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Liana M. Kozlowski - 4 & 5 Star Island AND 6 Star Island Residence Land Trust • it gt,s- isic4 RECEIVED IV\I AM I B E `C H Office of the City Clerk JUL 01 2022 1700 Convention Center Drive CITY OF Miami Beach, FL 33139MIAMI BEACH 305.673.7411 OFFICE OF THE CITY 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"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: Kozlowski Liana M. NAME OF LOBBYIST (Last) (First) (Middle Name) Bilzin Sumberg-1450 Brickell Avenue,Suite 2300 Miami FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-2415 305-323-2685 Kozlowski@bilzin.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLt EI_Efjjli0E NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Brian Bilzin as Trustee under Trust No.2401-3302-00(4&5 Star Island AND Brian Bilzin as Trustee Under 6 Star Island Residence Land Trust) NAME OF PRINCIPAL (Last) (First) (Middle Name) 25 West Flagler Street,Miami,FL 33130 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-2363 bbilzin@bilzin.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS ur'uant to City Code Section 2482(li)(1)(aa): A principal'6 any corporation, partnership,m1110 entity who appears ED Qaobbyist m behalf of th. ntity,without special compensation or reimbursement for the appearance,whether direct,indirect,CEP contingent,to ress support of or opposition t aniitemishatl r Ister withlthelClerk as reguiredibyrthis.subsectionlbutishall not1beTrequired tolpaWant/registration feed 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): Stuart Miller • 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): Stuart Miller 100% Page 1 of 5 zs60oon.1 r 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. Design and architectural approvals for development of 4-6 Star Island 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 Planning Director, Planning and Zoning Department Not applicable X staff, Design Review Board, City Commission 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): $725 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 moods, 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 Citv's Future Land Use Man? 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 x,-No:• If vet, has it been less than 1'3 months since the elected official(s)whom-you provided ampaidu (insulting services wag awornlrn 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 lobbvino the City Commission at a public meetin4. _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 x-No: f year"were you Promised or did you receive economic-consideration in:exchange for,campaign, (insultng semicosl TO BE COMPLETED BY CITY CLERK'S STAFF1ONLY �1 Annual Registration fee: [ I Yes[ No -Amount Paid$3 'J'O CMCR# v5'7 9S Date Paid 0 1'©C` kt Lobbyist Registration Form receive d verified by: -` ` - - F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-31-26 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 TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENS TION DURI THE EPORTING PERIOD.' Signature of Lobbyist: Date (/Z.3/2 2 iana M. zlo ki 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 II repo ' g qu' ment . Signature of Lobbyist: Date (0/23/22 ana M. Ko ow ' 1104_ Signature of Principa: Brian L. Bilzin Date o6/,n/2n22 Brian Bilzin as Trustee(#2401-3302-00 4&5 Star Island and.as Trustee under 6 Star Island Residence Land Trust Agreement) VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: 1 PRINCIPAL State of Fk CD d Y1 C1/4 State of Texas County of: tC.Y111..I:et Q, County of: Coryell Sworn to( r affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means oo physical presence by means of❑ physical presence oF4l.onlin notariz- 'on, or©online notarization, this aarw day of 20��by thisaotn day of June 20�, by '� r Brian L. Bilzin E OF LO==YIST�iana M.Kozlowski NAME OF PRINCIPAL Brian Bilzin as Trustee(#2401-3302.00 4&5 Star Island and as Trustee under 6 Star Island Residence Land Trust Agreement) _Produced ID V Produced ID DRIVER LICENSE FORM OF IDENTIFICATION FORM OF IDENTIFICATION ona Known _Persor)ally own V4—Q_____ __ s- g2j4 7-- Signature of Notary Public Signature of Notary Public (j• Y'►`w Elva Elizabeth Ruggles iV4 NotaryiNinrinted or Stamped Name of Notary,Typed, Printed or Stamped it 0,14,v ern i HH228026l„ . Elva Elizabeth Ruggles c� xuary15,2028 (NOTARY SEAL) a a•.`''\�G S s :.6 ID NUMBER Nor`��\r:'p°j, 133622294 7►'.........'+Cc 8'Op ib���� COMMISSION EXPIRES n/�9iflillppp\0\�a March 2.2028 I The term"lobbyist"specifically excludes the following persons: . Notarized online using audio-video communication 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 • , s.• . MAM BEACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov Tel: 305,673.7411, Fax:305.673.7254 NAME OF LOBBYIST: Liana M. Kozlowski 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. / , . (s/a3ItZ S'!if of L byi Liana M. Kozlowski Date F:\CLER\SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.00c Page 5 of 5 • Mlscellansous.Cash Receipt ^ . , CITY I A#AI BEACH QF�A ,�. 4' ^ .aC � N7,428795 '� , . Cash C1 Credit Card l Check R , / •^ M B[ }(a 2gp :.(§ay \ �a C f! yy cu 'fCr n`"" d'✓ ,.A'�'^ 4 C I ,„MT . C3'.: II I��t� 9 - Wn A 029 Es e d�10 1fd22d3:2fiPt�( N' ° 1 . ,Stir < _ , \. ;y C Y \ ::,.) y. m 1, S,y.+ t t F;.- , T1ON MUST ae COMPLETED) k;: 4. 1,41411 A1cccwitt Nub' 1 ? "I ',' , \\ ' a\ M 1yF ,JY t �a I'^ .'Ld 4::! tom, t a' " A en t a1y a t ,v• ' c. • •