2024 Lobbyist Registration Form - 1901 Alton RD (Marisa Galbut) � /go ) ra)�r, �,,�L
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Miami Beach, FL 33139 � � � � . �
305.6737411 � �
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employetl or retaineQ whether paid or not, by a pnncipal who seeks to enmurage ihe passage, tlefeat or
motlifcation of any artlinance, resoWtion, action or tlecisian of any commissioner; any action, tlecision, recommentlation o! the City
Manager or any City boartl or committee;or any action, tlecision or recommentlalion of any City personnel tluring ihe time penotl of the
entire decisiommaking process on such action, tlecision or recommendation that foreseeably will be heaM or reviewed by the City
wmmission, or a City boaN or committee. The term specifcally includes the principal as well as any employee engagetl in lobbying
ac[ivities.The term"LobOyisis" has specific ezclusions. Please reter to City Cotle Chapter 2, Article VII, Division 3, entitletl "Lobbyisis;
for additional information.
Instmctions: Please complete all sections of Ihis tortn antl submit lhe comple[ed form,with ihe applicable(ee, to the Offce of the City
Clerk. If you need mo2 space�o wmplete an answer, use a separa�e sheet(s)of paper. If you have nothing �o repoh in a particular
section, you must wnte "none" or "n/a" in Ihat sepion. Any change ro any intorma�ion originalry fleQ or any atltlitional City
Commissioner or personnel who are also sought to be lobbied shall require�hat Ihe lobbyist fle an amentlment to Ihe regis�rdtion form.
The lobbyist has a mntinuing duty �o supply information ana amend the forms filed �hmughout Ihe penotl that ihe lobbying occurs.
Separa[e registration farms shall be requiretl for each pnncipal representetl on each specific issue.
I. LOBBYIST INFORMATION:
Velez �ustine
NAMEOFLOBBVIST (Last) (Flrsl) (MIOtlIeName)
Urban Robot Assceiates 420 Lincoln Road,6th Floor Miami Beach Florida 33139
LOBBYISTBUSINESSNAMEAN�AODRE55 (Num�eran4Streep (Ciry) (State) (ZipGotle)
786-246-4857 justlneC�3urbanrobotnet
LOBBVISTBUSMESSTELEPHONENl1MBER CELWURTELEPHONENIIMBER EMAILADDRESS
II. PRINCIPAL INFORMATION:
Galbut Marisa
NAME OF PRINqPAL (Lasp (Firsq (Mltltlle Name)
1901 Alton Property LLC 2200 Biscayne Blvd., Miami Florida 33137
PRINCIPALBUSMESSNAMEANDADDRESS (Num�erantlSUezt) (Ci�y) (Slale) (ZipCotle)
. 305-374-5700 mgalbutQaesccnthcightscom
PRINqPALBIISMESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADORESS
� Pursuanl to City Cotle Secllon 2>82�h)(1)(a�: A pnncipal of any mrporatioq paMership, or o��er en(�y wlro appears as a lobbyis�on be�alf of tM1at
enlity,wilbout special compensation w reimbu5ement(or I�e a0Pea2nce,wM1e�er tllrecl,intllrect,o mntingenl,�o express suppo�of or oOWsition b
an ilem shall�eglster with iM1e Qed as reQuireO by�his subseclion�ut s�all not be repuiretl lo pay anyrregis�ralion 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 BENEFICIARV(if none,write N/A�: M. Gelbut
• NAME OF ALL PERSONS MOLUING, DIRECTLV OR INDIRECTLV,A 5%OR MORE OWNE25HIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP Ok TRUST(H none,write N/A�: PleasC See the attaCheC1
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III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a speci£c description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development Approvals & Permitring Issues, including but not limited to the Historic Preservarion
Board, Design Review Boa�d,Planning Board, Board ot Adjustment, Land Usc Development, City
Commission, and any City Workshops or Committees,if necessary,relafing to the property loca[ed
at 1901 Alton Road in Miami Beach,Florida.
IV. CITYAGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-082(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 72 months preceding such commencement of service
with the City to the present date, sWting the generol nature of the subject contractual relationship.
