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Adrienne Noto - Mila Florida LLC (90 L&i c014 /� n I RECEIVED M I/\ V 1 IBE.IAC.H Office of the City Clerk AUG 2 5 2020 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH • 305.673.7411 OFFICE OF THE CITY CLERK 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 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: NOTO ADRIENNE NAME OF LOBBYIST (Last) (First) (Middle Name) 600 BRICKELL AVENUE,SUITE 3600 MIAMI FLORIDA 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)789-2733 N/A ADRIENNE.NOTO@GMLAW.COM LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: MILA FLORIDA LLC NAME OF PRINCIPAL (Last) (First) (Middle Name) 800 LINCOLN ROAD MIAMI BEACH FLORIDA 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) • N/A (646)750-6765 GREG@MILARESTAURANT.COM PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS (b M ..- 2-482(h)(1)(a):Q principal CIQJV corporation, partnership,CPCMIZ'aftdilp appears EP a lobbyist OE Willggagiff Effki,z5fEre special compensation&p reimb rsement for f.0 appearance,whether indirect Cp contingent,Q:7 ezi7>'i eI '•Iii d1•r o..asition{a n item shall register with the Clerk as required by this subsection but shall not be required to.ay any registration fees 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): GREGORY GALY, MANAGER • 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 EXHIBIT"A" 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. ANY AND ALL LAND USE,DEVELOPMENT,ZONING,DESIGN,OR LICENSING ISSUES RELATED TO THE PROPERTY LOCATED AT 800 LINCOLN ROAD,MIAMI BEACH,'FLORIDA 33139. 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/PARKING DIRECTOR AND STAFF X PLANNING BOARD X BOARD OF ADJUSTMENT X MAYOR AND COMMISSIONERS X CITY ATTORNEY'S OFFICE X HISTORIC PRESERVATION 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 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): $450/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. _Yes XNo: 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 No: If yes, has if been lessthan 12 months since the elected'official(s) whom you provided campaign consulting serw 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 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 No: f yes, were you promised or did you receive economic consideration in exchange for campaig onsultiric-T ices?I J TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes CIL.;._-]No Amount Paid$ MCR-# t4 j4 3L'1( � Date Paid Zo ) Lobbyist Registration Form received and verified by:- F:\CLER\$ALL\eFORMS\LOBBYIST FORMS\Lobbyist Registrationform;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 COMPENSATION DURING THE REPORTING PERIOD.' Signature of Lobbyist: tq - o Date O'}/001610 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: ,, .1.� I. Date OT/OBI/610 Signature of Principal: IIA I Date 7/3 /2-0 Vr lI VII. •NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of FLORIDA State of r (0/1j( County of: MIAMI-DADS County of: V "� Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed) nd subscribed before me this r day of j J ,202°, by this 5 day of ;My ,2020, by ADRIENNE NOTO GREGORY GALY 1 . NAME OF LOBBYIST NAME OF PRINCIPAL ff�� _Produced ID _Produced ID r()s'� FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known _Personally Known Signature of Notary Public Signature of •t - -P blic N „ . *tar i +- amped Name of Notary,Typ d, Printed o Stamped Comm.