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Ahmet Oktay Cini - 3425 Collins, LLc. 2 LI)cRECce:Et 1' SEP 1 2020 Office of the City Clerk 1700 Convention Center Drive Crr OF Miami Beach,FL 33139 ' 'JAMI Pr-r-IC-'H 305.673.7411 OFFICE OF •-: iT;,^,! �n . 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;.oranyaction,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 "Lobbyist"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: City"' AHMET pKTAY NAME OF LOBBYIST (Last) ' .. " (First).'. (Middle Name) O K;0 &R-O U P LI4 00 NE AND.AVE)sTF_303 . MIAMI FL. 3313 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)' +1 305" 8o0 4000 41.614 SDy 0624 CLoc!n1 okoGRovP,cot LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR'TELEPHONE NUMBER' EMAIL ADDRESS II. PRINCIPAL INFORMATION: 3425 Collins, LLC NAME OF PRINCIPAL ' (Last) (First) (Middle Name) 3425.Collins,.LLC 3201. Collins Avenue, Miami Beach FL 33140.. PRINCIPAL BUSINESS NAME AND ADDRESS' (Number and Street) ' (City) (State) ' ' ' (Zip Code) 305-534-8800 908-251-7702 sgeraghty@faena.com PRINCIPAL BUSINESS TELEPHONE NUMBER. CELLULAR TELEPHONE NUMBER. EMAIL ADDRESS Pur' sTuant m City Code Section 21'482(6)11M: A principal of eng corporation, partnersliip,Cp other entity who ...-. ap O l3i5byist CP behalf of that entity,MCIIIMIgiin compensation CP reimbursement for'Re appearance,S2111i12p6M indirect,1pcontingent,m su..ort CQCro..osition t an item shall register with the Clerk as required by this subsection but shall not be required to pay 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): Leonard Blavatnik • 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): Leonard.Blavatnik Page 1 of 5 HI. 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. Renovation of historic Versailles building and construction of new.multifamily.building at 3425 Collins. Modification of Faena Zoning District Overlay. 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 Dept. staff x Historic Preservation Boardmembers x Mayor and City Commissioners 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): V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee is prohibited pursuant to C' Code.Sec. 2-485.3): 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 orpending bid forr goods,.equipment or services. or on a presentor 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 pendingapplication for a Development Agreement with the City orapplication. 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 2481)who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance,whetherdirect or indirect to express support of oropposition 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 .compensationor 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 personwho only appears es 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: f yes, has it been less than 1�2 months since the elected officiays) whom vow provided campaign onsultinq services was sworn ine . 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 beforelobbyingthe 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: fw'es we e ivouspromtse adidli,Youl'iireceive economic consideration in exchange for campaign ccon'sultinnq seivices?a —— — - TO BE COMPLETED BY CITY CLERK'S STAFF ONLY ' .. Annual Registration.fee: [k]Yes[ ]No. Amount Paid$ _ f MCR# { 'to°' S Date.Paid7` 7 Lobbyist Registration'Form received and verified by: --ANION)ON) ,iLty F:\CLER\BALL\aFORM51\'LOBBYISTFORMS\Lobbyist,Registratiop FormRevised'03-11-20 R_E-Gdoe Revised 03/11/2020 Page3of5 • 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: Date C2: //t`� 23 1-0 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 aril familiar with the provisions contained in Chapter 2, Alt VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting requirements: Signature of Lobbyist: Date 7//t) Signature of Principal: Date . VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of NE W:.y State of County v County of: of: � Sworn to(or affirmed)and subscribed before me, - Sworn to(or affirmed)and subscribed before me', by means of 1y1 physical presence . by means of❑ physical presence or 0 online notarization, 1�: or 0 online notarization, this 10th Seinen,day of Se l Dei . ,20.t0,by this day of L 20_,_by A.HMST .OKTPcY .CTNT:.. NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION LP Kno n Personally Known Signature of No Public Signature of Notary Public ANASTPcSLE4 .V WETSSE Name of Notary,Typed,atiafa iStatn dl S S E Name of Notary,Typed, Printed or Stamped NOTARY PUBLIC-STATE OF NEW YORK (NOTARY SEAL) No.01 WE6390112 (NOTARY SEAL) Qualified in Kings County MAV eARAfflI§§113R KOlf@§h4=§§= ®P§ 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. Page4of5 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: 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: l 4-- Date 0)/Zb 7 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL likNe State of State of ! 'if7 County of: County of:r }c ,clil( , Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of❑ physical presence by means of 0 physical presence or❑ online notarization, or 0 online notarizatio , this day of .20_, by this I i) day of t .btA.,,0 61/ ,.202.0 by NAME OF LOBBYIST NAMEOIN�A �dVT.L�LI�'�1 _Produced ID V Produced ID: ))-QY'l ChCA W'air (/Chia FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known _Personally Known .ice " / Signature of Notary Public Sig,-ture of Nota' -- •lic 19 rHYr\ V)h. Name of Notary, Typed, Printed or Stamped Name of N tary,Typed,iinted or Stamped (NOTARY SEAL) (NOTARY SEAL) *rNet, 8lrkynlOng *° State of Florida s'_1z., 0.*Commission Expires 01/1012021 I The term"lobbyist'specifically excludes the following persons: 'aoFOP Commission No.60 934778 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 y MIAMI BEACH City of Miami Beach,1700 Convention Center Drive,Miami Peach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granath),City Clerk CityClerk@miamibeachfl.gov' Tel:305.673.7411,Fax:305.673.7254 NAME OF LOBBYIST: AHMEV. OIZThO mire_ 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 suspendedfrom 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 $500.00pursuant to Section 2-482 of the Miami Beach City Code. Signatu/4-01/ - of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 • MIAMI .BEACH RECEIVE' City of Miami Beach SEP b 2020 1700 Convention Center Drive_ Miami Beach, Florida 33139 CITY OFMIAMI BEACHwww.miamibeachfl.:gov OFF1c_,� "!� OIFY CLERK City Clerk's Office Tel 305-673.7411 Fax 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM AHMET . OKT Icy . CJINZ Business Name: 0140 : &&OU P Address:. 11100 . NE 2Nn .AVE, CTE. 303 . N2At i T F1.:_ 33134 .. Office Telephone Number: 41 ..305' goo ioao. . Cellular Telephone Number: 1-1.. 611/ 804/. t'&Zy Email Address: A0 masa-ROUP. COIy (',TNT g If more than one lobbyist,please list 2 6) 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 For City Clerk's Office Use Only MCR#: Amount paid:. 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