Full Name of Individual antl Contractual Re�alionship(If yes, explain) VES NO
Title of Penon to be Lobbied
Staff for the Planning & Building Department None X
Public Works &City AdministraHon,PB, HPB, BO None X
DRB,City Commission, and Mayor as necessary None X
Land Use&Sustainabili Committee None X
Pursuant to Ciry Code Section 2•462(g), every registrent shall be required to state the extent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearence of an impropriety, with any current City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyisl registration form filed.
List any eusiness, Financial, Familial or Professional Relationship, or other relationship giving rise to an
a earance of im ro rie if none,write N/A :
> Nonc
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�:
300
$ per hour
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The following aix(6)queatlons MUST be answeretl:
1) Pursuant to City Cotle Section]d88,entitletl"Prohibited Campaign Coniribulions By Lobbyists On Pmcurement Issues":
_Yes x No: Are y I bb ' t d' n b'tl f n d t t
oendino awartl for aootls.eouioment or service?
2) Pursuant lo City Code Section 2-490, entitletl"Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues"
_VesxNo: Are I bb ' d" ool' f t D I tA t 'thth C'N I' t'
for chanae oizonina mao tlesianation or chanae to[he CiN's Future Lantl Use Mao7
3) Pursuant to Ciry Cotle Section 2-482�h�, any person (except �hose exempt from the defnition of "lobbyisf' as set brth in
Seclion 2-481)who only appears as a representative of a no4for-pmfit corporation or entity without special mmpensatian or
reimbursement for the appearance,whether Cirect or intlirec[to express support of or opposition to any item,shall register vnth
the ciry clerk as requiretl by�his section,but shall not be requiretl to pay any regisiration fees.
_VesxNo: Are you reoresentina a not-for-orofit corooretion or entiN w'thout soec'al comcensafon or
reimEursement7
4) Pursuan� �o City Cotle Section 2d87, the term "lobbyisC' specifically excludes ihe follavnng persons: Ezpert witnesses who
provitle only scientifq technical or other specializetl iMormation or�estimony in public meelings;any person who only appears
as a represen�ative ot a neighborhootl association wi�hout mmpensation or reimbursement far ihe appearance,whelher tlirect,
intlirect or conlingenl,to express support of or opposition to any item;and any person who onty appears as a representalive of
not-for-pmft communiry baseC organization for the purpose of requeslin9 a grent without special compensalion or
reimbursement for ihe appearance.
_VesXNo: Are vou orovitlina onlv scientific. teehni<al or other soeial¢ed 'niarmat'on� aooeanno as a
reoresentative of a neiahborhood association without soecial eomcensation or reimbursement or
renresentino a nol-tor-orofit basetl omanization for Me ouroose of reauestina a aant w'thou[
soecial comcensation or reimbursement7
5) Pursuant to City Cotle Section 2-497(7�, na campaign consWtant shall lobby the City Commissian far a penotl ot 12 monihs
follovnng the swearing in of any elected oHcial(s)ior whom the campaigm m�sultant provided campaign consNting services
within lhe past election cycle.See Section 2-491 for more information.
_Ves zNo: Have vou oroviEetl camoaion consultino sarvices to an incumben[member oi the CiN Commias'on
within the oast election cvcle7lf ves olease list the incumbent memberfs)of the C"h Comm'ss'on'
_Ves x No: If v¢s. has it been less than t2 months since ih¢ electetl official/sl whom vou orovided camoaion
consultina services was svrorn in7
6) Pursuant ro City Code Seclion Yd82(a�µ�a., a lobbyist who has within the past election cycle provitletl campai9n consulting
services�o an incumbent member of the City Cammission(which lobbying adivity is not otherwise pmhibited by Cotle section
2491J shall tlisdose such paM1icular service on hislher lobbyist registrelion fortn and shall orallv tlisclose such oarticular
.. service before lobbvino the CiN Commission at a oubl'c meeCna.
