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2024 Lobbyist Registration Form - 1901 Alton RD (Marisa Galbut) 19a I pi+o� P� �ocu5'jn Envelope 10�. FBM4fiE1-FC2F-0E56-8641-0283E1893FBB '��HV}=D � ' � 2U24 , �`�,I�-�,}�� _" vI1F 2il � Office of the City Clerk 1700 Convention Center Orive Miaml Beach. FL 33139 .. � � � -^�H 305.67374�1 - _ . . . �. - "-`�x LOBBYIST REGISTRATION FORM Lobbyist means all persons employetl or retained. whether paitl or nol. by a principal who seeks to encourage�he passage. tlefeat or motldrea0on of any ortlinance. resolution, action or decision of any commissioneq any aclion, tlecision, recammendation of Ihe City Manaoer or any Ciry board ar committee�. or any action. tlecision cr recommentlation of any Ci�y personnel during the time penod of the enNre decision-making process on such actlon, tlecision or recommentletion thet fareseeebly will be heartl or reviewetl by the Glty commission, or a Gity boartl or commitlee. The term specifically includes the principal as well as any employee engagetl in labbying activities. The term "LoObyists' has specific exclusions. Please reter to Ciry Cotle Chapter 2, Article VII. Divisian 3, entitlea "Lobbyists," for additional Information. Instrucllons: Pleese complete all sections of ihis form and submit the complated form, with I�e eppliceble tee, to the Offme at Iha Ciry Clerk. If you need more space lo complete an enswer, use a seperate sheet(s) of paper. If you have nothing to report in a particular secCion, you must wnte "none' or 'nla" in thet secllon. Any chan9e to any information originally pletl, or eny atltlilional City Commissioner or personnel who are also sought to be lobbied shall require thal the lobbyisl(le an amentlmen�ta Ihe registration (orm The lobbyist has a continuing dury to supply lnformation antl amentl the forms filetl Ihroughout the penotl that the lobbying occurs. Separeto registratlon forms shall be requiretl tor each principal represented on each speci(ic issua I. LOBBYIST INFORMATION: Pc�n Ceallam NAMEOFLOBBVISt (Lesp (Flrs�) IMItltlleNameJ Berrow Radell Fernandez Laikin&'Iapanes,YLLC 200 South Iiiscayne Dlvd.,Ste 300 Miami, Florida M13I31 �oPSnsreusiNessNnmenNonooaess �N�mee�a�as�aep �ciry7 tsiaie7 �z�pcode; (305) 37#-5300 gpenn:�brznniny,law.com LOU6Vi5T 13USINE55 TELEPHONF NUMeFR CELWLAR TELEPHONE NUMBER BdAR AfJDRF55 II. PRINCIPAL INFORMATION: Galbul Nlarisa NAMEOFaFWQPAL (Laetl fFrst) (MitltlleNeme) 1901 Alton Properh� LLC 2200 Biscavnc Bl��d., Miami Florida 33137 PRINCIPALBUSWESSNAMEANOADORESS (Numbe�anrlS�rseq (GRy) (Sle�e) fZIpGo0e1 (305) 374-5700 mgalbut@crescentheighis.mm PRINQPAI.BUSWESSTELEPHONENl1PdBEF CELLULARTELEPHONENUMBER EMNIADDHE55 Pursuent lo Clty Cotle SeoGon 2482(ry(1)(a)�. A principel o!eny mr0oretlon, petlnershlp.or other en1iN�*'ho appeare as a lo��ylst on be�elt of Ihat entiry,wit�out speciai compensation o�reimbursemen�for�he appearance,whelher direcl,indirect,or con�ingen�.to express support oi or opposilion lo � an item shall re9ister wifh ihe Clerk as required by Ihis subsection bW shall not Oe requiretl to pay any regisVa(on fees. If [he principal is a Corporation, Partnership or Trust, the following information MUST 6e provided pursuant to City Code Section 2-482(c): � • NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARV(if none,write NIA�: blansa Galbut �. • NAME OF ALL PERSONS HOLDING, OIRECTLY OR INDIRECTLV,A 5% OR MORE OWNERSHIP INTEREST IN SUCH � CORPORATION, PARTNERSHIP OR TRUST(if none.write NIA�: Please see attachetl Page 1 of 5 �� ..... _.._. . . . .... .. _. .. _.. ... .. � . .iM1i � �>.civiv� roovosdr,,, . . ... . _ _ ._ . ..... . aaea,a^ . _.. .