#G4e VF Expires:October 20;2023 ,,tg( RAIL CHAVARRIA Welled He led TM, Notary (NOTARY SEAL) 4, •••• Commission#GG953280 oQ Expires March 6,2024 9''opr'° Bonded ThwBudget Notary Services 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 hot-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 MiAMI BEACH 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: ADRIENNE NOTO 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 haveregistered 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. A �1kf v 01/0/Lt w Signature of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 Lobbyist Registration Form—Gregory Galy r, • I SGP ( STATE OF I/dt1dc ) )ss COUNTY OF 1l The foregoing instrument was sworn to, subscribed to and acknowledged before me this 5 day of U[ ,2020,by GREGORY GALY,MANAGER of MILA FLORIDA LLC, who appeared by means o physical presence or❑online noortarization,at the time of notarization,and who is personally known to me or who has produced f l.W i Ct( Qi; — IlA4set as identification. • NOTARY PUBLIC,State of A'I f at Large ioctg.Pue,,c RAUL CHAVARRIA Commission#GG,953280 qi1"•"Q Expires March 6,2024 9lE0F.0,e Bonded Mu Budget Notary Services —7 Lobbyist Registration Form—Adrienne Noto STATE OF ROn-c ) COUNTY OF f ialhfr SIL aT e foregoing instrument was sworn to, subscribed to and acknowledged before me this rayof 'V ,2020,by ADRIENNE NOTO, who appeared by means of'hysical presence or 0 online notarizatio�i1..0/Personally at the time of notarization, and who is known to me or who has produced as identification. ' n2leial44/4—')"4 -1:>74--- NOTARY PUBLIC, State of F/ariCkat Large Rennet r4:. ! 0 #GG907348 � * E r 20.202 s x s:October Notes ,•. Bonded TIN A EXHIBIT "A" 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.* MILA FLORIDA LLC*' • CORPORATION NAME NAME AND ADDRESS % OF STOCK MILA FLORIDA LLC Mila Group LLC 100% 800 Lincoln Road Miami Beach,Florida 33139 MILA GROUP LLC Gregory Galy 37.57% Sebastien Gault 2.43% Holding Pages 5.00% Brigitte Pages 1.00% SAS Soldiese 5.00% Sofinvent Inc. 4.00% Degaro USA Inc. 0.30% Richard Galy 2.00% Gregory Galy 1.50% Sebastien Gault 1.00% 1 Mila Florida LLC,a Delaware limited liability company known as Mila Miami,LLC 26584773v1 Hardeep Birdi 1.00% UL Holdings LLC 15.00% Plantower LLC 2.00% Ocean Blue Capital I LLC V 8.40% Livingston LA LLC 2.70% Livingston LI LLC 2.00% Hurt Family Partnership LTD. 1.00% Mosler Holdings LLC 2.00% Matt&Chris Wideman 0.50% Christian Galfre 2.50% OFL Invest LLC 1.00% PPN International LLC 1.00% Beir Group LLC 0.50% Glacier Equities LLC 0.60% HOLDING PAGES Serge Pages 100.00% SAS SOLDIESE Anny Courtade 100.00% SOFINVENT INC. Edouard Dogramacyian 50.00% Remy Fillon 50.00% DEGARO USA INC. Edouard Dogramacyian 100.00% UL HOLDINGS LLC Leo Ducroix 100.00% 26584773v1 PLANTOWER LLC Philipe Milliet 100.00% OCEAN BLUE CAPITAL I LLC V Ulrike K. Hemmerich 2016 Trust 100.00% LIVINGSTON LA,LLC Jan Hemmerich 2019 Trust 100.00% LIVINGSTON LI,LLC Till T. Hemmerich 2019 Trust 100.00% HURT FAMILY PARTNERSHIP LTD. J.L. Hurt 100.00% MOSLER HOLDINGS LLC Michael H. Mosler 100.00% OFL INVEST LLC Olivier Flament 100.00% PPN INTERNATIONAL LLC Richard Canale Parola 100.00% BEIR GROUP LLC Antonio Bechara 100.00% GLACIER EQUITIES LLC Sarah McClane 50.00% Brock McClane 50.00% 26584773v1 ULRIKE K. HEMMERICH 2016 TRUST Trustee: Brock McClane Grantor/Settlor: Ulrike K. Hemmerich The Ulrike K. Hemmerich 2016 Trust has no vested beneficiaries. The Ulrike K. Hemmerich 2016 Trust has discretionary potential beneficiaries. JAN HEMMERICH 2019 TRUST Trustee: Brock McClane Grantor/Settlor: Jan H. Hemmerich The Jan Hemmerich 2019 Trust has no vested beneficiaries. The Jan Hemmerich 2019 Trust has discretionary potential beneficiaries. TILL T. HEMMERICH 2019 TRUST Trustee: Brock McClane Grantor/Settlor: Till H. Hemmerich The Till T. Hemmerich 2019 Trust has no vested beneficiaries. The Till T. Hemmerich 2019 Trust has discretionary potential beneficiaries. 26584773v1 bMeiscellaneous Cash''Receipt .,CITY OF MIAMI BEACH; 1 4263.44 } © Cash D Credit Card1 Check# $ .''' ` 24 `1 a ‘ 2.'6'3 ��Y3a h1z1R � { „T.,,,, �, } 3� A vuNIL-K2uu " Qfl �1 ''f � r 7 "!Miscellaneos 91 a yl 't ''.v 111° ) `Df FBF Ttst �PymentvRmof' 2a6344 {THIS INFORMATION MUST BE COMPLETED} Office of Finance Director Account Number ', " , > ,„` ' F,1? ' , - T' � _ \ 1 Preparer^ \,. - � -",,:%'-..;: , �„w\"''''2;:'. . 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