Jose L.Gomez - Robin Brown •
RECEIVED
JAN 30 2023
M I AM I B EAC H Office of the City Clerk Cis OF MIAMI BEACH
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"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.
L LOBBYIST INFORMATION:
Gomez Jose L.
NAME OF LOBBYIST (Last) (First) (Middle Name)
Beilinson Gomez Architects PA 8101 Biscayne Blvd., No. 309 Miami FL 33138
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-559-1250 jgomez@beilinsonarchitectspa.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Brown • Robin
NAME OF PRINCIPAL (Last) (First) (Middle Name)
SOV CMB Hotel Owner LLC 250 Smoke Valley Road. Osterville MA 02655
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
617-775-6789 robinbrown@spotonventures.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
• rsu- fbC'ty Ca.a ec'.n2-482h, 1; G1p n psi cifssrj corpora on [Sin,Gag NDf=L°i li--1mt UzINIO O'd behalf C9a•a
Mat, ti rol. l L.3f aftb APJaP re mbursement for frakil sT Iibutta, itil2M CI?CK.1ri$ra- UU a ex.ass suppot[Slay ag.•sUaa t.
ail OCR shall re.Ister( C (§143 as t EDFah subsection al803 required ttj I,Lay OW re.istration lb
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): Robin Brown -Manager
• 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 Exhibit A
Page 1 of 5
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.
Land use, zoning and permitting issues for the property located at 4000 Collins Avenue
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
City Commission x
Historic Preservation Board x
Board of Adjustment x
City Manager x
City Staff
x
Building Department x
Planning Board 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 NIA):
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):
$275/hour
Page2of5
•
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 lobbvinq 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 Citv'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 ZC,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 officials)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 memberfsl of the City Commission:
Yes XNo: f yes, has it been less than 12 months since he elected official(%) whom ye provided campaign
onsuiti III ,:ices was s, o,n inid
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 hislher 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 memberfsl of the City Commission:
_
Yes XNo: If as, were au. promised or did you receive economic consideration in exchange for campain.
onsuttinp services,?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
i'Annual Registration fee:'.[, ].:Yea,[; ]tNo AmountPaid$• MCR#' - _ .- - Date Paid..
Lobbyist Registration FormIreceived•and,veritied:byr. "-
i;F:(CCEFic ALL\'aFORMS\LOBBYIST:FORMS\LobbyistRegistrat*(iirn Rev ged;yo3 11c20 REd:d6c �_..
- ._... •_ _:Iteyisedi1:13%11%3020`_.
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 PRECEDIN CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED 0 LOBBY.A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR CO S ING THE REPORTING PERIOD.1
Signature of Lobbyist: • Date OHM",
I do solemnly swear or ffir that all f th:-foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or m fa War th the provisions contained in Chapter 2, Art.VII,Division 3, entitled"Lobbyists"of
the Miami Beach City Cod- .rid a :sorb requirements.
Signature of Lobby' • r• Dat t'( �
Signature of Pri -
ff/. wissinpunw .I �, 01/23/2023
/ /
VII. NOTARY SIG ATURE AND S. AL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: Miami-Dade County of: Broward
Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me,
by means ofXphysical presence by means of 0 physical presence
or 0 online notarization, or tif nlline notarization,
this 19{s day of January 20221 by this 2r day of January ,20 23 by
Jose L. Gomez Robin Brown
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID • V Produced ID MA driver's license
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
Personally Known 1'� _Personally Known
Si natur of NotaryPublic na ure of NotaryPublic
9 � 9
CINIA .1_E\J v ^]R E S Jaylen C Ford
Name of Notary 5 = .� ,��'��;K•5 I NNotarized oni�r'ie using Printed orcommunication
. Notary Public•State of Florida
(NOTARY SE' ) ;Ede Commission#HH.141349 (NOTARY SEAL) ; o" .UYt ENC FORD
,,,,orn.. My Comm.Expires Jun 17,2023 !��. Notary Public-State of Florida
a. o
Bonded through National NotaryAssn. ) 4' ii1n eamrnissiona txeosis
i
• A:10:° Expires on Jwey 14.my
1 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.
Page 4 of 5
MIAM1I 'BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeochfl.gov
Office of theCity Clerk
Rafael,E.Granada,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.741 1,Fax:.305.673.7254
•
NAME OF LOBBYIST: Jose L. Gomez
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
$500.0 ant t Section 2-482 of the Miami Beach City Code.
•
Sign ture of L bbyist Date
F:ICLERI$AtL FORMSILOSSYIST FORMSLLobbylst Registration Form Revised 03.11-20 REG.dac
Page 5 of 5
Exhibit A
Disclosure of Interest: SOV CMB HOTEL OWNER LLC
Property Owned by:
SOV CMB HOTEL OWNER LLC 100%
250 Smoke Valley Road
Osterville,MA 02655
SOV CMB HOTEL OWNER LLC Owned by:
SOV CMB VENTURE LLC 100%
250 Smoke Valley Road
Osterville,MA 02655
SOV CMB VENTURE LLC Owned by:
SOV CMB LLC 5%
250 Smoke Valley Road
Osterville,MA 02655
Highwater Hospitality,LLC 95%
10 St.James Ave. Suite 1700
Boston,MA 02116
SOV CMB LLC Owned by:
Spot On Ventures LLC I00%
250 Smoke Valley Road
Osterville,MA 02655
Highwater Hospitality,LLC Owned by:
Samuel S.Plimpton 1%
10 St.James Ave. Suite 1700
Boston,MA 02116
Quiet Cove Capital Corp Ltd. 19.8%
Paulton House,Old Mills
Bristol,BS39 7SX,United Kingdom
Orbex Holdings LLC 19.8%
PO Box 961510
Boston,MA 02196
66988958;1
DeWitt Davenport 19.8%
20 North Main Street
South Yarmouth,MA 02664
Pendo Investments.II,LLC 19.8%
300 Commonwealth Avenue
Boston,MA 02115
Longtail Miami LLC 19.8%
10 St.James Ave. Suite 1700
Boston,MA 02116
Spot On Ventures LLC Owned by:
Robin Brown 100%
250 Smoke Valley Road
Osterville,MA 02655
Quiet Cove Capital Corp Ltd Owned by:
Brian Paes-Braga 100%
Paulton House,Old Mills
Bristol,BS39 7SX,United Kingdom
Orbex Holdings LLC Owned by:
Pamela Kolhberg 50%
PO Box 961510
Boston MA 02196
A.Curt Greer 50%
PO Box 961510
Boston MA 02196
Pendo Investments II,LLC Owned by:
Thomas W.Blumenthal Trust 2008 100%
Beneficiary(100%):Thomas W.Blumental
300 Commonwealth Avenue
Boston,MA 02115
Longtail Miami LLC Owned by:
66988958;1
Samuel S.Plimpton 100%
10 St.James Ave/Suite 1700
Boston,MA 02116
66988958;1
MBF
City Hall
d f • -.. . ta,
1700 Convention Center Dr.
Miami Beach , FL 33139 , : .m
305-673-742Q h �` ##
Welcome n' 2 m 6r fD -s -Ili' n =.
005929-0007 Adrian V V. 01/30/2023 12;41 PM * z-°o.�� •i ..' n. , g ET',• '
MISCELLANEOUS
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Reference 1: MCR431267
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MCR OPEN (MCR) 1,050'OU•
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Total 1 050.OQ �
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CHECK --
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Check Number30032481 '"
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