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Vanessa Madrid - 7510 Harding Ave, LLC ?510 ‘i\ / . RECEIVE MI AM I EAC Fl Office of the City Clerk Cid,(��MIAMI 20 2021 r^� 1700 Convention Center Drive I BEACH Miami Beach, FL 33139 OFF!CE OF THE 0117 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 "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: Madrid Vanessa NAME OF LOBBYIST (Last) (First) (Middle Name) Holland & Knight LLP 701 Brickell Avenue, Suite 3300 Miami FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.789.7453 vanessa.madrid@hklaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Montecchiarini Florencia NAME OF PRINCIPAL (Last) (First) (Middle Name) 7510 Harding Ave, LLC 1162 NE 91 Street Miami FL 33138 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.904.9995 florencia@fpminvestment.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS ursuant t oVISi Cod"e'Sect ,62=482(li)(1)(a) ?Wiilcipal'i of any,corporation ,partnership for other entit who.appears,asca'lbbbyistron behalf ofj,tha_ nti y withoutTs ec aalcorn ensa ion or reirnb sur eme t for thea"earance�'whethertdirect indirectt'or co ent to ex ressEsu ort of or4oL position tp ,� �.� ��sr�a� �p�„ �r-�- � «.�'.-�� .pp_:� � �nw - �,�� °�; r�:��9 � p EP_ pp 0� niitemis"tiall reglste lwithathe Cl lreas required bytthis subsection'but shall 1 of he required to`'pay any;registratraf ees:l 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): Please see attached. • 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): Page 1 of 6 e 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 HPB, PB, DRB and BOA, City Commission and Mayor, relating to the property located at 7510 Harding Ave. 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 Historic Preservation Board (HPB), X Planning Board (PB) , Design Review Board (DRB) X Board of Adjustment(BOA), 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): $492 per hour Page 2 of 6 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)(No: 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 K(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 )(1o: 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: �Qnsult npsery en !os sthan 12 months_since the elected;official( 1whom'you'provided'campaign, 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 ZNo: 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 eonsult nq servic S�ymised or_did you receive'economic.consideration 'in exchange_for campaign]� , - r— TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: i ]Yes i ]No Amount Paid,$ 3 50 , MCR#, t1 �i ( a Date Paid pt' ' .14 Lobbyist Registration Form received and verified by: j • g vw 0, 3tL \a3.CR'=4S\LOSSYLST FCRMS\Lebayi6t e?fr=trato a Form EttNised 03-41-2D REG.d•ac Revised 03/11/2020 Page 3 of 6 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 COMPENSATI DURING THE REPORTING PERIOD.1 Signature of Lobbyist: 4444;0. Date 11 1 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 eporting requirements. Signature of Lobbyist: Date *IN 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 affir ed)and subscribed before me, Sworn to (or affirmed) and subscribed before me, by means of 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 r Vanessa Madrid Florencia P. Montecchiarini NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known _Personally Known Signatu of Notary Public Signature of Notary Public m,e k /7-VC -- Name of Notaty, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SEAL) . 01, MERCYARCE (NOTARY SEAL) r>> ;, .MY COMMISSION#HH 054416 '1::i;;--- „,:47i EXPIRES:October 18,2024 Bonded Thru Notary Public Underwriters I The term"lobbyist"sped . 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 6 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: _oggii1111 Date O 1 1 11171 VII. NOTARY SIGNATURE •' S AL: LOBBYIST: PRINCIPAL State of Florida State of F/o Y►C)C� County of: Miami-Dade County of: al I Qm I - la CLQ Sworn to(or affirmed) and subscribed before me, Sworn to (or affymed)and subscribed before me, by means of 0 physical presence by means of C�physical presence or 0 online notarization, or D online notariw tion,. this day of , 20_, by this PI day of Hpr.I / , 2021, by Vanessa Madrid Florencia P. Montecchiarini NAME OF LOBBYIST NAME OF PRINCIPAL 1 _Produced ID _Produced ID dr i v-V s IiC•fnS-e FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known _Personally Known 1/4 Signature of Notary Public Signatur of Notary Public Name of Notary, Typed, Printed or Stamped Name of Notafy, Typed, Printed or Stamped (NOTARY SEAL) (NOTARY SEAL),—== 2p«" `''Itt% MERCYARCE t .=a; icer .1.1 MY COMMISSION#HH 054416 1 ,,�`�pq`.' EXPIRES:October 16,20.:The term"lobbyist"specifically excludes the following persons: 1 .',F°F":°•'• Bonded triuNacryPublic under uii,.. 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 MIAMIBEACH 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: Vanessa Madrid 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. -LON Signature of o%byist Date F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 6 of 6 DISCLOSURE OF INTEREST 7510 HARDING AVE LLC NAME AND ADDRESS % of Ownership GM 7510 DEVELOPMENT LLC, a Florida limited liability 20% company Gustavo Masri 1162 NE 91st St, Miami, FL 33138 RUTO LLC, a Delaware limited liability company 20% Alvaro Castro 21500 Biscayne Blvd Suite 401, Aventura, FL 33180 ST HUSKY LLC, a Florida limited liability company 20% Emiliano Fernandez Balague 21500 Biscayne Blvd Suite 401, Aventura, FL 33180 ERA DEVELOPMENT TRUST 10% Beneficiaries: Fabio Humberto Attaguile Sergio Adolfo Ebert Jose Diego Reboredo 1162 NE 91st St, Miami, FL 33138 75 NB GROUP, LLC, a Florida Limited liability company 10% Alvaro Castro 1162 NE 91st St, Miami, FL 33138 GM JET INVESTMENT LLC, a Florida limited liability company 10% Gustavo Masri 1162__NE 91st St, Miami, FL 33138 ROSTOCK BLACK LLC 5% Jorge Andres Abraham 21500 Biscayne Blvd Suite 401, Aventura, FL 33180 WHITE ROCA LLC 5% Matias Ariel Maggiolo 21500 Biscayne Blvd Suite 401, Aventura, FL 33180 TOTAL 100% 2 • • i, Mlscehaneous Cash Receipt _ - - = . • CRY O►F UTAM18EACH • •No: 427682 . . '-' Q:Cash �7Cred�t Card 7. check.,, :, ,,,,,: #, w. „ :1,-/-„,,(.----, -,-..- , (0::::::::„., r --t,. } :z, ,,,,, ,,), ,-.. . . : ,., -, ,,::,.„' ,:,„ ,„ ...... .. , . , . . ,. . .. ,, , , , .. . . ., ,..._ ... ice lAr , .. ,.... . . , . , ...: BF' Na Of !,tl e-rel + p I4 GR-102.. r'1, I . , , ' ! i r, For ISS-i., _"` , .. Payment Amount: . ` 1'400.00 • ' (MS Q /flMN $T BE COMPLETED �df�Ici�ot,Financo DJr+�ctor � . . Account,Nwaber: i 2.t 1 .5° "' \,,,Y. 6,, t 1.°e.,c, '-77...C''.."?,,-,-2 l'')