��g� oeo ..n. ��APS'.[`.e�� DacuSiyn Envelopelp'F9AA4fiE1-FG2F-0E56-8641-02B3E18B3F88 III. ISSUE TO 8E 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. Devclopment Approvals & Plannuig Issucs, indudin�; but not limited to the Histnric Preservatinn Board, Design Review Board, PLaiming Board, Board of Adjust�nent, Land Use Ucvclopment Citv Commission, and any Cih• GVorkshops or Comntittees, if�ccessary, relafing h� the properh'located at1901 Alton Rd in �3iami 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 Qf yes, explain) �ES NO Title of Persan to be Lobbied St�(f (ur the Planning & Building Depariment I�nne X Public Ih'orks & Ciq° Administratinn, P6, HPB, BO.� None X�i DRB, Cib� Commission, and Mavor as necessarV None X �i �I _. � Pursuant to City Code Sec[ion 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 lobhied as identified on the lobbyist registration form filed. List any Business, Financial, Familial or Pro(essional Relationship, or other relationship giving rise to an � a earance of im ro riet if none, write N/A : � Nonc �� V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Sqecific. (Note that a contingency fee is prohibi[ed pursuant to City Code Sec. 2-485.3): Sfl00 per hour Page 2 of 5 .�.. ..�... . . »z,,mm � ya o or..�i J__. . .. , . v%�aa ms za�raascF,., ,II��F'F.c�'I II I DacuSlgn Envelope I�_FBA0.46E1-FG2FLESG964�-02�3NBB3FBB The(ollowing siz(6)queslions Ml1ST be answeretl: i) Pursuan[to Ciry Cotle Sechon 2-488,enlitled "Prohibitetl Gampaign Contnbutions By LobDyists On Pmcurement Issues'. Yes xNo: A v I bb ' q p t tl' b'd f q tl q 'p t e ' es or on a p t p¢ndiltq dWdltl(OI QOOtlS 2qUlpfllEnt oI seNiC¢7 2) Pursuan�to City Code Sectton 2-090. entitled "Pmhlblted Gampelgn GonVibutions 8y Lobbyists On Reel Estata Davelop�'r:ent Issues' V¢5 R N0: A I bb ' q p d f C f D I p f A nt 'th lhe CIN pPl' t !or chanqe of zon'nq map tlesianation or chanqe to[he Citv's FuNre Land Use Map7 3) Pursuant to City Cotle Section 2-482(h), any person (except those ezempt fmm (he tlefinihon af"lobbyist" as set fotlh in Section 2-48�)who onty appears as a representative of a nobfar-pro(it corporaHon or entity wilhou[apacial compensa�on or reimbursementfor the appearance, whe�hertllrector Indlrectto express support of oropposltion to any itam. shall registerwith the ciry derk as required by this section. buI shall not be requlretl lo pay any registratlon feas. VesxNo: Are vou rearesenYnq a nobfor-pmtil coraora[ion or entiN without soecial comaensation or reimburs¢ment? 4) PursuaN to Ciry Cotle Sectian 2-0Bt, the term "IobbyisP specif�cally exdutles the Following persons�. Expert witnesses who provitle only sclenhfic, technlcal or oiher speciaGzetl infarmation o�testimony in public mee�ings: any person who only appears as e representative of a neighborhootl assaciatian without compensation or reimbursement for the appearance.whether tl�rect. intlirect or contingent. lo express support of or opposition to any item� antl any person wno onty appears as a representahve of not-for-proft communiry based organlzation tor the purposa of requesting a g�ant wilhaut special compansacion ar reimbursemen�for ihe appearence. Yes X No: A v o 'd q Iv Tf t h ' I th p ' I' tl ' 1 t' ' aoo ' a reoresen[aCve of a ne'qhborhood association without special compensation or reimbursement or p [ q F1 -p (f h d � C f th p p f q S['�q q t �lh f soecial wmpensation or reimbursemen[7 6) Pursuant to Ciry Cotle Section 2-491�1�. no cempaign consultant shall lobby the Clry Commrsslon for a periotl of 12 mon:hs following the sweering