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Michael Marrero - Philippe Harari h6 A.c� DocuSign Envelope ID:F2E44B71-0C4F-4AD1-91B2-0470773CB36C RECEIV ® RECEIVE® CH DEC 15 2022 MIA I B EAC H oEC 1 z°2z M �73a0GIFF.:MTNE ���Office of the City Clerk CITY OF MIAMI BE CITY CLERK 1700 Convention Center Drive OFFICE OF THE CITY CLERK Miami Beach, FL 33139 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: Marrero Michael J. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin&Tapanes PLLC 200 S.Biscayne Blvd.Suite 300 Miami FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)374-5300 mmarrero@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Harari Philippe NAME OF PRINCIPAL (Last) (First) (Middle Name) 320 Aqua LLC 320 West Di Lido Drive Miami Beach FL 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)672-3232 aquabluedesign@gmail.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS t1.7 =w . 2-482(h)(1i)(a): Q. i.:I dEre.. .'. .Mati,partnership,c•77aio[ 'J ' • - • ®el lobbyist p Lgidli1CPW agMzfIGEEB .D compensation airdijaurgi a�IIfortt rt indirect,CH contingent,fi c a B e Iii Cijo..osi ion{t n item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees. n If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): io • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): Philippe Harari • 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): See Attached 0 0 Page 1 of 5 i . 83D-8EA2-418E-A9F2-6A12369CFF2F L Page 1 of6 I 16A12369CFF2F so Resin III DocuSign Envelope ID:F2E44B71-0C4F-4AD1-91B2-0470773CB36C 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 Review Board approval for new-single family homes including understory and waiver for additional height. 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 • 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 8 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 + LL U M N 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): $600.00 ih Page 2 of 5 DocVerify ID: do er�6663483D-SEA2-418E-A9F2-6A12369CFF2F L Page 2 of 6 26A12369CFF2F I ,11I�qy,'K �Q� III DocuSign Envelope ID:F2E44B71-OC4F-4AD1-91B2-0470773CB36C 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 X No: Are you lobbvinq 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 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 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 4.No: If yes, has i been less than 12 onths since the elected official(s)whom you Provided campaia consulting)services was sworn ini 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. N _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: O N LL Yes XNo: f yes, were You Promised or did You receive economic consideration in exchange for minutia on offing services) TO BE COMPLETED BY CITY CLERK'S STAFF ONLY a , Annual Registration fee: [ ]Yes[ _)No Amount Pald$ MCR U Date Paid Lobbyist Registration Form received and verified by: F:\CLER\BALL\aFORNS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018 Page 3 of 5 DocVerify ID:66634830-8EA2-418E-A9F2-6A12369CFF2F L Page 3 of 6 36A12369CFF2Fi lII .• 1611 III www docvenfy.com f ,,, DocuSign Envelope ID:F2E44B71-0C4F-4AD1-91B2-0470773CB36C 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 COMPENSANIONI DURING THE REPORTING PERIOD.' Aitidar Signature of Lobbyist: Mt're Date 12/15/2022 bU&*282/hbu24be... 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 rec airei>:0 tsi by: Signature of Lobbyist: DocuSigned by: Mict att I itortrO Date 12/15/2022 \--tLUI-1 /rbU24bL.... ELitirr, (kay'art Signature of Principal: Date 12/1ri/9022 BoDk904,37,196r2A... 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 0 physical presence by means of 0 physical presence or EI online notarization, 12/15/2022 or®online notarization, 12/15/2022 this 16 day of December ,2022, by this 16 day of December ,20 22 by Michael J.Marrero Philippe Harari NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Kn x Personally Know SOW „ .10,,,NA602 s4,,.n2.2.,,,r �<m,, Signature of Notary Public Signature of NotaryKamOSic Diana Ramos Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped ��� — — — — — — 1 7 LL Diana Ramos Tana Ramos .ommission#GG 308355 Commission#GG 308355 N tNbtary Public-State of Florida Notary Public-State of Florida I My Commission Expires Apr 10,2023 t, 1 The My Commission Expires Apr 10,2023 LL persons:9 < n T_-.