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Adele Valencia - Todd Rosenberg I Sot Col IS •/e.• RECEIVED FEB 6 2023 MI AM I BEACH Office of the City Clerk IA�I BEACH 1700 Convention Center Drive CITY OF Miami Beach, FL 33139 OFFICE OF THE CITY CLERK 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 comniittee; 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. I. LOBBYIST INFORMATION: Valencia Adele NAME OF LOBBYIST (Last) (First) (Middle Name) LSN Partners 3800 NE 1st Avenue, Suite 200 Miami Fl 33137 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-673-2585 avalencia@lsnlaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Rosenberg Todd NAME OF PRINCIPAL (Last) (First) (Middle Name) 1501 Collins, LLC 7900 Glades Rd., Ste 540 Boca Raton Fl 33434 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 561-430-3113 1501@pebbcap.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS POMBA (M Code 1. 0 2-482(h)(1KM L°1 principal @jig corporation partner hip cedkraiirdk0.+o-. Fp I Iobb is CIO e . giEE anti y,Takla FIE:12dacompensation CoL ort r.�a :s��Inlai l p' (a �(l C2 con ingen inogig§gigigmadjaroseos ilon t%o II GB? the Rah aDirmadWI&subseo on Endasici•i OG Dimly Eglie 0 • t 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): • 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 attached. 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. Development approvals & permitting issues, including, but not limited to Member of City Administration, Members of City Staff and members of HPB, PB, DRB, and BOA, City Commission and Mayor, relating to the property located at 1501 Collins Ave for file number HPB22-0559 and PB23-0572 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 Members of City Administration and Members City Staff X Members of Historic Preservation Board (HPB), X Planning Board (PB), Design Review Board (DRB) X Board of Adjustment (BOA), City Commission and Mayor 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): 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): $450 hr Page 2 of 5 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": —YesX_No: 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. _YesX_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. _YesX_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: YesXNo: If yes, has it been less than 12 mon hs since the elected official(s) o you provided campaign consulting services wa sworn int. 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. _YesXNo:• 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: _YesX_No:• If yes, were .ou promised or did you receive economic consideration in exchange for campagq Cons lting_senricesr: TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Revised 03/11/2020 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 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 COMPENSATION(DURING THE REPORTING PERIOD.1 roll U Signature of Lobbyist: �� Date I i/2---Y /1, Z 3 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 requirements. ,y • Signature of Lobbyist: l� U Date �i 1 /Z° 2 3 Signature of Principal: Date t\' 2-L1 L VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: Il\\ \ PRINCIPAL State of 'fLV�\tli State of Fla(I L. County of: NAM\ %V. County of: r-PGI 01 I.. GG11 Sworn to (or affirmed) and subscribed before me, Sworn to(or affirmed) and subscribed before me, by means ofphysical presence by means of R 1 ysical presence or 0 of�liyle notarization,'` 11`` or 0 ogljne notarization, this 'iU day of V��U� , 201$by this rgreElay of J c n u A(- , 2023 by Adele Valencia Todd Rosenberg NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID Produced ID JF M OF IDENTIFICATION FORM OF IDENTIFICATION Pers o Personally Known Signature o .prl otary Public Sig re of Notary Public A2 Tyr 1 90-0 6VIC >-kb^ \-)d ►r) S Name of Notary,Typed, Printed or Stamped Name of Notary, Typed, Pri_ r Stamped ib.dowiliY*fie'•. MEGHAN DUGGINS' v (NOTARY SEAL) . (NOTARY SEAL) 14�:. Notary Public•State of Florida ` imy w"'°f;,• LIZBETH BUENO `k `a` Commission 4 HH 240608 1 �:� • : 1 '" My Comm.Expires Apr 2.2026 '*• ,, ' •*= MY COMMISSION#HH328244 • :+,;.,�^�..o. ,l 4 I Bonded through National rotary Assn. The term"lobbyist'speci .