in of any alectad official(s) for whom the campalgn consultanl pmvitled cempaign consulting services within the past election cyde. See Section 2-49� brmore Inlormation. Ves xNo: Have vou prov'tletl camoa'qn consW['nq serv'ces m an incumbent member of[he CiN Commission 'th' th t I t V 1 7 1f Y pi f l lh ' b [ b r�s)ot lhe Ct Comm'ss'on' Yes X No: It yes has 't been less than 12 months s'nce th¢ electetl officiallsl whom vou orovitletl campaiqn consultinn services was sworn In? 6) Pursuan[ro Ciry Cotle Seclion 2-082(a�(4�a., a lobbyist who has within the past election cycle provitletl campaigm m�sulting services to an incumbent member of Ihe City Commission (which lobbying activity is not otharvvisa pmhibited by Code section . 2-491) shall tlisdose sueh particulai service on his/her lobbyist regislralion lorm antl shell orellv disclose such patlicular � SBIVICB�JB�OIB IObbVIIIO[IlE Ci�IIV COTTI6610I1 81 B pUbIICIIIBBlIf1Q- Ves x No: H V 'd d if t b t b f lh CN Comm'ss'on � 'th' th p t I f I 71f pl f lth ' b t b ( 1 ftheCt Comm'ss'on� � Yes x No: I( v v u tl tl'tl i n 'd¢raCon 'n exchanae for camoa'an � consultinn s¢rvices7 � TO 9E COMPLETED BY CITY CLERK'S STAFF ONLY OV � AnnualRegisimtiontae: � ]Yes[ ]No AmouniPTatl��♦s�' MCftk 33�15 DatePaitl� � � � Lobbps[Regishat on Form recalved anE e IGetl by /lJ�'1 � r �snGu=�on �sitauonsiroiu+ ��iivi.�a��. r.n=iFe t�n n�-xo-t€n�� .^o�: 0.eviseE09/20/i018 .. Page 3 of 5 ..... __. ._ ..... ... . . .... __.. .. ..... .. . . . . . _.. . .... .. ..... _. _. . ry�y p��p .�v�r�yi Liq�e340 L��Oo6Ci1�1 . .. �... . . .... .... .. Pa9e]olE 996�OBC6CFlP1 �� +p�y�� WXB�'S DocuSign Emelope I��. F6AAa6ELFC2F�4E56-8641-WB3Et8B3F8B VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITV 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 L086YIST HAS BEEN ENGAGED TO LOBBY. A STATEMEN7 SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMP NSAT ON DURING THE REPORTING PERIOD.' Signature oF Lob6yist: GV'AU,P�N PLUIn, Date 3-22-2024 zF�aenocaci+ea . I do solemnly swear or affirm that all of�he foregoing facis. statements, and disclosures in this form are true antl mrrect, and that I have reatl or am familiar with the provisions contained in Chapter 2. Art. VII. Division 3, entitled "Lobbyists` of �he Miami Beach Ci�y Code n all reporting requiremeNs. SignaNre of Lobbyist �/��va�a�ua �P�an�n. Date 3-22-2024 zr�omroaciae--ooasv�m ey: Slgnawre of Principal: � �ate 3-22-2oza _ IFP3lBfiE4�9d<'N VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida Counry aE Miami-0ade County oC I�4iami-Dade Swom to(or affrmed)and subscribed before me, Swom to (or affirmed) and subscribed before me, by means of O physical presence by means of� physical presence or � online notarization, or L� online notarization, this z2 day of March p0z4, by this ZZ day of March pp24, pY Graham Pem� Mansa Galbut NAME OF LOBBVIST NAn4E OF PRWQPAL Praduced ID _Pmduced ID Fo FoaM oF ioENriFicnnoN i �x Personalty Kno � x Personally Kno n � � Signature of Notary �olit'�"��'" �� Signature oi Nolar . ...._.. ,. .. �� Veitly Monlesina Perez Veitly Montesina Perez Name of Notary, Typed, Printed or Stamped Name a N � r e P in e r t d Yeitly Montesino Peroz Yeltly Monfesino Perez (NOT CommissiankHHOB02]] (NOT CommissionbHH0842]3 Nolery Publlc-S�ate of Florida No�ary Publlc-State of Fiorida � My Commission Expires Jan 24.2a25 My Gommission Expires Jan 24.2025 ' Theterm"Ic s: ..._._...-.,..... _.,_.. Expert witnesses who pmvide only scien�ific.