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Graham C. Penn - EBJ Sagamore LLC 1 DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 1 uoco 1�,` I1 i 61 t Co(I I'I RECEIVED M I AM I BEACH Office of the City Clerk OCT 20 2022 1700 Convention Center Drive CITY CE OFOF MIAMI Miami Beach, FL 33139 FT THE CITY CLERKBEACH OF 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 "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: Penn Graham C. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin & Tapanes, PLLC 200 South Biscayne Blvd., Suite 300, Miami, FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5300 gpenn@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Granda Javier NAME OF PRINCIPAL (Last) (First) (Middle Name) EBJ Sagamore LLC 4100 NE 2 Avenue,Suite 202 Miami Florida 33137 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-728-8240 javier@lionstone.net PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2-482(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 N/A): J. GraIlda • 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): Please see the attached. Page 1 of 5 DocVeny ID BBEEB5E2-580r-40f fl•98D009399D62 ,III 'I III ��.� Page 1 of 24 198D009399D62 DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 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. Lincoln Road Improvements, Development Approvals & Permitting 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 1 Lincoln Road and 1671 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 Land Use & Sustainability Committee 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 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): $625.00 per hour Page 2 of 5 DocVerify ID:BBEEB5E2-580E-40E9-9668-980009399D62 ,III ,III www dot coin Page 2 of 24 298D009399062 DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 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 X 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 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 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 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 XNo: Have you provided campaiqn 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[1.0o Amount Paid$ -?SO,c7MCR# /t 0 Date Paid Lobbyist Registration Form received and verified by: �? F:\CLER\BALL\aFORMS\LOBBYIST FORMS\Lobbyist F, •tration Form Revised 09-20-18 REG.doc Revised 09/20/2018 Page 3 of 5 I DDocVderify(,ID:BBEEBSE2-580E-40E9-9668-98D009399D62www ,III 1I III Page 3 of 24 398D009399D62 DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 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 COMPENSd4PTIONbDURING THE REPORTING PERIOD.' (iratiSignature of Lobbyist: �t Date 10/19 2022 zFiOe'771!).,aC a6a 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 Co of tfu&It0r Porting requirements. Signature of Lobbyist: Pt, zF eeree1c'469 DocusigoedbY: Date 10/19/2022 Signature of Principal: jAttY Date 1 011 9/2 02 2 \---Jl,/4/14A19 1J4AA 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, by means of❑ physical presence by means of❑ physical presence or Dnline notarization, or Ikonline notarization, this day of 10/19/2022 , 20_, by this_day of 10/19/2022 , 20_, by Graham C. Penn Javier Granda NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION X Personally Know< _Personally Kn --- nee — 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 Diana Ramos Diana Ramos 1 Commission#GG 308355 Commission#GG 308355 1 Notary Public-State of Florida Notary Public-State of Florida i My Commission Expires Apr 10,2023 My Commission Expires Apr 10,2023 ' The . 1 persons: 1 Expert :',`== N„.i:. iY .. .a9 or other specialize niiuiineiiu1T ui ICJLII HUI y vv1 puullr. IiI LIIIyS4ny 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 Dww do y IDY BBEEB5E2-5801-40E9-9668-98D009399D62 Page 4 of 24 498D009399D62 ,III ,I III DocuSign Envelope ID:90870B55-04AF-4741-9E5B-650F835334B8 MIAMI BEACH 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: Graham C. Penn 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. DocuSIgned by. aiawM Pun,1A, 21-10077003C1403... 