Neisen Kasdin - 727 4th Street LLC 7o1-1141 if �►b-,- 4
RECEIVE
t\AIA/\AI f _ Offic of the City Clerk
1700 Co vention Center Drive JUN 21 20 2
Mia i Beach, FL 33139
05.673.7411 CITY OF MIAMI EACH
LOBBYIS REGISTRATION FORM OFFICE OF THE CI CLERK
Lobbyist means all persons mployed or retained, whether paid or not, by a principal wh• seeks to encourage the pass ge, defeat or
modification of any ordinanc , resolution, action or decisio of any commissioner; any a tion, decision, recommendati n of the City
Manager or any City board oil 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 of 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:
Kasdin Nelsen
NAME OF LOBBYIST (Last) (First) (Middle Name)
Akerman LLP 98 SE 7th St, Suite 1100 Miami FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-374-5600 N/A neisen.kasdin@akerman.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Kamhi Eric X.
NAME OF PRINCIPAL (Last) (First) (Middle Name)
727 4th Street LLC 322 E Dilido Dr. Miami Beach FL 33131
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-982-5547 N/A eric@col.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursuant to City;Code.Section2-482(h)(1)(a): A principal of any corporation, partnership, or other entity.who appears as.a,lobbyist on behalf of that
entity,without special compensation or reimbursement for the appearance,whether direct,indirect or contingent,to express support of or opposition to
an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees.
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 NIA): Eric X Kamhi
• 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): Eric X. Kamhi
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III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including bu not limited to a specific description where
applicable;of a pending request for proposal, invitation to bid, or public hearing number.
Represent clilent in connection with proposed legislation to create 4th Stre t Overlay and other land use and zoning matters in
connection vVith the Property at 701-747 4th St.
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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
All Members of the Planning Board X
All Members of the City Commission 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 o 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):
$1,000/hr
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he following six(6)questlo s MUST be answered:
Pursuant to City Cod Section 2-488,entitled"Prohibited Campaign Contributions :y Lobbyists On Procurement I sues":
_Yes x No:• : Are ou lobb in• on a •resent •r •endin• bid for •oods e•ui•ment or services or on • •resent or
pe ding award for goods,equip ent or service?
•) Pursuant to City Codl Section 2-490, entitled"Proh bated Campaign Contributions By Lobbyists On Real Estate evelopment
Issues":
_Yes x No: Are you lobbying on a pending application for a Development Agreement with the City o 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 it been less than 12 months since the elected.official(s)whom you-provided campaign
consulting services was sworn in?
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 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, were.,you promised or did'You receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[N No Amount Paid$ 3'D-mco MCR# 4°A 71° Date Paid CY2•2t-Z2
Lobbyist Registration Form received and verified by: J5
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Revised 03/11/2020
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VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EA H LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, !STING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC I SUE ON WHICH THE
LOBBYIST HAP BEEN ENGAGED LQBBY. A STATEMENT SHALL BE FILED EVEN IF 'MERE HAS BEEN NO
EXPENDITURE OR COMPENSA7 U ING THE REPORTING PERIOD.1
Signature of Lobbyist: Date 06/17/22
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 it a provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all p i g requirements.
Signature of Lobbyist: Date 06/17/22
Signature of Principal: Date 06/17/22
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VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of flUhdq State of Florida
County of: 11 Iaml -Dial County of: Broward
Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed) and subscribed before me,
by means of IA physical presence by means of 0 physical presence
or 0 online notarization, or Wonline notarization,
this Si day of ju.-E , 20L2, by this17th day of June ,2022, by
NCIv-n k4siii6 Eric X Kamhi
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID V Produced ID State of Florida DRIVER LICENSE
FORM OF IDENTIFICATION FORM OF IDENTIFICATION •
1\ Personally Known Personally Known
Signature'of Notary Public Signature of Notary Public
Chri siophei" 4-. P e..IO s Natasha T.Thomas, Online Notary Public
Name of Notary,Types., ame of Notary, Typed, Printed or Stamped
tt,,,
,.fir„ o„%, CHRISTOPHER A. PENELAS
(NOTARY SEAL) .illi, 'Notary Public-State of Florida (NOTARY SEAL) two°•.t. NNASHALTMorus
' *' Commission#GG 363276 '' • 6 Notary Public•State of Florida
o,, ,x F',�, My Commission Expires k" 4,41,,...4' I rAyn�ion#,uaretl
Onnu` August 07, 2023 '.. o` Expires onF.way rt.2O25
1 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.
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City of Miami Beach,1700 Convention Center Drive,Miami Beach, Florida 33139,'www.miamibeachfl.gov
Office of the City Clerk -
Rafael E.Granado,City I lerk CityClerk@miamibeachfl.gov
Tel:305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: Nelsen Kasdin
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
$500.00 pursuant ction 2-482 of the Miami Beach City Code.
06/17/22
Signature of Lobbyist Date
F:ICLERI$ALLIaFORMSILOBBYIST FORMS\Lobbyist Reglstratlon Form Revised 03-11-20 REG.doo
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