�echnical or other specialized information or�estimony In public mee�ings', any person who � �� only appears as a representa[ive ofa neighborhood association without compensation or reimbursementforthe appearance, whether � direci, intlirect or contingent, to express supporl of or opposition m any item: and any person who only appears as a represenlalive ot �� nobfor-pmlit community based o�gan'¢ation for[he purpose of requesling a grent without special campensa�ion o� reimbu�semenl for �he appearance. Page 4 of 5 ..... _. __ _.._ .. . .. . . . .__ . . . .. . ____... . .. . . . . _. .... .__.____ . .. . ..... ...... _ . .. . . . . _ .____... _ p�+ . . .. . . ... . __.. . .__ . .. .ioaen.m . . . aucc�v� =.,a„ame 000eoccr,n ��'�,2,aF'i�� . �ocuSign Emelope ID'. FBAAG6E1-FC2FaE56�8641-02B3Et8B3F8B Cify of Miami Beaah, 1]00 Comemion Cen�er D�i�e,Mloml Beacn,Floeido 33139,um�w.mlam��beochfl.gov Offlce ofihe Ciry Clerk kafael E Gmnoao, Clly Clerk GfyQark@miamibeachfl.gov Tel: 305.673741 I, Fox_305.673 7254 NAME OF LOBBYIST: Graham Penn 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the Ciry 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 Ethlcs and Public Trust of the faiWre 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 30'h 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 shali immediatety fle a Notice of Withdrawal with the Office of the City Clerk. �� 3) ANNUAL LOBBYIST REGISTRATION FEE �� I understand annual registration of atl 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 Ciry Code. Smasq��a ey�. Gvab.a,+, P�wn a-zz-zosa -. Signatur�ro byist Date . —.LLEN�SPLLN�ORMSL009Y6tFONMSb��pslRepu4aLo+F�'niRnm¢ed 0}'420REGJoc Pay= 5 of 5 „ o.,e �.� - �aafi�.r ., , ois� ooOos�F��, ♦I��`i�♦IIII � U ��,yyyyyy �J � j O L I iQ8 O � Q N E _ _ � � a i :�i � E � � � ¢ - �: � - a � � a �� m � _ ,� " v = � m � - � o � � J d a W (A m E cLi o� .E � � W Q ,. �,,. E � ma d o � � � �.. r O 3 V � S - � p p ❑ II o `m _ � W Q > F- 2 � � � o a`- (n 1- �7 � d _ To UJ � wM J � � Z U7 E � `EO w O Q u- � o � 1- � �' a H Q � � Q '�O o � a aa w � o I . i E « � �` J (n O Q O � o a 3 0� Q Q N � � P � � N c 9 � O � � I N � � V �, � e d a' N � _ ,� � a p1 P m 'p m � a � `m �' g3, a ° E � '�. O .c c 2 ¢ O E o� nz m . 1 I '�. N C. � '- m p $ �= C� � L � LL � � u ' �2 r � E � C � d m � � m m � -°, � <`� a � � a - ° v � .-� � _ a mQ mo `V E � ' � I I � � a I m - - ` " w __ rV '_ - � aad �", _ � m J � � m � u � I o - - a` » v� F=J N � y v T N N H � E � U > 7 N p V � a � � � � q U J LL � � O � � CJ � , m �i �' N Y a � `° J _ I E o-� . m X !, U Ba � � �F � w I � E �E '�� m I = __ � m a p o � v � � op va =' a m c2 � ¢ Ep p E �.. ° t � ¢ � a '� j y � a Q m W C � � O = N � � � � � O _J O City of Miani Beach � . . . City �11 �� ` 1700 Carventian A�.�er Dr. � _ o � T Mian�i Beach , FL 33199 � d � *,� 305-673-7420 '�� . v �' � Welcome �'` � ° � V W O � 03/25/2024 11:22AM Carmen V. � .N � ~ .L � 10 � 006850-0005 � � � - �u-, � �, � MISCELLANE0115 0 �.. � �� . 1 � Reference t: MCR433225 " _ . MCA OPF.N (MCR) z �j � > . � . 2024 Item: MCR . 1 � $2,400.0000 � `'` • - MCR OPEN (MCR) $2,400.00 y ��- �� , -�. m . �� . y :� � a G i2,4(10.00 . � � �-; � �. . Suhtotal i2,400•00 . o � Total i2,�.� - / ^, W ^ -.: - y . CHECK $2,400.00 , " _ . Check Numher000112 �� , � �� ' �� : � V Chan9e due -------�.00 ',y � r .. ; . ' W � m . 6 � . Paid by: 1901 ALTON PROPERTY LLC � f� � � o � � � C = . 9 c�v' a . . u ��N��I��H��I�N��M��b��Nq�� , , „ �� '_ � � a � � � , s � a e - ��, �_ ,,, j � � u vi 'z ; m , � s � g � _.. '° o Q " ��,� � ' � _ �? � : on. " /� q _ �' �p m�.�n,�wom.m.. �., Y N m �:_, g � N � ac VI O 6 ..,�.....w ,fQf��_ I'I � V V � Ol1 �. g %n U 5`� Q 6 . ❑ �� U f o F n Thank you for your payment CUSiOMER COPY