10/19/2022 Signature of Lobbyist Date F\CLER\$ALL\aFORMS\LOBBYIST FORMS1Lobbyist Registration Form Revved 03-11-20 REG doc Page 5 of 5 DocVertfy ID:BBEEB5E2-580E-40E9-9668-980009399D62 ,III R ,I II www dorvr;nN coin I'agc t,n 74 ',fannnnt33s3s,nti1 DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 EXHIBIT "A" Organizational Chart of Oil Sagamore LLC F r r v r Fl,g DI Lido Flag Di lido tiorismrr DI Lido Uonstens DI tide Eiii Properties,LLC 1 l J Sespruwre JY LLC DPenttIng CrP-(FI.) I Ventures,Ltd.(FL) LP,LLC(Ft) GP,lee.(R) (DFi I (DE) 1 •.. 1 \ / ) •_ .67% 29.5% 35% LS% 31.604 1.67% i DI Lido Beads Resort I Managers of(i)DI Lido Beach Resort Parent LLC,and iiil Pament Ur IDE) (ii)EDI Sagamore U.C: j Lionstone Group: I 10096 L Diego iawensteln 2. Javier Granda o Kanavos Group: i 1. Paul C.Kanavos 2. Dayssr Olarte de KanavosUV ,i c: o Ben-Josef Group: 1. Ron Ben-Josef 2. Ronen Ben-Josef e • Uonstone entities on page 2. • Kanavos entities on page 3. • Ben-Josef entities on page 4. c F. c, C` DocVerify ID.BBEEB5E2-580E-40E9-9668-98D009399D87 J �--i�— '- Page 21 of 24 2198D009399D82 _.._ ,III '''_t ,I II I W - ww f y IID BE -i DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F83533488 10+a+w. t ( AZAII atxE& �halA Ffnviaj//Pru+�� �pf�o rAfFrarr�o %%llRStone Group�CcdON L f LOWE1& ii ) % LcwENSTflN t LUYFt457FJH- `4 townisTEIN1 3.81% towf,NsTr IN 3.81% 10.48% 10.48% ! 10.48% / 10.48% / 100% f [ L - .9n Fam/1yTrust (Rem.r.ab4e)ppm) \ \ // ., 100% i Lowesten Holdings Ltd. I , (qV1} I 100% 1 i,onstooe Hold fitatindos}Ltd 100% I 50.4EL%. Uonst eeGGr up,k,. o (F&) J q 100% 8 Uoneta!(DpI LItM LP LLC i ) I f a tone D Lido GP Inc.1 N x 35% 1.5% R. Kanavos entities on page 3; DI Lido:Bea h Resort Ben-Josef entities on page 4. Parent U.0 L www docv ID.BBEEBSE2-SBOF-4OE9-9668-98D009399D62 ,III I '��I III www docw;r rty corn Page 22 of 24 229BD009399062 FR'.�5([{:�c: DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 ' iKanavos Group Nth.0 Prat / PAUL (PETER-...,, �KAMA�) K.wonros Kromus Kuuvos J 50%1- 50% 50%1 T 50% 1 ws a wo , MIN 134 Rim* %midge Lowe Lawl.Tunas& \ arts do ,i \ e DA ►• spay LLC Dellwadan at i(t %at awes p ty Itaassos Dynasty Usreurss Inc. �d6/ Owttf PwL G PraR� ` f OM Trust Trust 2011 La rost DE IGw►v� r AaAvns \ (R} 1 Trust \ f s. tap70tJ EAn4+ro5 I i .67% 2381166%I 4.50328% 6.78%I 12.39452% 5.05532%I .93114% 2 25299% i 27.93632%I 27.93632% 9.3031 Crib ;lag Di Lido I ventures,Ltd. I lventures,ill')(FL) I 29.5% c Uonston*entities on page 2; Ben-Josef entitles on page 4, r _— Di Ude Beach •` I rn Resort Parent Ur ! G s DocVerOy ID'BBEEBSE2-580P-40E9-9668-985009399D67 �t.t_ 4 www dorvenW corn Page 23 of 24 2398D009399D62 ,III in III III DocuSign Envelope ID:90870B55-04AF-4741-9E5B-B50F835334B8 Ben-Josef Group (........,___ RUrvR \`• RON BEN- ``.1 RONEN Rpm' Jour BEN-JosEF KRAUS �—==— 25% 25% 25% 25% 25% 25% 25% 125% I The Edeed Ben- ` I Josef and Lidia Ben- V Each of (1) Ronit Neuman, (1i) Ron Ben-Josef, (Iii) i losef irrevocable 1 Holdings 1LC Konen Ben-Josef and(iv)Ravft Kraus are the trustees , Trust f 1 ) of The Edeed Ben-Josef and Lldia Ben-Josef Irrevocable Trust 100% 100% f Ell Properties,LLC f ( Sesame:H (0E1 ' ttJC MO — 31.66% 1.67% a 7. R IJonstone entities on pare 2 DI lido Beach Meson Parent lLC Kanavos entities on page 3. (DE) it 'ti .. 0 g LL c. 0 a v1 DocVeriry ID:BBEEB5E2-580E-40E9 9668-98D009399D62 ,III Ia E 'I II www docvonly cornPage 24 of 24 2498D009399D82 Sgi9s�' Miscellaneous Cash Receipt CITY OF MIAMI BEACH No. 430780 E Cash ❑Credit Card ❑Check# $ 20 Received of Address For tMMBF Miscellaneous- MCR-2023 005751-0010 Adrian V... 10/21/2022 1 1:34AM MCR OPEN(MCR) Payment Amount: 1.400.00 (THIS INFORMATIOR.MUST BE COMPLETED) Office of Finance Director Account number: By Preparer: Dept: EXT: