Paul Fischman - Florida Property Holdco LLC 0.13 564- 151c-41d .0r.
t
RECEIVEDBEA
, iA
a �i Office of the City Clerk
1700 Convention Center Drive FEB 0 8 2021
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 "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:
Fischman Paul
NAME OF LOBBYIST (Last) (First) (Middle Name)
Choeff Levy Fischman 8425 Biscayne Blvd. Suite 201 Miami FL 33138
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-434-8338 pfischman@clfarchitects.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Florida Property Holdco LLC 11100 NNE 8th St. #400 8n Porter& Co., PLLC Bellevue WA 98004
E
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-814-8007 floridapropertyholdcollc@rjpc.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursuant to City Code Section 2-482(h)(1)(a): A principal of any corporation, partnership, or other entity who appears as a lobbyist on behalf of that
entity,without special compensation or reimbursement for the appearance,whether direct, indirect, or contingent,to express support of or opposition to
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): Robert Pera
• 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): Robert Pera -100%
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 & permitting issues, including, but not limited to Members of City Administration, Members of
City Staff and Members of PB, DRB and BOA, City Commission and Mayor, relating to the property
located at 23 Star Island Drive.
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):
200 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 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 No: 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.
YesX No: 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 )(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 XNo: 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 XNcb 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, 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[N.No Amount Paid$ 3.56 MCR# ((t I [,3 ( Date Paid 01-12-21
Lobbyist Registration Form received and verified by:
z,URS=r; Ub.1 .ws'<°;i.S a re7aviSi',Iabrest registration Form Revised 03-11-20 REG.doc Revised 03/11/2020
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 ' LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR Cs ,' ' - - DURING THE REPORTING PERIOD.'
Signature of Lobbyist: 'Amp Date
I do solemnly swear or affirm that all of th= ,regoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am famili- ,. ,`I provisions contained in Chapter 2, Art. II, Division 3, entitled "Lobbyists" of
the Miami Beach " -- - • - 5. ng requirements.
ri 219,21
Signature of Lobbyist: /�i` Date
Signature of Principal: Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of
County of: Miami-Dade County of:
Sworn to (or affirmed)and subscribed before me, Sworn to(or affirmed) and subscribed before me,
by means of L�J'physical presence by means of❑ physical presence
or 0 onli a notarizatiQ,n, or 0 online notarization,
this i day of J G v-0.kP J , 201i by this_day of , 20_, by
'YCLAl \ I S C IAA Ct.,&_)
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
'ersonally Known _Personally Known
10X e / ?. . C/
Signature of Notary Public Signature of Notary Public
tuot- B 2,01-, Ll
Name of Notary, Typed, Printed or Sthmped Name of Notary, Typed, Printed or Stamped
(NOTARY SEAL);;.. (NOTARY SEAL)
' ,u,,, NotaryPublic State of Flontla
�' Oma 8ronshteyn
nay Commission �{pA2oc
1 The term "lobbyist'i'sp't Iy f iglIb ig per .ns:
Expert witnesses who provide only scienti ic, t-c n . - er 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.'
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
Joseph Abadi on behalf of Florida P•e.• oldco LLC da
Signature of Principal: / Date I / ) )7_0 CI
VII. NOTARY SIGN URE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of F ( L r-I d cl
County of: Miami-Dade County of: MI C1►'Yl I - Dc (Le.
Sworn to (or affirmed) and subscribed before me, Sworn to (or affirmed) and subscribed before me,
by means of 0 physical presence by means of® physical presence
or 0 online notarization, or 0 online notarization,
this day of , 20_, by this 15 day of Sh )ayVQ Y , 20/1, by
Tocch
ch
NAME OF LOBBYIST NA E OF IRI I AL �`
Produced ID /Produced ID Di(tie rus tIC(2Ase
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known _Personally Known
-727
Signature of Notary Public Signatur&of Notary Public
f ✓ ci Piva _
Name of Notary, Typed, Printed or Stamped Name of Notal, Typed, Printed or Stamped
( ( ; .SEA } MERCYARCE
NOTARY SEAL) 1VCOMMISSION#HH 054416
�� ;es EXPIRES:October 18,2024
=-.3,,..-1, ;(6/
Bonded Thru Notary Public Underwriters
' 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
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: 305.673.741 1, Fax: 305.673.7254
NAME OF LOBBYIST: Paul Fischman
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
$500.00 rsuant to Section 2-482 of the Miami Beach City Code.
Z
re of Lobbyist Dat
F:\CLER\SALL\aFORM S\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG doc
Page 5 of 5
Page 5 of 8
POWER of ATTORNEY AFFIDAVIT
STATE OF 90 r"t c q
COUNTY OF 1 1 ami Race,
I, Robert Pera , being first duly sworn, depose and certify as follows: (1) I am the owner or
representative of the owner of the real property that is the subject of this application. (2) I hereby authorize
Joseph Ahadl,Tracy Sloven*,Ralph ChoeH d Raul Rachman to be my representative before the Board of Adjustment Board. (3) I also hereby
authorize the City of Miami Beach to enter my property for the sole purpose of posting a Notice of Public Hearing on my
property, as required by law. (4) I am responsible for remove this notice after the date of the hearing.
Robert Pera
PRINT NAME (and Title, if applicable) SIGNATURE
r 4
Sworn to and subscribed before me this day ofa ki , 20 21 . The foregoing instrument
was acknowledged before me by means of physical presence or online notarization by
Robert Pere , who has produced(/SR f ;._$,. )Uf-"as identification and/or i e-rsonally known to
me and ho di. •id not take an oath.
NOTARY SEAL OR STAMP r`�.0111111t��t . ,. __ 4
�.o aPTH0 11 fig NOTARY PUBUC
_„z•te..**40rAft>R0.:**Vaaria A I
My Commission Expires: t' •...r: a. .yM ."x V
: PUBLIC 2% ? PRINT NAME
j COMM.motors e: '"
*: EXPIRES .*
i:- ••, FEB N, 3021
d
CONTRACT 4 ► fiUJ ....A E
If the applicant is not the owner of the property, but the applicant is a party to a contract to purchase the property, whether
or not such contract is contingent on this application, the applicant shall list the names of the contract purchasers below,
including any and all principal officers, stockholders, beneficiaries or partners. If any of the contact purchasers are
corporations, partnerships, limited liability companies, trusts, or other corporate entities, the applicant shall further disclose
the identity of the individuals(s) (natural persons) having the ultimate ownership interest in the entity. If any contingency
clause or contract terms involve additional individuals, corporations, partnerships, limited liability companies, trusts, or other
corporate entities, list all individuals and/or corporate entities.
NAME DATE OF CONTRACT
NAME, ADDRESS AND OFFICE %OF STOCK
In the event of any changes of ownership or changes in contracts for purchase, subsequent to the date that this application if
filed, but prior to the date of a final public hearing, the applicant shall file a supplemental disclosure of interest.
We are camm$fed b pro ifiF!g(_ c ie?t pubic sorv;ce awl soiery to all who Iva woit,00,5 ploy T 'u'v brofit,tro Ci•, ,,,,tu. ;,X `� ,
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
No, 427431
0 Cash 0Crodit Card 0, Chad(# .1)L.Lill - $
,
FFR 8 2,11 2OL:)
Rscelvod ot A 07- yvt( )4\
Address -t-fiNf- ,4 -
/ aYitify itkt A 4
For 3i/ar, -//1,,„.
'
(THIS INFORMATION MUST SE COMPLETED) Office of Finencs Mr-octet
- - By
Account Number:
°
Preparr: Dept: EXT: