g;Dew 17,2021 (NOTARY SEAL) 04 i,° EXPIRE Underefs ' STATE OF FLORIDA • ''6•o `?'� Bonded Notary Public— " z Comm#GG162393 - - NCE 1e Expires 2/20/2022 1 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-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 M1AMBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411,Fax:305.673.7254 • NAME OF LOBBYIST: Vanessa Madrid 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. 12/2-(/ / 10 Signature o Lobbyist Date F:ICLERI$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 Disclosure of Interest for Miami Beach Port, LLC Miami Beach Port, LLC, a Florida limited liability company, is 100%owned by MICO, LLC, a Florida limited liability company MICO, LLC is 50% owned by PRH Terminal Island, LLC, a Florida limited liability company, and 50% owned by BCH Terminal Island, LLC, a Florida limited liability company • PRH Terminal Island, LLC is 97.5% owned by PRH Investments, LLC, a Florida limited liability company, and 2.5% owned by Carlos Rosso Revocable Trust o PRH Investments, LLC, a Florida limited liability company, is wholly owned by PRH Related Holdings, LLC ■ PRH Related Holdings, LLC, a Florida limited liability company, is wholly owned by Perez Ross Holdings, LLC • Perez Ross Holdings, LLC, is 75% owned by Jorge M Perez Holding Ltd., and 25% owned by Related NY Holdings, LLC o Jorge M Perez Holdings, Ltd is 68%owned by Jorge M. Perez, 15%owned by Jorge M Perez 2012 Family Trust, 15%owned by Jorge M Perez 2002 Family Trust, 1% owned by Related Florida Inc., and 1%owned by JMP Holdings GP, LLC • Jorge M Perez 2012 Family Trust • Jon Paul Perez and Nicholas Alexander Perez are the beneficiaries • Jorge M Perez 2002 Family Trust • Jon Paul Perez,Nicholas Alexander Perez, Christina Anne Perez and Felipe Manuel Perez are the beneficiaries ■ Related Florida Inc. • Wholly owned by Jorge M. Perez ■ JMP Holdings GP, LLC • Wholly owned by Jorge M. Perez o Related NY Holdings, LLC, a Florida limited liability company, is 99.99%owned by The Related Companies, L.P., and .01%owned by RCMP, Inc. • The Related Realty Group, Inc., a Delaware corporation, is the sole general partner of The Related Companies, L.P., a New York limited partnership. • The Related Realty Group, Inc. is wholly owned by Stephen M. Ross • RCMP, Inc., a Delaware corporation, is wholly owned by The Related Companies, L.P. • The Related Realty Group, Inc., a Delaware corporation, is the sole general partner of The Related Companies, L.P., a New York limited partnership. o The Related Realty Group, Inc. is wholly owned by Stephen M. Ross o Carlos Rosso Revocable Trust ■ Carlos Rosso is the sole beneficiary during his lifetime • BCH Terminal Island, LLC, a Florida limited liability company, is 67%owned by BeachCo Holdings, LLC, and 33%owned by NLI Holdings, LLC o BeachCo Holdings, LLC, a Florida limited liability company, is wholly owned by Victor A. Bared o NLI Holdings, LLC, a Florida limited liability company, is 25% owned by Jose Boschetti and Silvia Boschetti, as Tenants by the Entirety, 24.25% owned by Luis Boschetti and Lina Boschetti, as Tenants by the Entirety, 23.50% owned by Jose R. Boschetti, as trustee of the Jose R. Boschetti Declaration of Children's Irrevocable Trust dated March 30, 2009; 24.25% owned by Luis R. Boschetti as trustee of the Luis R. Boschetti Declaration of Children's Irrevocable Trust dated March 4, 2009, and 3% owned by Mariannie Boschetti and Juan S. Cordovez, as Tenants by the Entirety. ■ Jose R. Boschetti Declaration of Children's Irrevocable Trust dated March 30, 2009 • Jose Boschetti, Jr. and Maurice Boschetti are the beneficiaries • Luis R. Boschetti Declaration of Children's Irrevocable Trust dated March 4, 2009 • Luis E. Boschetti is the sole beneficiary 2 #49307275_v1 Miscellaneous Cash Receipt I �j CITY OF MIAMI BEACH 11 I. No. 423750 ' y Cash Credit Card 0 Check# $ /05c,. 0 o is Recz�J dr jus- Mc `20i j?ft 12-v,1/.;t`rrg , .• Gc:\ ,, k P V rti. a2%ti-: Ac w-no34 Mari/ 1.n9fo54.2pm 1toAmi ,d `Li,fliki y i 1'}ii 4-,-L �? M CR O E (. "7_. s s C. 3. i , ill t 0t. it Fo yment Amt r-5. %ti4�" 15:050; ;"2l`7 , ' ('//L'I!"t d r"• a r. 49 � ash ..C.:'1.1,/ �t"�� �.:�� f f�' �' L{.: ��<f(-" �`�!',r�r.jr c. 423750 (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director By I Account Number: (-)1, .. 3'OC Q • : .,j%hi i/. ,`;0 . Wit)7. 3 C`•^(. ' (2 . £;r,. C- Preparer: 5 "�,) . (I-L ".a 7', :k. Dept e r. EXT: -7 I i !