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Michael W. Larkin - Alex Smith . . 2060 Co1114,17 DocuSign Envelope ID:D0162EB5-228E-4D56-8EA4-A00004A91BF6 RECEIVED MI AMI BEACH JAN 23 2023 Office of the City Clerk 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI 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"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: Larkin Michael W. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin&Tapanes,PLLC 200 South Biscayne Blvd., Ste. 300 Miami,Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 mlarkin@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Smith Alex NAME OF PRINCIPAL (Last) (First) (Middle Name) Regal 2000 Collins Retail Holdings,LLC 330 Fifth Avenue,Suite 802,New York,NY 10001 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 646-685-8778 Alex®regal acquisitions.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS o Pursuant to City Code Section 2-482(h)(1)(a): L:1 principal of any corporation, partnership,or other entity who appears as a lobbyist on behalf of that entity,diRCIER special compensation Eplr lLitr•i•.-flnta,{$for(ibra t cilt tutxb t indirect,cap •- wittutjac2cyo••csition to an item shall register with the Clerk as required by this subsection but shall not be required to Ray any registration fees 0 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): A. Smith e • 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 L "�g870-8687-42EF-AE26-3181 D8AC6263 ,1IIIII III 11 L__Page 1 of.7___1 131 B1 D8AC62B3� DocuSign Envelope ID:00162EB5-228E-4D56-8EA4-A00004A91BF6 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 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 property located at 2000 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. ry List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): None m U 0 0 G 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): $825.00 per hour O Page 2 of 5 DocVerify ID:17BAB870-8687-42EF-AE26-31 Bt D8AC62B3 L Page 2 of 7 1 231 B1DBAC6283 EmBratm www,docverify.com DocuSign Envelope ID:D0162EB5-228E-4D56-8EA4-A00004A91BF6 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 yI es�halitfbe nilcssTthanZ1C2 monthsTsin theTelc'ctedlrfFicial(s�Zwhom vouprovided cam•ai•n eonsultinq servicCs was sworn inr 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 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: N O [O -Yes XNo: If yes,were you +romised or did you receive economic consideration in exchange for campaign eonsultinq services, TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r Annual Registration fee: [ ]Yes K No Amount Paid �45'0'07 MCR S 113 P'� Date Paid Lobbyist Registration Form received and verified by: '2 F l-'a,SAA F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.do Revised 09/20/2018 Page 3 of 5 ' DocVerify ID:17BA6870-8687-42EF-AE26-3101DBAC62B3 r Page 3of7 I 331 B1 D8AC628 l Uti III www docveriy com �]3ifk r DocuSign Envelope ID:D0162EB5-228E-4D56-8EA4-A00004A91BF6 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 COMPENSAIT DURING THE REPORTING PERIOD.' Signature of Lobbyist: aoactln' Date 01/23/2023 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 regdiregvlertid by: Signature of Lobbyist: e—Decusigoed by: dit' `tlit' Date 01/23/2023 \—c,urrurotob 4lU... Signature of Principal: , a S l 9AoG.1s9r2F6w6,... Date 01/23/2023 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 El online notarization, or®online notarization, this day of n1/23/2023 ,20 , by this_day of nir9v7n9a , 20_, by Michael W. Larkin Alex Smith NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Knowi X Personally Kn -- �® 0 "< Signature of Notary Public Signature of Nota Public M Diana Ramos Diana Ramos N_ O th- Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped © . � r. . � - y,� _ _� ( ! -- - --A.A/�/►�- -. ��A.A1, Jana Ramos ► Diana Ramos a Commission#GG 308355 o _ommission#GG 308355 1 E Notary Public-State of Florida Notary Public-State of Florida ligy Commission Expires Apr 10,2023 lyy Commission Expires Apr 10,2023 1 The ❑ persons: ❑ • Expert.uL r., ....,,,..., ., ., I or other specializes intormanon or testimony in puouc meeungs;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 b 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 DocVerity ID:178AB870-8687-42EF-AE26-3181 DBAC6283 Lpage 4 of 7 I 431 B1 D8AC62B3 1 111NS11 II I 1 www docvenfy.com Ill: DocuSign Envelope ID:D0162EB5-228E-4D56-8EA4-A00004A91BF6 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 CiyClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Michael W. Larkin 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. 0 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. p-DoeuSigned by: tn.ithAti �,QY�ctln. 01/23/2023 �.rnGFncAEsaaAa7n Signature of Lobbyist Date LL u m F:\CLERI$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 DocVerify do eID:comA8870-6667-42EF-AE26-31 B1 D8AC62B3 I Page 5 of I 53181 D8AC62B3 I ,0I dt, �'IIII Exhibit C DocuSign Envelope ID:6316D6BF-6EEF-4F55-83BE-71F2F95DB12E • - t. Alexander Smith Joey Cohen Regal 2000 Collins Retail Holdings LLC 100% 100% (DE) I AKE Smith LLC(NY) TJDJ.C.LLC(NY) Managing Member 50% Managing Member 50% 100% z Regal 2000 Collins Manager Regal Capital Acquisitions Ventures LLC(DE) LLC(DE) Elyahu Cohen Kheder Fatiha Y&H 2O00 Collins TeddyKafif Peer Investments Dayan Group-6 LLC Elie Ballas 2009 Family Trust 9.96% LLC(NY) 2.00% 0.73% LLC(FL) ) 28.26% 2.19% .73/0 (NY)3.65% 16.79/o Elyahu Cohen Yosef Abohamra Alberto Dayan MULTIPLE-No member 100% owns 10%or more Stormy AMI Realty Weather LLC IG Gindi 2009 Associates LLC(NY) TJDJ.C.LLC Dainese Holdings Mayer Lati 3.65% Alan Fallas Generational 0.73% (NY) LLC(NY) 5.00% Ralph Pastore 1.09% Trust Alan Fallas—40% 2.50% 0.11% 0 2.19% Moses Fallas—40% Joey Cohen Sean Dainese 100% Isaac Gindi Isaac Fallas—20% 100% 100% Toby Cohen Edmond Harary Raymond Dayan Michael Jemal Jack Gindi The Charlotte Harary 0.53% 1.82% 1.82% 2.19% 0.36% 2009 Irrevocable Trust 1.09% Charlotte Harary Elliot Raymond EHS Capital Group Dennis Ringer Rachel Ringer OC-2000 Collins Tebele LLC(NY) 1.82% 0.36% HDG Group LLC(NY) LLC(NY) 1.09% 2.01% 1.09% 2.92% Zaki Haber-50% Raymond Dayan-45% Elliot Romano Isaac Fariwa Hillel Haber—50/o Arin Funding LLC(NY) 0 1.09% Edmond Harary-45% a 100% 2.92% Adam Ringer Jack Gindi- 10% W 100% W 0 0 m ti g G m LL w r W 3 ¢'. IDwww.docver com6C487-1 E77-45F9-ASAB-987CCEEC2ED9 Page 20 of 23 1209B7CCEEC2ED91 IN LO nl • E F docv'erify OCCVEVO Lobbyist Registration Form - MWL - Regal 2000 Collins - executed.pdf DocVerify ID: 17BAB870-8687-42EF-AE26-31B1 D8AC62B3 Created: January 23, 2023 05:44:27 -8:00 Pages: 7 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.docverify.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) January 23,2023 05:45:55-8:00[EC3B21CB8DFD][74.220.90.117] dramos@brzoningiaw.com I r � IIII c � I IIIIII'IIIII IIII IIIIII IIII IIIII IIIIII IIIII IIII IIIIII IIIII IIIII III 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. DocVerify ID[17BAa870-8687-42EF-AE26-31 Bt D8AC6283 'Generated Cover Page 31B1D8AC62B3 ,QI �I UI ■ www.docvenfy.com C u ! ti `• " City Hall , MBF c 1700 Convention Center Dr. a Miami Beach , FL 33139 ' u� o • , W 7.4f , w, Welcome r y'" , rAi • rt ., 005914-0007 Adrian V. 01/23/2023 04:17PM ,tcu MISCELLANEOUS z • t' j ``,.; .,, ,' Reference 1: MCR431255 iR • ° NCR OPEN (MCR) �` (S ' ` 2023 Item: NCR ,. 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