2024 Lobbyist Registration Form - 1901 Alton RD (Marisa Galbut) (2) �ocu5ign Envelopel0-.F6F9FOE1-A9E0<158-884b]4898FG4lFEA I q O� A�� �.
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MIAMIBEACH o��eaf,he��,Y��e,k : ih ��Z4
1700 Convention Center Drive
Miami Beach, FL 33139 - - � �
305.673.7411
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or relained, whelher paitl or not, by a pnncipal who seeks lo encourage lhe passage, defeat or
motlificalion of any ordinance, resolution, action or decision of any commissioner, any action, decision, recommentlation of Ihe City
Manager or any City boartl or committee;or any action, decision or recommendation ot any City personnel during the lime periotl of�he
entire decision-making pmcess on such action, tlecision or recommendation that foreseeably will be heard or reviewed 6y the City
commission, or a City board or committee. The term specifically indudes�he principal as well as any employee engagetl in lobbying
activities.The teim "Lob6yisls" has specifc e�cclusions. Please refer to Ci�y Code Chapter 2, Article VII, Division 3, enti�led"Lobbyisls;
for atltlitional information.
Inslructions: Please complete all sections of ihis form and submit lhe completetl fortn,wilh lhe applicable fee, to Ihe Offce of the Cily
Clerk. If you neee more space to complete an answer, use a separate sheet(s) of paper. If you have nolhing to report in a particular
sedion, you must wnte "none" or "n/a" in lhal sectian. Any change to any information onginally fletl, or any adtlitional City
Commissioner or pereonnel who are also sought lo be lobbied shall require�hal Ihe lo�byist file an amendmen�to the registration form.
The lobbyisl has a conlinuing duy lo supply information and amend �he fortns fled Ihmughoul lhe penotl that the lobbying occurs.
Separate regisValion fortns shall be requiretl for each pnncipal represen�etl on each specifc issue.
I. LOBBYIST INFORMATION:
Velez iustine
NAMEOFLOBBVIST (Las�) (FirsQ (MitltlleName)
Urban Robot Associates 420 Lincoln Road, 6th Floor Miami Beach Florida 33139
LOBBYISTBUSMESSNAMEANDADDRE55 (NumberantlStreet) (Gty) (Sle[e) (ZlpCatle)
786-246-4857 justineQurbanrobot.net
LOBBVISTBUSWESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILA�DRESS
II. PRINCIPAL INFORMATION:
Galbut Marisa
NAME OF PRINCIPAL (Last) (Firs[) (Mltltlle Name)
1907 Alton Pcoperty LLC 2200 Biscayne Blvd., Miami Floiida 33137
PRINCIPAL BUSME55 NAME PND ADDRE55 (Number antl Street) (Clty) (Slele) (Zlp Gotle)
305-3745700 mgalbutC�crescentheights.com
PRINCIPALBUSWESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRE55
PursuaN�o City Cotle Section 2-482(h)(1)(a): A pnncipal of any corporation, partnereM1ip, or o�her entity w�o appea5 as a lobbyist on beM1alf of iha�
entiry,wiNOW special compensa�ion or reimbursement for[he appeaance,whether tlirec�,indirect, or continqent,to express support of or opposition ro
an item shall registerwiM ihe Clerk as requiretl by ihis subseIXion but shall not be requiretl�o pay any registra�ion fees.
If the principal is a Corporation, Partnership or Trust, the Tollowing 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. Ga�but
. NAME OF ALL PERSONS HOLDING, DIRECTLV OR INDIRECTLY,A 5%OR MORE OWNERSMIP INTEREST IN SUCM
CORPORATION, PARTNERSHIP OR TRUST(if none,writa N/A): PlCace See t�le attaCllet�
Page 1 of 5 ,��
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III. ISSUE TO BE IOBBIED:
DaserlM with �s much MGiI as is praclical, Including but not Ilmibd to a s{wciflc deseriptlon wh�n
epplieabb of a p�nding nqu�st for proposal, Invitation lo bid, or public h�aring numbsr.