_Ves%No: Have vou orovitlatl camoaian consultina xrvices [o an incumbent member oi the C'N Gomm"ss'on
within�he oast eleclion cvcle?If ves ulease list the incumbent membedsl ot[he CN Comm'as'om
y¢y x Na: If ves, were vou oromised or tlid vou receive economic consitleration in exchanae tor camoa'an
consultina services4
TO BE COMPLETED BY CITV CLERN'S STAFF ONLY
G a� ^( �r
Annual RegisVaUon fee: � ]Yes[ �No Pmoun[Pa�itl S O(�5/�� . MCR ��J��V Oa[e Paitl3 S � �
- Lobbyist Registra�on Fwm receivetl an0 vetlfetl by:1JJ��
:�'� �- � c 0.eviseE09/20/2018
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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 L088VING 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 1�fdPIiDURING THE REPORTING PERIOD.'
�ASIINA
Signature of LobbyisC � Date_ Ovtz/zoza
I do solemnly swear or affrm that all of the foregoing (acts, stalements, and disclosures in lhis form are tme and correct,
and ihat I have read or am familiar with the provisions containetl in Chapter 2, Art. VII, Division 3, entitled "Lobbyisls" of
Ihe Miami Beach Ciry Cod �ail ing requiremenis.
SignaWre of LobbyisL '����� o«�si �.a : Date ovizrzoaa
SignaWre of Principal: �`��' �� Dale ovtvzoza
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Fbrida
County oE Miami-Dadc County oE Miami-Dadc
Swom to(or affrmed)and subscribed before me, Swom (o(or affrmed)and subscri6ed before me,
by means of O physical presence by means of O physical presence
or Gjonline notarization, or q(online nolanzalion,
this_day of ronnnroa 20_, by Ihis_day of . 20_, by
Justine Velez Marisa Galbut'd
NAME OF LOB9VIST NAME OF PRINCIPAL
_Produced ID Produced ID
FO ���yyy FO
�Personally Kno `I7� � �Personally Kno � �
�
Signature of Nolary Public% � -�� Signature of Notary Public �
_ Diana Ramos Diana Ramos
= Name of Notary, Typed, Prinled or Stamped Name of Notary, Typetl, Printed or Stamped
� Diana Ramos olana Ramos
Commission:Y HH�8692) Commission#HH]8692]
Notary Public-Sta�e of Florida No�ary Public-State ot Floritla
My Commission Expires Apr i6.202] My Commission Eepires Apr 1Q 2�2]
'Th ng persons:
° Ezpetl witnesses who provitle only sciantlfiq technical or other speciellzetl'mformation or tes�imony in publlc meetings;eny person who
3 only appears as a represen�a�ive ot a neighborhood association wi�hout�nmpensation or reim�ursement for the appearance, whether
tlirec�, intlirect or contingent, to express support of or opposition ro any item; antl any person who only appears as a representative o/
nohfor-profit communiry basetl organization for ihe purpose of reQuesting a granl without special mmpensa�ion or reimbursement for
the aOPearance.
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Ci1y of Miami Beach, I�00 Convention Canre�Drlve,Mioml&ach,Florido 33139,www.mlomibeachA.go�
OHi<e af the Ciy Clerk
Rafael E. Granado, Ciry Clerk CilyClerk�miamibeochfl.gov
TeP. 305.673741I, Fax�. 305.6737254
NAME OF LOBBYIST: Justine Vclez
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 Sta[ements filed after the
due date. The City Clerk shall no[ify the Miami-Dade County Commission on Ethics and
Public Trust of the failure of a lobbyist (or principap to fle the Statement or pay the
assessed fines after notification.
Any lobbyist, who fails to fle the required Statement by April 30'" 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 Offce 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 Sec[ion 2-482 of the Miami Beach City Code.
��.sh�u,�U�le.y
avizizoza
Signature of Lobbyist � Date
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City of Niani Beach
CitY �11
1700 Conventian Ge..ter Dr. «
Miami Beach , FL 93139 .._, I L _
305-613-7420
Welcame a i X
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03/25/2024 11:22AM Carmen V. N � �
006850-0005 � LL
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MISCELLANEOUS a w
Reference I: MCR433225 ° "
MCR OPFN (MCR) � � o
2024 Item: MCR
1 � $2,400.0000
MGR OPEN (MCR) $'1,400.U0 . . �'
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fz,aoo.00 °
Su6total 52,400.00 p
Total i2.40�.0o F
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CHECK $2,400.00 a
Check Number000112 �
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Change due 50.00 d m
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Thank you for your payment
CIlSTOMER COFY