Todd Tragash - G3120 Collins, LLC 3'/ o colli „,
f\/\I A/ V 1 I B[AC H Office of the CityClerk )3C
1VED
1700 Convention.Center Drive
Miami Beach, FL 33139 MAR
12
305.673.7411 2020
Crry
LOBBYIST REGISTRATION FORMp OFANA
Lobbyist means all persons employed or retained, whether paid or not,by a principal who s®ks/toEec g
of • e�hF,Rpest age, defeat or
modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommehlla0 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,"
foradditional 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 morespace 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:
Tragash Todd
NAME OF LOBBYIST (Last) (First) (Middle Name)
STA Architectural Group 3526 North Miami Avenue Miami Florida 33127
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City). (State) (Zip Code)
(305) 571-1811 , todd@staarchitecturalgroup. corn
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR.TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Wr1.1411hcAl)tin/
NAME OF PRINCIPAL (Last) 5 (First) (Middle Name)
G3120 Collins;LLC 3120 Collins Avenue Miami Beach Florida 33140
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
+44(0)20-7432-7372
PRINCIPAL BUSINESS.TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
it7EIV Code 2-482(h)(11)(a): Q. I I•-1 Cif eV corporation, partnership,OJ d a&V ' • •r- m iD lobbyist CM111211EPIEGEE
MadIRCIER special compensation 07 reimbursement for f n:'e ,•z 1�elniKa g'"' . 1: indirect, K• •- f3] • d sue.ort CliCp•••osition l
2i1 uniaI lD re•istera:MO- tm re•uired subsection Cll3 nd EIB Lb r-•uiredn y re.istratiori
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): Matthew Berhinig
• 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.
Development Approvals &Planning Issues,including but not limited to the Historic Preservation Board,
Design Review Board,Planning Board, Board of Adjustment,Land Use Development,City Commission,
and any City Workshops or Committees, if necessary,relating to the property located at 3120 Collins
Avenue in Miami Beach,Florida.
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
Staff for the Planning&Building Department None X
Public Works &City Administration, PB,HPB, BOA None X
•
DRB, City Commission, and Mayor 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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
None
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):
$/75.o0per 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 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 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 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.
_Yes XNo: 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.
_YesX_No: 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.
_Yes XNo: 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 x No: 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 on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
—Yes x No: 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 XNo• If yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF� ONLY�
Annual Registration fee: [ ]Yes t10]No Amount Paid$ 3 •�' l
MCR# i5 1 L3 Date Paid 03`1'k'lo
Lobbyist Registration Form received and verified by: .0 .,vr Q
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 PRECE ING CALEN YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENG G D TO LO: :Y. A,,,STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPE/ hli/.
•N RI G 9, l;f t REPORTING PERIOD.'
r IMss-, 2pzSignature of Lobbyist: Date
I do solemnly swear or affirm th-t all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am fa II ar with the o isions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code . • :l -p-�n req .i -ments.
Signature of Lobbyist: -111 v. Date KO-• I C0 t 7.U',-6
Signature of Principal: Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of -V Lo z I piiN State of
County of: rk(A 1-1 i -D P.1"-)E County of:
Sworn to(or affirmed) and subscribed before me Sworn to(or affirmed) and subscribed before me
this `off. day of 1--t.Pte-CAN , 20Q by this_day of , 20_, by
Todd Tragash
NAME OF LOBBYIST NAME OF PRINCIPAL
/Produced ID Dl. "022-80:2-S�-381-0 _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known _Personally Known
Signature of Notary Public Signature of Notary Public
C`�i S'I r3 P\ 3D . G o i:vzAL. --a
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
►o Notary Public State of Florida
(NOTARY SEAL) ' Cristina Diana Gonzalez (NOTARY SEAL)
y, i My Commission GG 176710
nror,4pr Expires 03/23/2022
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
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 COMPENSATION DURING THE REPORTING PERIOD.1
Signature of Lobbyist: Date
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 reporting requirements.
Signature of Lobbyist: Date
Signature of Principal: ?j-t- Date 02. 1131 2.462.c.,
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of State of b I D R
County of: County of: M►A M t --DPiD
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me '
this day of t 20_, by this 131kday of Tr'E(32U AfZ`( ,20`o.9 by
Todd Tragash h Pk-'T k,3 43Q21.11 N G
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced IDoduced ID D 1.. ��oS 2 SSo "-IS - 7 b,
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
x Personally Known _Personally Known
Signature of Notary Public Signature of Notary Public
C12-1STa n1•A D. Gry N z-Af. Z–
Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
(NOTARY SEAL) (NOTARY SEAL) =oOr•ut^ Notary Public State of Florida •
Cristina Diana Gonzalez
Cf My Commission GG 176710
of„00 .Expires 03/23/2022
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
i\AAt\A . BEACH
City of Miami Beach, 1/00 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.741 1, Fax:305.673.7254
NAME OF LOBBYIST: Todd Tragash
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
$500.1. ursuant to : tion 2-482 of the Miami Beach City Code.
, ' /,`
t5' 14
Signatur- ,0 ' L yis �A Date
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc
Page 5 of 5
Ownership of G3120 Collins LLC S.H.
Key Yeung Remaining 31.12%LP
LuxemburgMEI Mesh Mr&islands 100% investors each hold<20% Queensgate
UBO Investments II GP LLP
IIIII Wand unarm _ Queensgate _ tra4asun Sole Investor+
g Carry LP Queensgate
_ usn Fusion GP LLP Investments II AIV GP LLP
(English:LIP) (r_ngrishLIP).._
LP
GP ` GP /GP
Precise Result 6888
24.03% I lmenls Queensgate
Queensgate Fusion Co- � to Tted LP Queensgate Investments
Invest LP Fund II LP II AIV LP
en
tddMw,e;ti e+n,..,.pt - tln4ema.r 1.11+1e1 12.98% ague,m.O..nu....m
puecmpAtetnecaments 87.02%
Note:Remaining 75.97%LP 100% tA:m gtententl,Rlat+e.,
Investors each hold<20%.There
is no natural beneficial owner
with more than 10%. Queensgate Fusion Queensgate Fusion
Holdco 1 S r.I Holdco 2 S.a r.l
79.41% ' 1 2059%
Queensgate Generator S r.l
1100%
c,1riv t nlIntg
fluent Ltntlted
I100%..._..
C,ti iii ullnn
Holding,Inc
100%
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City Hall
1700 Convention Center Dr.
Miami Beach , FL 33139
305-673-7420
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