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Graham C. Penn - David Martin (MB Mixed Use Investment LLC) /'"i Cov TIN Ceivr von G.Cnier Vs', o na ssT 147 + sk. DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 RECEIVED M I AM I BEACH Office of the City Clerk APR 012024 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: Penn Graham C. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin&Tapanes PLLC 200 S. Biscayne Blvd.,#300 Miami Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5300 gpenn@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Martin David NAME OF PRINCIPAL (Last) (First) (Middle Name) MB Mixed Use Investment LLC 3310 Mary Street,Suite 302 Miami Florida 33133 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-3416-4566 dmartin@terragroup.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Z. s. Pursuant Co •+=I 2-482(h)(1)(a): Q principal(Sty corporation, r. = ([p? vj...•-. ifEla lobbyist •�i0 behalf cgiftt entity,(2[0:183special compensation MI-Iluf ivir-3i[I.3[11 1 -[ •'. = �y^ '- --y I +'• - Qua 1 a1[.x:}xjgpmaR e(, o'o,a osltlon tt, an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees. O 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): D. Martin u_ • 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 DocVerify ID:5F15C618-DFB7-4B4C-9524F6DF4EF5A9AE Ifi �'I III Page 8 of 28 BF6DF4EF5A9AE� www.docverify.com DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 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 1901 Convention Center Drive and 55517 Street 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 w u LL 0 • 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): $800.00 per hour Page 2 of 5 DocVerify ID IV com5C618-DFB7A84C-9524F6DF4EFSA9AE I 1DI 'I III I Page 9of2B I9F6DF4EF5A9AE DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 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: If yes, has it been less than 12 months since the elected official(s)whom you provided campai•n consulting sesvicGs 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 lobbvinq the City Commission at a public meeting. -Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission 0 within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: 0 _Yes XNo: If yes. were you promised or did you recgtve economic considerations in exchange fqr campaig consulting ae►v.icesr 0 LL �7 ;ou S ly I .c,n3. -k-c e,4, TO BE COMPLETED BY CITY CLERK'S STAFF ONLY o0 N Oo Annual Registration fee: [ ,]Yes[1]No Amount Paid$. SO= MCR S'933 1 Date Paid 3 J 0• Lobbyist Registration Form received and verified by:+V/_I F:\CLER\$ALL\aFORMS\LOBBYIST FORMS Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018 0 Page 3 of 5 DocVerify ID:5F15C618-DFB7-484C-9524-F6DF4EFSA9AE Page 10 of 26 I 10F6DF4EF5A9AE_j IIII��iii ��i S'I III www docverify.corn 11 DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 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 COMP,EI SATKINyDURING THE REPORTING PERIOD.' ardSignature of Lobbyist: ,O c�6s...IA. Date 04/01/2024 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 r 7lts w: Signature of Lobbyist: Docusigned by: Pam' Date n41mi2024 QLhlU6//0001.148A... Signature of Principal: / )4 Date mini 2n24 491.9d1-000/1-0444... 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 Monline notarization, or[online notarization, this day of 04/01/2024 ,20_, by this_day of namvno9A ,20_, by Graham C. Penn David Martin NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _ _Produced ID ,Personally Knowr ;ll Personally Knot 0 0 Signature of Notary Public Signature of Notary u`Siic 0 Diana Ramos Diana Ramos Name of Notary, Typed, Printed or Stamped Name of Notary,Typed Printed or Stamped 4 • a 4 cJana Ramos I tD Diana Ramos ommission#HH 386927 1 Commission#HH 386927 4 fyotary Public-State of Florida i 1 otary Public-State of Florida o i l y Commission Expires Apr 16,2027 I ldy Commission Expires Apr 16,2027 N 'Th g persons: ..