Jennifer McConney-Gayoso - 1501 Collins, LLC Iso C_IIiks. Aft
RECEIVE®
M I AM I a `.:EACH Office of the:City Clerk MAR 2 2022
1700 Convention Center Drive
Miami Beach,FL 33139 _ CITY 01=h/I1AMl BEgCH
305.673.7411
LOBBYIST REGISTRATION FORM : OFFICE CF 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
Clerks 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 ilformation 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:
McConney-Gayoso Jennifer
•NAME OF LOBBYIST (Last) (First) (Middle Name) •
Studio Mc+G Architecture 7500 NE 4th Ct#102. Miami FL 33138
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street). (City) (State) (Zip Code)
305-5 73-2728 jennifer@studio-mcg.com LOBBYIST BUSINESS TELEPHONE NUMBER • CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
- Rosenberg Todd
NAME OF PRINCIPAL ::• ,.. _ (Lest)..:, ,;. ;.. :� (Frst) . .
(Middle Name) :
1501 Collins, LLC 7900 Glades Rd Ste 540 Boca `Raton 33434
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street). " (City) (State) (Zip Code)
561-430-3113 1501 @pebbcap.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER : -EMAIL ADDRESS
UrsP h Ite9 etst�iylwha a aP oCi° 3 e P rar -i or,
er t0vouspcscornA eorOimrilbyserp tt thrapparancevh h9IR ine to09,,r1 pen rt oe paa pe s Sappt3aitst`4tipt'sp,,p?Rotl lopak,
aitgritsti Ve9IONtelkkzt" Lqlealby th.1 bs4,01 al1nt,ti iac4Riiar :l aot •
•
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(Ifnone,write N/A):' � � C.
NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 6%OR MORE OWNERSHIP INTEREST IN SUCH
it, Please see attached..
1 CORPORATION,PARTNERSHIP OR TRUST(If none,write
Page 1 of 5 . ' � .
rift
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 1501 Collins Ave:
IV. CITY AGENCIESIINDIVIDUALS 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),
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 improptiety°(if none,write NIA):'
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):
$ 275/hr
Page 2 of 6
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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':
_YesXNo: Are You lobbying an>-a present or pending bid for goods equipment'or services,oron 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: •:Areyou lobbying on a�pending application for-`a'Development Agreement with theCity or application .
for of:zoning map:designation or'change to`•theCity's Future'Lend 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. •
YesXNo: : -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 ZQIo: Are. you .providing only scientific technical or other specialized Information appearing as a
representative of.a neighborh_ood•association..without special,compensation nor reimbursement or.:
. representinq'.+a `not-for-profit based.organization y'for-the-!purpose ;of.requestino-'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.Sep•Section2-491 for more information.
Yes XNo: Havewou provided campaign consulting services to an incumbent'rnember of,the'.City:Commission
within the past election c�lcle?If yes;.please'list the incumbent member(s)'•of the-City Commission:.
•
Yes.XNo: if�Gyes°has it been`less thant-i2 months sincegthe`electedlofficcial(sl'.whom a yourprovitted}campaign,
Co nsuitittg s�vaswtservice in?E'_
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 abublc meeting.;
. Yes.2g4g81 Have you provided campaign consulting services to5an incumbent;member of the CityiCommission
withinthe'past''election cycle?if ves,`pleaselist•therincumbent member(s)'of the City.Commission:
Yes_No: Iffves; were.you promised or did`You'receive.economic consideration�int_exchange fah campalp
consultin-gaservices?l,'
. _.. TO BE COMPLETED'BY CITY CLERK'S STAFF ONLY :
,
C 9
L Annual Registration fee: [ "]Yest]No Amount Paid$3 J®" � MCR# 1��7 Date Paid ._�' .Z34z,
•
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d_.s n.\$ALL�6FOR Sr`l,.•• IS'POb t;IgWattitigO talk at.oi,Fo1�z Re
;•Cobb Ist Registration Form received and verified b 4 sleet �� y, az .'
Y _ - �- �� '� � „1oc Reyised03/11/2020
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 BEENjENGAGED TO LOBBY..A STATEMENT.SHALL'BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD?
Signature of Lobbyist: Date 3`1r 2 Z
C
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 ' with the provisions contained in Chapter 2, Art.VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and a eporting;requirements.
•
Signature of Lobbyis Date ,1zz
•
Signature of Principal; . Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of.