-4.;;Ades s . 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 AA I AAA I 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: Adele Valencia 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. t( 2 17-2 0 2 3 Signature of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 1501 COLLINS AVENUE ORG STRUCTURE AS OF 02-08-2022 BENEFICIARIES: BENEFICIARIES. BENEFICIARIES: Barbara Rosenberg 33.33% Fara Horowitz Todd Rosenberg Fara Horowitz 3333% Todd Rosenberg 3333% elrlwel_Rvh ermweleeW Todd Rosenberg earMneareneertzolsmmi ran Horovetantrims Todd Rosenberg 01151rust IIMMdual) ual) it R iL EIN:.6155193 EIN:661113a15 E116.6555165 3,750,000 1,350,00 1350.ero. 450,0% 410,0110 710% 25. 0.0% 60. 211.0% 20. ' Managing Member I Non Member Manager PCM Holdta LLC Todd Rosenberg DE EIN:87-1390863 2,250,000 100.096 0.0% Mane er Na additional members or Indirect beneficiaries own 5% or more of the Property Owner Geo.Ma0lmAas Pebb Capital Management,LLC Vac..Emgeyees (b611,16.1 DE IIM161.) EIN:46-5680624 3,000,030 2,250,000 25ofa0 100.0% 90.0% 10.0% • Managing Member No members or Indirect No additional members or beneficiaries of RonRuss awns 5% Indirect beneficiaries own 5% r more of the Property Owner r m ore of the Property Owner • 1601 Beach,LLC 50054 s Investments I,LLC Nikea,LLC All other limited Members 1501 Beach,SEC 1501 C)91ns Pebb Manager,LLC DE FL NV Pobio hihnet worth DE DE DN:87-2165015 EIN:47-2342968 ON:46-4376836 NlMduab EN:87-2165015 E154187-1697900 2,500,030 2,500,000 3,0130,000 1,650,000 2,500,000 2,500,000 50.0% 50.0% 64.5% 35.5% 50.0% 50.0% Major Derision Member Managing Member / No additional members or indirect beneficiaries own 5% or more of the Property Owner Ocean Eve Beach,LLC 1501 Co15ns Pref Equity,LLC All other Limited Members 1501 Collins Manager,LLC DE FLformed6/8/2021 Vamushr00nelw,m DE 05187-1132149 Inahwwb 0.5187.1431270 5,000,000 4,650,000 7,350,000 5,000,003 22.73% 21.14% 33.41% 22.72% Managing Member 1501 Collins Holdings,LLC OE EIN:87-1404713 22,000,000 100% 1501 Calves,SEC DE EIN:N/A Passthrough • . . • • • • • --44;414,-4 . 4.,„„•4,•;,..-4,,,,,I.',•70.t.';',14V•'-i-t•74:'-i..--1i.:!1 -- ,,,,,,`*kr-V4r4;ceffft14;-1:' ',..•:'.K..".14AZ.V.,,'W'0-'74.1??. 7 ki:e'; .MBF P-*,=ft,:-- 4k'''''-"- -'''-4 '4.-1'''''---'-'4'-',`,-- --'-','A'''''A'-,, ''- '''''',' ,"1'1"'-.--(:-,'•-,'':':',,,d'.1,',„',)4;,-,:.%::" . ,..-.. 4 -':-,,XP , #' ',-,----,-,",W,', ',.?'. ,•,i',"'. ,'-,--',N.,,, --,' ,,'-A City Hall • 0 F7R---s •'ittii-4.t.,,,-,•-!,14,i-- -J:v&••.;!, .,k,. ,,.:•:44,•,-;1,-.3A-!:'9, :•,,,,,,,-7-,•.• ,1C-1 .-m:•k••Ez,'";,t,.":,:•.-i.,,i -,--'f'A-'itii•,••0 -._„„,70--tft•Nk;. •••••,,,J,-,3,•-,•.•,,,,,-,.:."•,,k..,,,,„,,„;.*:144,.,.,-; ••••:,,,,:,,,, ,...,,.,6,,4,•,..,,-.;:,,,z4-„,_.,,, ,,,,,,•,,..7„:„.1 4--,,,,,..1,-7•-•,.. ,, ..1,-,•xv:•;•:„Kt.••,,A4,0•,:•„,,,j,.-.„.,•c„:8,•„,... .,. .?.;**-..74,-,,,:..01:5;;;;:,,,a).7,`, .'4,,;..,:i3-15„..,,i,,,,.•k- _A•••,,,,ii.:-.,,,,,,•,y.-; -,t4-i•',-%Agvi-"A-;-,_>,5(•4i, •'--iw,w-:,t:.h--N,-,i,•qt,•-,'--,--;:Pi-'";o- ,ii•Ao.:z•;-9•Tii.••,.(4,.--,;,,,„,,,.t,,,,,,••.„,••.,-.• ,;th,,..;,,4--..,,,,,,,,,,-..zi 1700 Convention, .Crtn31:3eria9r. 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