�... rr 4.---4- 4.-r.� = 4- 4-cl — gym, ..gym...., :,P.. • 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 o 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. E. Page 4 of 5 .. _ DocVerify ID:5F15C618-DFB7-4B4C-9524-F6DF4EF5A9AE www.docvenfy.com Page11of28 11F6DF4EF5A9AE IDI III III I , DocuSign Envelope ID:9BAF460E-8832.4DFF-91AD-14D3A22C2625 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 CityClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Graham C. Penn 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 0 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 $500.00 pursuant to Section 2-482 of the Miami:Beach City Code. rDocuSigned by: a IAAAAAA A P 2r10077003c1403... 04/01/2024 Signature of Lobbyist Date LL F:ICLERI$ALLIaFORMSILOBBYIST FORMSILobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 DocVerify ID:5F15C618•DFB7-4B4C-9524F6DF4EFSASAE Pege 12 of 28 j12F6DF4EF5A9AE ,�I I�L� 'I II I www docvenfy cam DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 MB MIXED USE INVESTMENT,LLC 3310 Mary Street,Suite 302,Miami,FL 33133 PEDRO A MARTIN DAVID P MARTIN • • • 25% �� a. 75% • • PINES BEACH INVESTMENTS, LLC r 100% MB MIXED USE INVESTMENT HOLDINGS MEMBER OWNER, LLC 100% MB MIXED USE INVESTMENT HOLDINGS MEMBER PARENT, LLC 100% MB MIXED USE INVESTMENT` TB MBCC HOTEL HOLDINGS MEMBER I,LLC INVESTMENT,LLC MB MIXED USE INVESTMENT 0 HOLDINGS,LLC 0 100% w MB MIXED USE INVESTEMENT,LLC 0 U m ❑ W LL UI il DocVerify ID:5F15C618-DFB7-4B4C-9524-F6DF4EF5A9AE Page 13 of 28 73F6DF4EF5A9AE ,11I 'I III www docverdy.com DocuSign Envelope ID:9BAF460E-8832-4DFF-91AD-14D3A22C2625 PRINCIPALS OF TURNBERRY MEMBER OF MB MIXED USE INVESTMENT HOLDINGS,LLC 3310 Mary Street,Suite 302,'Miami, FL 33131 'Members are(i)Jacquelyn Softer and/or trusts,partnerships or other entities for estate planning purposes of Jacquelyn Softer Jacquelyn Members` (collectively,',tackle Softer"),(II)one or more of the following Softer 1 , relatives of Jacquelyn Softer:(x)Rock Softer,(y)Max Rappaport, and(z)Brooke Soifer,and/or(iii)senior employees of Tumberry -- - -. Associates;provided that(1)Jackie Softer shall own at least five percent (5%) of TB MCC Hotel Investment LLC and (2) no individual will directly or indirectly own more than thirty percent • (30%)of TB MBCC Hotel Investment LLC. 0%Manager \ / 100%Equity TB MBCC HOTEL INVESTMENT LLC MB MIXED USE INVESTMENT (FL—6/6/18) HOLDINGS MEMBER,LLC 50%Member 50%Member MB MIXED USE INVESTMENT HOLDINGS,LLC (FL—5/30/18) • 0 0 5 O m �n IL W LL 0 LL h N W LL co LL Sri DocVerify ID: er N com5C618•DFB7-4B4C-9524-F6DF4EFSA9AE page 14 of 28 i 14F6DF4EFBA9AE 1 ,YI IN I UI(I I I a of'Miami. Beach City City Hall _ =e: 1700Convention Center. Dr. ^' g :c, Miami Beach ,° FL 33139 n _ xi a o . ,• - n•. o g • 305-673-7420 �` c_n °; p f °' 4 �' e WelCpme f''DM. ',Z` z` o cr r in di - °� m 3 c, 04/02/2024 01:13PM Carmen V. ,:o °' " � ' 006871-0019 cr -I < iv• P co n-. MISCELLANEOUS ;', n Reference.1: MCR433231 MCR OPEN (NCR) 3 N : z ° 1 2024 Item; •MCR ,0lp E' 1 @ $1,900.0000 W '. NCR OPEN (NCR) = 1,900,00 $1,900.00 D v Subtotal- . ` $1,900.00 "' Total $1,900.00 j F CHECK $1,050.00 v. Check Number000097 $B50 00 CHECK � • Check'Number000098 t ` Change due $0.00 , ° Paid by: MB MIXED USE INVESTMENT LLC 11110.1111111011111111111111111I11111111111111111111111111111 r N v ril3r[.aM6mlkm `"i1.g9UA4 "��-., P OINAMWlHyrWWW rt i Wnlire T ar r9000u1r COCA101.Cua0 Q09011.654r •3� CiilavMF11.1im, _0II60.00 AIC knifed Wind MAW. yM •{, .P000V+Cn,µ0915Ii ON4ii614� H• = Thank you far your `payment ""°` • CUS 3ME"COPyl,,41