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Levy Harris - Robert Springer FtEcEivED MIAMIBEACH' MAR28a�OZn Office of the City Clerk 1700 Convention Center Drive CITY OF MIAMI Miami Beach, FL 33139 grf(ga-gp fiM CITIZACFP 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. I. LOBBYIST INFORMATION: Levy Harris NAME OF LOBBYIST (Last) (First) (Middle Name) EOA Group 192. 9 Ponce De Leon Blvd Coral Gables FL 33134 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.444.0990 harris@eoagroup.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Golden Palms LLC Springer Robert NAME OF PRINCIPAL (Last) (First) (Middle Name) Golden Palms LLC 200 Spectrum Drive, 21st Floor, Irvine, CA 92618 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-7202 legal@sunstonehotels.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant{b @IDN @Oft;Section 2-482(h)(in Q principal cQ corporation, partnership,ly aka? dkJ -++-, Et%)a lobbyist(+Ti1i C• nr.1p d}Q entity,without special compensation a?reimbursement ft2(19 r.�+�+ixt ur+�- talligkpaggl,indirect,ISr contingent,.23 +•• dia?oil position((e an item shall register with the Clerk as required b this subsection but shall not be required to pay an 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): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): Robert Springer • 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): N/A Page 1 of 5 c?C/ 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, design, and development approvals from Historic Preservation Board , and permitting issues, associated with property located at 4041 Collins Ave, Miami Beach. 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 Planning Director x Planning and Zoning Dept Staff x Historic Preservation Board members and staff x Planning Board members and staff x City Commission x 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): $215 per 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 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 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 XNo: )f yes, has it been less than 12months since the elected officials) whom you provided campaign consulting services was 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. _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 yes, were you promised or did you receive economic consideration in exchange for campaiq consulting servicesr. 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.' Signature of Lobbyist: y Date ("2_)_/zo3 arris Levy 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 an I reporting requirements. Signature of Lobbyist: Date l'.22-12_02_ 3 Harris Levy Signature of Principal: Date Robert Springer VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of 4-110d'iCAC, State of County of: {ictrn\ pode County of: Sworn to (or affirmed)and subscribed before me, Sworn to (or affirmed)and subscribed before me, by means of® physical presence by means of 0 physical presence or 0 online notarization, or 0 online notarization, this 22 day of OnQIG4\ , 2023, by this day of , 20_, by Harris Levy Robert Springer NAME OF LOBBYIST NAME OF PRINCIPAL X Produced ID -VVOfid,c., DL.-. _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known _Personally Known .. Signatu a of Notary Public Signature of Notary Public C t o(tC�SINJS N of'Notary,Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped io`�.....4/0 JORGE MONTESINOS (NOTARY SEAL) (NOTARY SEAL) * (4 * Commission#HF1.327491. w ' IU' •,Q lik. F�,.# Expires October 30,2026 'OFThe 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 • • • • • 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 • Signature of Lobbyist: Date Harris Levy 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. Signature of Lobbyist: _ _. Date - Harris Levy Signature.of Principal: Date . 3127� Robert Sprin er VII. NOTARY SIGNATURE AN SEAL: LOBBYIST: PRINCIPAL • State of State of.Ca ka p•AO County of: County of: 0 f GUYS 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 0 online notarization, • or 0 online notarization, this day of .20_,by this_day of - . 20 ,by 0)7 . Hams Levy Robert Sprin•-r , NAME OF LOBBYIST • NAME OF PRINCIPAL- WOW ,• _Produced ID _Produced ID ' FORM OF IDENTIFICATION •'-M OF IDENTIFICATION Personally Known Pe a' I nown • Signature of Notary Public • Sign re of Notary Public Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped • (NOTARY SEAL) (NOTARY SEAL) • 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. Page4of5 ©l,fbl EIRI EA ASWAN MTN Alr OY S TEtu1 :GOVERNMENT CODE§8202 ) See Attached Document(Notary to cross out lines 1-6.below) D See.Statement Below(Lines 1-6 to be completed only by document'signer[s],not Not .). . . • • • 'Signature of Document Signer No. 1 Signature of Document Signer No.2(if any) A,notary public or other officer completing this certificate verifies only the identity of the individual who signed the -document to which this certificate is attached,and not the truthfulness,accuracy;or validity of that document. State of California Subscribed and sworn to :(or affirmed) before me County of Orange on this �Z day of:Mcre , 2013., by Datete Month Year (1) iket P.rl /j1t/1 r (and (2) ), ,. ;.,,� LYNNAE STOEHA NELSEN _ ' Wa Oraannge ic CouCalifornia Name(sr f.Signer(sj' �.w comtssia,Expires a u:4711��s�.. ry Lamm.m ,mi'3 proved to me on the basis of satisfactory evidence to be the person(q who appeared before me. Signature: igna ure of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing.this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: ©2014 National Notary Association•www.NationalNotary.org•14300-US NOTARY(1-800-876-6827) Item#5910 MIAMIMIAMIBEACH 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: Harris Levy 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. Signature of Lob yist Harris Levy Date F:\CLER\$ALL1aFORMS\LOBBYIST FORMS'Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 • MBF City Hall 1700 Convention Center Dr. Miami Beach , FL 33139r <, 1 305-673-7420 Welcome � \oU� 006022-0037 Ebani T. 03/28/2023 03:21PM x*` � wo " e MISCELLANEOUS ,3' �° �" " °, D c', Reference 1: MCR_431426 a -i;4� ;. • MCR OPEN (MCR) • tDDi ` 2023 Item: NCR p :w W - 113 "m y 1 0 1,050.00 �":g MCR OPEN (MCR) 1,050.00 . 2; t C c,N W., 1,050.00 ,. rn Subtotal 1,050.00 • Total 1,050.00 ° `` CHECK 1,050.00 : a ! Check Number023457 `" n Change due 0.00 t.D . Paid by: BILZIN SUMBERG BAENA PRICE '' i; 111111111111111111111111111111011111111111 1 a., Mill ., � -# I macaw run WO as/l,a C4tl••• L wvc4 at,7if1 I••rl.aia.a0 f \ • Thank you for your payment o CUSTOMER COPY