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Vahe Yacoubian - WPH Properties, LLC DocuSign Envelope ID:B5BODF94-F968-41 DF-8342-A511642F7C82 RECEIVED MI AMI BEACH MAY 2027 Office of the City Clerk 1700 Convention Center Drive CITY OF MIAMI BEACH Miami Beach, FL 33139 OFFICE OF THE CITY CLERK 305.673.7411 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: Yacoubian Vahe NAME OF LOBBYIST (Last) (First) (Middle Name) WPH Properties,LLC 18911 Collins Avenue, #3401 Sunny Isles Beach Florida 33160 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 310-490-0000 vahe5@aol.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Cohen Mikael NAME OF PRINCIPAL (Last) (First) (Middle Name) WPH Properties,LLC 18911 Collins Avenue, #3401 Sunny Isles Beach Florida 33160 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 310-205 5555 Mikaelc@ildicoinc.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS urs ant m UV(WAD agAito 2-'82 h } G;1. i®-I d/lify corporation, partnership tip COirliOlgagidi0 appears Epp lobbyist Oil<e r oCQ that R1ME/RiiCEOspecial copensation CP rei bursement for IRO appearance, indirect,Cp contingent,ODOM1M mimed&o...sition to th Itut 1l C n1t C Fp -• -o IS7tliab • I iut n li 3a l . .t}Jpasvan1 -• t If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): LL • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): Mikael Cohen • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH m CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): Please see the attached. m Page 1 of 5 innaRnMOS.: �n 9B-38290FD10D62 ,III �IIII Page 1 of 7__ 138290FD10D62 �ViEpiR'1a�GY�i��tc DocuSign Envelope ID:B5BODF94-F968-41 DF-8342-A511642F7C82 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 properties located at 1020, 1030, 1036, 1040,1050 Washington Avenue and Folios: 02-4203-009-0280,02-4203-009-0290 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): s None N N LL • 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): $ 0.00 per hour w Page 2 of 5 DocVerify ID:eE837E69.6A324B6C-BD9e38290F010D62 www.docve ,III 1I III rify.com Page 2 of 7 I 238290FD10D62 J DocuSign Envelope ID:B5BODF94-F968-41DF-8342-A511642F7C82 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 x 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. _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 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, has i been less than 12 months since the elected officials) worn :ou provided campaign consulting services wa sworn ini. 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 XNo: f yes, were you promised or did you receive economic consideration in exchange for campaign o — onsultinq serviced TO BE COMPLETED BY CITY CLERK'S TAFF ONLY /' Annual'Registration fee: [' ]Yes[ No Amount Paid$ — MCR# J"7fr,C,Vicc ��l Date Paid Lobbyist Registration Form received and verified by: S 1J F:\ LER\$6VLL.\arORMS\B!OBBYIST'FORMS\',9!obbvi;t Registration Form Revised!09.20-18 REG:dos Revised 09/20/2018 Page 3 of 5 DocVerify ID:BE837E69-6A32-456C-8D9B-38290FD10D62 L Page 3 of 7 338290FD10D62 j IIIIMBLIN. 11111 kl www.docverify.com - -- DocuSign Envelope ID:B5BODF94-F968-41DF-8342-A511642F7C82 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: C " �'� Date — 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, by means of 0 physical presence by means of 0 physical presence or 0 online notarization, or 0 online notarization, this day of ,20_, by this_day of ,20_, by Vahe Yacoubian Mikael Cohen NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION X Personally Known Personally Known Signature of Notary Public Signature of Notary Pubf• Diana Ramos Name of Notary,Typed, Printed or Stamped Name of Nota ,Typed, Printed or Stamped (NOTARY SEAL) (NOTAR EAL) SEE ATTACHED NOTARIAL TIFICATE 1 The term"lobbyist specifically excludes the following persons: 04. �J. C tr. 3�Z/ a` 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 DocVerify wwww.docve'riify.com37E69-6A32.4B6C-SD9B•38290FD70D62 �_ Page 4 of 7 _I 438290FD10D62 1 ,III ,I III DocuSign Envelope ID:B5BODF94-F968-41DF-8342-A511642F7C82 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES Subscribed nd sworn to (or affirmed) before me on this 2 a'��- day of fr -i % \ , 20 21 , by 11 164 E( (sod-n/ proved to me on the basis of satisfactory evidence to be the person(s)who appeared before me.at> AGUSTIN RIVERA-CORADO. `�. Notary Public-California z a i'y," + Los Angeles County g z V „" Commission#2262289 �' `` My Comm.Expires Nov 8,2022 (Seal) Signature N •N N N L. E LL O m N m O U m Q W W Q] DocVerify ID:BE837E69-6A32.456C-8098-38290F1310D62 7 e 5 of 0 www.docverify.corn Page 9 I53929FD10D62 ._. _0 J ,III!7-'Wim 11 II I DocuSign Envelope ID:B5BODF94-F968-41 DF-8342-A511642F7C82 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 df REPORTING PERIOD.' Signature of Lobbyist: P 2� kt Date 5/3/2021 _Doeusignod s : _ 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 repcl Meitkn 1Affne — 14,13 Ca60KGi•�W Signature of Lobbyist: _ Date 5/3/2021 Signature of Principal: Date 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, by means of❑ physical presence by means of❑ physical presence or II online notarization, or 0 online notarization, this 3 day of May ,2021, by this—day of ,20_, by Vahe Yacoubian Mikael Cohen NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Kno _Personally Known Signature of Notary Public Signature of Notary Public Diana Ramos Name of Notary,Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped e Diana Ramos 1 (NO Commission#GG 308355 (NOTARY SEAL) Lotary Public-State of Florida t Icy Commission Expires Apr 10,2023 1 The term 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 DDocVorc e'riDfy.Bom37E69.6A32.466C-8096-38290FD10D62 [PageIII 6 of 7 _1 638290FD10D62 J , apaii III I DocuSign Envelope ID:B5BODF94-F968-41 DF-8342-A511642F7C82 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: Vahe Yacoubian 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. 8855076AAA814DF rah& yw 5/3/2021 • p:Vahe Yaceubian Signature o obbytst Date F:\CLER1$ALL1aFORMS\LOBBYIST FORMS1Lobbyist Registration Form Revised 03-11-20 REG.doc in Page 5 of 5 I DocVerif ID:BE837E69.6A32.4B6C-8D9B-38290FD10D62 Page 7 of 7 738290FD10D62 9 I I ,III iIC3g Pa' ,I II I www.docverify.com Disclosure of Interest Interests in WPH Properties,LLC Percentage of Interest JS Group Hospitality, LLC 100% 1425 Brickell Avenue,#PH2C Miami, FL 33131 Interests in JS Group Hospitality,LLC Percentage of Interest Jean Simonian 100% 1425 Brickell Avenue, #PH2C Miami,FL 33131 5/3/2021 Detail by Entity Name DIVISION OF CORPORATIONS 31/44tA.Org C l_j_r?:P R^\rfirCjftfjj u!i ulfirtul.;twi cJF!'rLtt s.Fbsile Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Limited Liability Company WPH PROPERTIES LLC. Filing Information Document Number L21000032665 FEI/EIN Number NONE Date Filed 02/02/2021 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 04/29/2021 Event Effective Date NONE Principal Address 1050 WASHINGTON AVE MIAMI BEACH, FL 33139 Changed:04/02/2021 Mailing Address 1946 TYLER ST HOLLYWOOD, FL 33030 Registered Agent Name&Address PARACORP INCORPORATED 155 OFFICE PLAZA DR 1ST FLOOR TALLAHASSEE, FL 32301 Authorized Person(s)Detail Name&Address Title AMBR JS GROUP HOSPITALITY LLC 1425 BRICKELL AVE #PH2C MIAMI, FL 33131 Title MGR SIMONIAN,JEAN 1425 BRICKELL AVE search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityNameBdirectionType=lnitial&searchNameOrder=WPHPROPERTI... 1/2 5/3/2021 Detail by Entity Name #PH2C MIAMI, FL 33131 Title MGR COHEN, MIKAEL 8701 WILSHIRE BLVD BEVERLY HILLS, CA 90211 • Title MGR YACOUBIAN,VAHE 18911 COLLINS AVE #3401 SUNNY ISLES BEACH, FL 33160 Annual Reports No Annual Reports Filed Document Images 04/02/2021—LC Amendment View image in PDF format 02/02/2021—Florida Limited Liability View image in PDF format Florida Department of State,Division of Corporations search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=initial&searchNameOrder=WPH PROPERTI... 2/2 �Ac� , ...,,,, , --- doc Ierif -,-. ,; ,, B,:�,•_:9 '9CVElk-- Lobbyist Registration Form -V. Yacoubian - signed.pdf DocVerify ID: BE837E69-6A32-4B6C-8D9B-38290FDI0D62 Created: May 03, 2021 12:47:35 -8:00 Pages: 7 Electronic Notary: Yes / State: FL This document is a DocVerify VeriVaulted protected version of the document named above.It was created by a notary or on the behalf of a notary,and it is also a DocVerify E-Sign document,which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary.Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system. Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document. E-Signature Summary E-Signature Notary:Diana Ramos(dra) May 03,2021 12:48:24-8:00[6BDCDFDA6E6C][162.244.152.118] dramos@brzoninglaw.com a 11111 1,11 111111111111111111 11111 M I 11111111111111111111 NM III 111111I IIIIII DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System.Best viewed with Adobe Reader or Adobe Acrobat. All visible electronic signatures contained in this document are symbolic representations of the persons signature,and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws. I DocVerify ww do elr fy.com37E69-6A32dB6C•BD96-38290FD10D62 ,III 6h Er 1IIII ' Generated Cover Page. 38290FD10D62 j