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Kobi Karp - Dillip B. Patel DocuSign Envelope ID:E65D321B-4FC2-4F08-A767-5B90082EF03B RECEIVED tv\I A/V\I BEACH Office of th ®��® JAN 30 2023 1700 Conven tCity CIe nter Drive &, QM'OF MIAMI BEACH Miami Beacre 934N � OFFICE OF THE CITY CLERK 305.673.7 QFTyc.q/vd LOBBYIST REGISTRATION F6c�9Oh, Lobbyist means all persons employed or retained,whether paid or not, by a principal whG� eks 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: Karp Kobi NAME OF LOBBYIST (Last) (First) (Middle Name) Kobi Karp Architecture&Interior Design,Inc. 571 NW 28 Street, Miami,Florida 33127 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-573-1818 kobikarp@kobikarp.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Patel Dilip B. NAME OF PRINCIPAL (Last) (First) (Middle Name) • The Luce Del Sole Trust 6455 Pine Tree Drive Circle Miami Beach Florida 33141 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 212-554-5220 dpatel@brickpatel.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant Q8 air Code Raelni 2-482(h)(11)(a): Q' ' i•:f •i eity corporation,partnership,Opt• e t J.l egio_•• 62i a lobbyist @ D - CQf entity,akin special compensation CH reimbursement fortlapt l•1•r +ri�ix=�tiraGpalitaa indirect,[pcontingent, is „ij.u3 OCR o••osition 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): LL • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): D. Patel • 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): Elliott Weinstein 100% 600 5th Avenue, 14th Floor,NY,NY 10020 LL Page 1 of 5 DocVerify ID:32FD1 FDS-1C044D59-B43F-8AC69AF36ABB L Page 11 of15 � 118AC69AF36ABB j 11I1 'tfall III www docvenfy.com RiiiiSS , DocuSign Envelope ID:E65D321B-4FC2-4F08-A767-5B90082EFO3B 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 6455 Pine Tree Drive Circle 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): 0 None u. LL 4'J 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): 350 $ .00 per hour LL Page 2 of 5 Docvercvenf 32FD7 FDS-1C04-4D59-B43F-6AC69AF36ABB [ Page 12 of155 126AC69AF36ABB ,pl •i ��5c,Illl wovw docveriry.com � U L.�iC. ,DocuSign Envelope ID:E65D321B-4FC2-4F08-A767-5B90082EF03B 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 X No: 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• f yes, has it been less than 1-2 months since the elected official(slwhom you provided campaign onsultinq 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: h E En Yes XNo: If yes, were you promised or did you receive economic consid!ration in exchange for campaign co"nsultina'� rvicen TO BE COMPLETED BY CITY CLERK'S STAFF ONLY m 7 o Annual Registration fee: [ ]Yes[ ]No Amount Paid to MCR# Date Paid Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018 Page 3 of 5 DocVerlfy ID:32FD1 FD5-1C04-4D59-B43F-8AC69AF36ABB I Page 13 of 15 138AC69AF36ABB ,III g C¢Siif'I III www docvenfy.com , ,DocuSign'Envelope ID:E65D321B-4FC2-4F08-A767-5B90082EF03B 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 CON DURING THE REPORTING PERIOD.1 Signature of Lobbyist: ik. Date 01/27/2023 DPOr,E,D990544,E... 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-ant reporting requirements. 07 ) Signature of Lobbyist: Docusigned by: Date 01/27/2023 ''---UI-UAh 11.19UB 447t... Qll/ / P Signature of Principal: 1!/U N,4}y��/ Date 01/27/2023 DAM,BoBuse490... 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 I online notarization, or®online notarization, this day of 01/27/2023 ,20 , by this-_day of 01/27/2023 t 20_,by Kobi Karp Dilip B. Patel NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Kn --• Personally Kn --•-DO ---- spnm„:mow wrrto,-too s=vem mavrm saes 4110 Signature o Notary ublic Signature of Nota Public Tana Ramos Diana Ramos N_ O N Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped - --- - -CO ana Ramos 1'Dana Ramos 1 *Commission#GG 308355 / ommisslon#GG 308355 4 JJotary Public-State of Florida < 4 votary Public-State of Florida 1 Tht i6y Commission Expires Apr 10,2023 1 cl Commission Expires Apr 10,2023 / 1 Ihg persons: I o l c, ....nc�o=ma"mm.xo-os= o Expe • ^^^•• ^ 'gal or other specializes inrormanon or testimony in;puouc meeiings;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 u. 5 the appearance. IJ- M Page 4 of 5 DocVerify ID:32FD1FD5-1 C044D59-B43F-8AC69AF36ABB I Page 14 of 15r148AC69AF36ABB 7 'IIII EMI III i www-docvenfy:com — Il ;5iii ,ocuSigri Envelope ID:E65D321B-4FC2-4F08-A767-5B90082EF03B MIAMi B City of Miami Beach,1700 Convention Center Drive,Miami Beach, Florida 33139,www.micmibeachfl.gov Office of the City Clerk Rafael E.Granado, City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.741 1, Fax: 305.673.7254 NAME OF LOBBYIST: Kobi Karp 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. �IDocuSi ned by: 01/27/2023 Dr0AE1D330;A11E... Signature of Lobbyist Date 0 U LL F:\CLER1$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 DocVerify ID:32FD1FD5-1 C044D59-B43F-8AC69AF36ABB' L Page 15 of 15 r 158AC69AF36ABB I no,'Borst III I www docvenfy.com IYass5fiii�ii doclerify® y 3 •OocvE10 Lobbyist Registration Forms - MWL MA KK - 6455 Pine Tree Drive Circle - executed.pdf DocVerify ID: 32FD 1 FD5-1 C04-4D59-B43F-8AC69AF36ABB Created: January 27, 2023 09:41:58 -8:00 Pages: 15 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(dra) January 27,2023 09:49:04-8:00[E1788E1DBA40][74.220.90.117] dramos@brzoninglaw.com r�r tiL1I r • I IIIIIII IIII IIIII IIIII IIIII IIIIIIliii IIIIII I'l1I IIIII IIII IIIII 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. 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