County of:..Mlami Dade County of:
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 -day of,: ;,,20_,by
_, by this
Jennifer McConney-Gayoso Todd Rosenberg
NAME OF LOBBYIST NAME OF PRINCIPAL
._Produced ID,'.. Produced ID
FORM,OF IDENTIFICATION FORM OF IDENTIFICATION'
-Personally Known. • _Personally-Known
Signature otary lc" Signature of Notary Public
,Malfe" acadio
Name of Notary,: " rii o l t + 1Y000B Name of Notary,Typed,Printed or Stamped
ry talc State of Florida
mission No.CG966965
(NOTARY-SEAL) ''+a - Commission (NOTARY SEAL)
Expires 03/09/2024
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,
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.. •
•
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 3115�22
VII. NOTARY SIGNATURE AND SEAL:
: LOBBYIST: PRINCIPAL
•State of Florida:: State of Ft(1Ci d A
Miami-Dade . . 11 •
County of: County of: �a l> � �_
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:K5hysical presence •-
•
•or 0 online notarization, or 0 ortline notarization,.
this . .day of ,20_, by. this /S day of. arc . 202aby
Jennifer McConney-Gayoso Todd Rosenberg
NAME OF LOBBYIST .. NAME OF PRINCIPAL
Produced ID • Produced°ID •
• FORM OF IDENTIFICATION FORM OF IDENTIFICATION
•
Personally Known personally Known
Signature of Notary Public Sign ure of Notary Public
l` e coIt _ t, /1 S
Name of Notary,Typed, Printed or Stamped Name of tNtary,Typed,' i,i ed or Stamped :
(NOTARY SEAL) (NOTARY SEAL) .... . - MEGHAN DUGGINS i
r°A� �: Notary Public.State of Florida
;' ` • Commission#GG 202693
9 ' or c' My Comm.Expires Apr 2.2022
1 The term"lobbyist"specifically excludes the following persons: I Bonded through National Notary Assn.
Expert witnesses who provide only scientific,technical or other specialized information ortestimony,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
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AA I AAA B E AC H
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::
Jennifer McConney-Gayoso
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 toile 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
$500 00 urn "nt to Section 2-482 of the Miami Beach City Code
3 r5 . 2 22
ignature ofLobbyist/ Date
F:ICLERI$ALL1aFORMSILOBBYIST FORMSILobbyist Registration Form Revised 03.11-20 REGidw
Page:6 of 5
1501 COLLINS AVENUE ORG STRUCTURE AS OF 02-08-2022
BENEFICIARIES: BENEFICIARIES: BENEFICIARIES:
Barbara Rosenberg Fara Horowitz Todd Rosenberg
Fara Horowitz
Todd Rosenberg
Rkk WebBsd Rya nWeislisch Todd Rosenberg BaAara Rosenberg 7016Tm0 I Fere Horowitz 1013 Trust Todd Rosenberg 2016 Trust
(Individual) (Ildi4dual) F- FL FL
FIN;306555183 SIN:036113875 Elan366555165
3,750,000 1,25p,000 1,350,000 450.000 450603
75.0% 25A% 0.0% 69A% I 20.0% 20.0%
. Managing Member Non Member Manager..
PCM Holdoo LLC Todd Rosenberg
DE
FIN:87-1390663
2,250,000
100.0% 0.0%
Manager
No additional members or
indirect beneficiaries own 5%
or more or the Property Owner
George maoim S.vsras Pebb Capital Management, .Emidbvees
pngio:2aa:l DE (Individual)
EIN:46-5680624
3,000,000 2,250,000 250,030
100.036 90.0% 160%
Managing Member •
No members or Indirect No additional members or
beneficiaries of RonRuss owns 5% indirect beneficiaries own 5%
or more of the Property Owner • or more of the Property Owner
1501 Beach,LLC RonRuss Investments 1,LLC Mkoe,LLC All other Limited Members 1501 Beady LLC 1501 Collins Pebb Manager,LLC
OE FL NV vawu5hgh net worth DE DE
ON:87-2165015 EIN:47-2342968 ON:464376836 mdhmuoh EIN:87-216503.5 EIN:67-1697900
2,500,000 2,5130,000 3,000,030 1,650,000 2,500,000 2,500,000
50.0% 50.0% 64.5% 35.5% 50.0% 50.0%
Major Decision Member Managing Member
/ I
No additional members or
Indirect beneficiaries own 5%m /
or more
Ocean Five Beach,LLC 1501 Collins Pref Equity,LLC All other Limited Members 1501 Collins Manager,LLC
DE FL formed6/8/2021 Eorbus highe000o,00 DE
ON:87-1132149 34620206 EIN:87-1431270
5,000,000 4,650,000 7,350,000 5,000,070
_ 22.73% 21.14% 33.41% 22.72%
Managing Member
n
1501 Collins Holdings,LLC
DE
EIN:87-1404713
22,000,000
100%
1501 Collins,LLC
DE
EIN:N/A Passthrough
-
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CITY OF{°II BEACH No 429786
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