-.z` �-, —`--... -- —4 • Expertf-_T;°r'-=_ T-T=_=T-zTl or other specialized intormation or testimony in public meetings;any person who 7 only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether p 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 Y DocVerify ID" do ry68o3483D-8EA2.418E-A9F2-6A12369CFF2F I Page 4 of 6 I 46A12369CFF2F I Ill ..a 'I Ill DocuSign Envelope ID:F2E44B71-0C4F-4AD1-91B2-0470773CB36C 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: Michael J.Marrero 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. O 3) ANNUAL LOBBYIST REGISTRATION FEE lt) 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 LL $500.00 pursuant to Section 2-482 of the Miami Beach City Code. LL cLLj DocuSigned by: Atitt a 1, Inoue re 12/15/2022 CD0r20E7f5D2450... Signature of Lobbyist Date CN F:ICLERI$ALL1aFORMSILOBBYIST FORMS1Lobbyist Registration Form Revised 03-11-20 REG.doc co co Page 5 of 5 DocVerify ID:6663483D-8EA2-418E-A9F2-6A12369CFF2F r Page of 6 I 56A12369CFF2F 1 Ell www docven y.com Sb$jj"'LLSSii>�� DocuSigh Envelope ID:F2E44B71-0C4F-4AD1-91B2-0470773CB36C Exhibit B: Disclosure of Interest "320 Aqua LLC" 320 Aqua LLC PHFT Investments LLC (Philippe Harari Family Trust) 90.8% • 1680 Michigan Avenue Suite 913 Miami Beach, Fl 33139 320 Maz Aqua LLC 9.2% 1680 Michigan Avenue Suite 913 Miami Beach, Fl 33139 . -PHFT Investments LLC (Philippe Harari Family Trust) Emma Harari, Beneficiary 33.33% 1680 Michigan Avenue Suite 913 Miami Beach, Fl 33139 Gabriel Harari, Beneficiary 33.33% 1680 Michigan Avenue Suite 913 Miami Beach, Fl 33139 Sophia Harari, Beneficiary 33.33% 1680 Michigan Avenue Suite 913 Miami Beach, Fl 33139 320 Maz Aqua LLC Philippe Harari 100% 1680 Michigan Avenue Suite 913 LL Miami Beach, Fl 33139 LL M LL W C, 4o Co DocVerify ID: do er�6663483D-6EA2-418E-A9F2-6A12369CFF2F Page6016 T 66A12369CFF2F ,nl t ? 'IIII 1 F doc'v'erify y 9 D A OCCVEK\� Lobbyist form MM - 320 Aqua - executed.pdf DocVerify ID: 6663483D-8EA2-418E-A9F2-6A12369CFF2F Created: December 15, 2022 12:15:16 -8:00 Pages: 6 Electronic Notary: Yes/ State: FL This document is a DocVerify VeriVaulted protected version of the document named above.It was created by a notary or on the behalf of a notary,and it is also a DocVerify E-Sign document,which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary.Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system. Go to www.docverifv.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document. E-Signature Summary E-Signature Notary:Diana Ramos(DR) December 15,2022 12:17:00-8:00[41972EC9D6C9][74.220.90.117] dramos@brzoninglaw.com I iimi • I IIIIII IIIII11111 IIIII IIIII IIIIII IIIII IIII IIIIII IIII IIIIII IIII IIII IIII DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System.Best viewed with Adobe Reader or Adobe Acrobat. All visible electronic signatures contained in this document are symbolic representations of the persons signature,and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws. r DocVerify docv l 6663463D-8EA2-416E-A9F2-6A72369CFF2Fwww - g ,III ,I III 1GLenerated Cover Page; 6A12369CFF2F u NSF cr+ City Hall t ' 17M00i amCoi nBveeancthi on, Center 39Dr. j ,n N ,.w 305-673-7420 M - 1 ..c, '-',,,-1 �.., . Welcome M <.. s -x u. ; '` j 1 , ` o '' 005855-0002 Adrian U. 12/16/2022 09:47AM ,a-, E. MISCELLANEOUS o Reference 1: MCR430935 � NCR OPEN (NCR) a ,,,1 ,, �" 2023 Item: MCR 1:' '' `.�. m 1 @ 1,200.00 ` %V - Q. s NCR OPEN (MCR) 1,200,00 <S ; ▪ t, T 1,200.00 g `^+� ..�. Subtotal 1,200.00 ,, } ''' ` ,4 W Tot al t 1 10200.00 ` �' '� " , ' o* "itt *° �.' CHECK 850.00 Check Number00008088 _ m " , CHECK 350.00 u �` : ;"' - N Check Number00008316 a� ^▪, 9, ,,"". n a ,, :' ..o 0 3 t g Chance due 0.00 `m " � M1 Paid by: BERCOW RADELL FERBABDEZ & LARKIN q O. Q L 4— ^w.., 'arm '`,,., r� OC ��` 4 1 .,.1.'" , 4 IIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII u .O �� moo. o EZ a c erwew,tv�a� aaawuaw — Aii.f 1 O "a � O i U L # '{ i L mg?.M1W n..�,.I11M11,'j'ip °o ct k 4 ►fi a • 17(� i .....�,w 0 wm i 1 m IV i . 1 roal nwoeu +n auw lie Fa mxa.aawwua J p y,---LCIL--e----"'"n. Ci Thank you for your payment CUSTOMER COPY