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Emily Balter - BC Deserves Better, LLC 5oSt-/ tiat cAk,c,u DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 RECEIVED M I AM I BEACH Office of the City Clerk APR 26 2021 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH 305.673.7411 OFFICE OF THE CIT(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: Baiter Emily NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin'&Tapanes,PLLC 200 South Biscayne Blvd.,Suite 300 Miami,Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 ebalter©brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Kapoor Rishi NAME OF PRINCIPAL (Last) (First) (Middle Name) BC Deserves Better, LLC 2665 S. Bayshore Dr., Suite 1101 Coconut Grove Floria 33313 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 404-449-4931 rkapoor@location.ventures PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS 'ursuant to City®ode SFEtion 21482'010 g5: A principal of E'Gu corporation partnership CP other entity who appears m Iolibyis Ctrl behalf of that entity,aka special compensation CP reimbursement for(Dm appearance dhargai2git indirect,CH contingent,tt i 3?aEM cliniiildiceopoosition to an item shall register with the Clerk as required by this subsection but shall not be required to °ay any registration fees: 0 If the principal is a Corporation, Partnership or Trust, the following information MUST be provided s pursuant to City Code Section 2-482(c): 0 • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): Rishi Kapoor • 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): Rishi Kapoor 100% U U Page 1 of 5 `CDwnaRamos��d� p78-CE98BD4D7CB5 I Page 1 of6 I 10E98BD4D7CB5 1111 lrw MII III Li DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 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 500 71 Street and 4621 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 U rn V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a r4 contingency fee is prohibited pursuant to City Code Sec. 2-485.3): N U N $275.00 per hour ❑ Page 2 of 5 L DocVerify ID:79DDEBD2-CCC2-4253-8578-CE98BD4D7CB5 Page 2 of 6 2CE98BD4D7CB5 'III L•. rt Ste. II I www.docvenfy.com DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 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 x_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 officiaI(s) whom you provided campaign consulting ser.Irt int. 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 0 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. 0 Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission N — within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: N ,9 N QI Yes xNo: If yes, were you promised or did you receive economic consideration in exchange for campaign mconsul ing servicesr: soW U m n m TO BE COMPLETED BY CITY CLERK'S STAFF ONLY rq Annual Registration fee: [ 1 Yes4No Amount Paid$ '350 MCR# 4-(2,768tq Date Paid 9 k7h.40zi U U Lobbyist Registration Form received and verified by: . ,r8(0Lot m F;'\CLER\*ALL\aFORMS\LOBBYIST FORMS\Lobbyi6t Registration Form Revised 09-20-18.-REG:doc Revised 09/20/2018 w 0 o Page 3 of 5 DocVerify 9DDEBD2-CCC2-0253-8578-CE98BD4D7CB5 Page 3 of 6 I 3CE98BD4D7CB5 1 1111 f IS'I III [ • DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 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 COMPENSMIRING THE REPORTING PERIOD.1 Signature of Lobbyist: 7::6i b_ _ Date 4/26/2021 61A1A14495944E6... 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 ati� ((,,t,rlg4equirements. bar Signature of Lobbyist: t~I Date 4/26/2021 1A I A 14495944EB... 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 this 26 day of April ,2021, by this_day of ,20_, by Emily Baiter Rishi Kapoor NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION X PersonallyKno X Personally Known 0 Signature of Notary Public Signature of Notary Public Diana Ramos Diana Ramos Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped O 1 Diana Ramos 1 Commission#GG 308355 (NOTARY SEAL) Rotary Public-State of Florida Igy Commission Expires Apr 10,2023 m O W • 1 ThC"".:,.,, ,.=5,s..,.- ;: '::trig persons: • Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who O• only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether U• 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 ID:79DDEBD2-CCC2-0253-B578-CE98BD4D7CB5 - IIII 's 1511111 www.docveri .com Page 4 of 6 4CE980D4D7CB5 PS-!;:L DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 • 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: ".- Date 1'r 14-Lb 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 this day of April ,2021,by this(/ day of April ,2021,by Emily Batter Rishi Kapoor NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION F.- of IDENTIFICATION X Personally Known x Personally t Signature of Notary Public Signature of Nota\ blic Diana Ramos Diana Ramos Name of Notary,Typed,Printed or Stamped Name of Notary,Typed,Printed or Stamped (NOTARY SEAL) • `(NOTA'. ' I DIN A RAMOS j*: 4 • • MY COMMISSION 11 GG 308355 r,•,, EXPIRES:April 10,2023 The term"lobbyist"specifically excludes the following persons: "°Ff ZoVBonded Thru Notary Public Underwrites Expert witnesses who provide only scientific,technical or other specialized Information or testimony!in public meetings;any person who A 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 whoppniy appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special i mpensation or reimbursement for the appearance. 8 Page4of5 ❑ 0] W m I DocVerify ID:79DDEBD2-CCC2-4253-B578•CE98BD4D7CB5 Page 5 of 6 5CE98BD4D7CB5 ,III ,._Y=1411 www.docverify.com DocuSign Envelope ID:5A509A32-3EFB-4834-BC9F-11A2850CB540 MIAMIBEACH City of Miami Beach, 170U 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: Emily Baiter 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. 0 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period 07, 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. DocuSigned by: oo LS% bakir 4/26/2021 U 01A1 14495944E0... 05 Signature of Lobbyist Date V U U F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc (J W Page 5 of 5 DocVerify ID:79DDEBD2-CCC2-0253.8578-CE98BD4D7CB5 I Page 6 of 6 6CE98BD4D7CB5 'III www_docverify.com • 't; Deac PPPtttJJJ • Miscellaneous.Cash Receipt CITY OF MI• AMI BEACH . ►� No.=;427689: : . Cash Coedit Caird' -1:161661(# 0 _ .v .• 1 i+l�sce la_neous 114, 0 (��h Pajnnen (THIS INFOftillATION"War BE COMPLETED) Offt as:of I=Irianc�DitMctor e By • .-4y{ 4 '"' "•.7_ j /''� $J t.. • )) •12:<?,3 - • _ - -M�wu#Number Dt f t' ,,i` t t,. EXT. m.:..:.. ...,..«..........:u .....w.....�_'.° _.._.r.,...�:;....�.w._.._y.._..Y...�.:.s.:.. ___..i..::.:��_._.._o-•.._�s....n_._>:�_«�,....,c:._.�.r..v:...._. ._�e„_......_.......�..�L:.:�_..�����w..�.��1..:..............«....:...: - ,