Development Approvals &Pecmitting 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 Commiriees, if necessary, relating to the property located
at 1901 Alton Road in Miami Beach,Florida.
N. CITY AGENCIESANDIVIDUALS TO BE LOBBIED:
Punuant to City Code Saction 2-182(aH4), list tha City Commissbnar or City panonnN soughl to be
IohbiW, and wh�thar th� lobbyist has anterad into any contrectual nlatlonahip (paid or unpaid) with
said City Commissionar or Cky panonnel from 12 months preuding sueh commanumant of service
with tha City lo the present data,aWtlng tha genaral nature of tha subjxt contraetual nlatlonship.
Full Nam�of Individual and Controctual Ralallonship(M yes,e:plain) vES NO
Titk W P�rson ta bs Lohbied
SWH for the Plannin &Buildin De artment None X
Public Works&Ci Administrafion,PB, HPB, BO None X
DRB,City Commission,and Mayor as necessary None x
Land Use&Sustainabili Committee None X
Purouant to City Coda Sectlon 2-182(p�, avery reylatrent shall M nqulnd to shte th� �#�nt of any
business, FlnanGal, familial or proNssional raledonship, or oth�r telationahip qiviny riss to an
appaannca of an impropdety, with any curcant City Commissioner or Cily penonnN who Is sought to
. M lobbfed as Idanliflad on lh�lobbyisl rogistration form Flled.
' Ust any Busin�u, Flnancial, Famillal or ProMslond RHationship, or oth�r nlrtionshlp pivinp dw W en
a nnu af im ro ri i/noM wrih ILA :
None
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —Bs Soeciflc. (Note that a
- conHngency fae is prohibitsd pursuant to City Code Sea 2d85.3�:
300
$ per hour
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�M/ollowinp sic(6)yuatbm MUST W�mwxW:
1 J Punuant to City Code Ssction tJBt,entiHad"Prohibiletl Cempaign Contnbutions By Lobbyiafs On Procunrrrnt Iawu":
Y�s xNe: on t ntl'na bitl/ aooC 1 on 1
— _ wnE'na�ward iw aeeA� wu'omenl er a�rvie�7
2) Pursuan�lo Ciry CaCe Section 2J90,antiOeE"Pmhibitetl Campaign ConMbutlons By Lobbyiafs On Real Eslate Development
Isauei:
_V�s j�No: ���^� I blwl Aina ao I' �' fa a Dewlaomenl Aarrm�nl wilh M�CiN w aoolieatian
(ar chana�oT xonina mao dwiunatim a chame to th�Citv's Fulun LanU Uw Wo7
3) Pursuanl to City CoCe Seclion 2�82�h�, any person (ezcept ttwx eaempt from Te definition of'IobDyisP as xt (orih in
Section 2<81�xAo mly appears as a representative o(a no4for-pmfit caporation or entity without apecial compensatlon w
roimW ra�menl(ar Na appearance,whalher direct a indirecl lo ezpress supporl of or opposition to any iMm,s�all ragistx with
Me tlty cle�k as repuireC by ihis section,bul shall nol be reQuirad b pay any registra6on(ees.
Yn x No: f a not fo dt CofoorH' M'h 'Ih t �wi�I Cpn f n d
f�IT�IYMIMllf7
4) Punuant lo Ciy Code Section 2-M1, Me lerm 'IobbyisC specifirally excludes the follovnng persons: Expert wilnesses who
provWe only scientific,bchnirsl or oNer spedalized informetion or testimony in pudic mealinga;any person who anly appears
as a represen�alive of a neighbortwoC associatlon wiMou[mmpensalim or reimbursementlor ttie eppearerke,wM�her direct,
indirect or canti�gent,to eKpress support of or oppositim lo any ilem;antl any person who only appears as a representafive of
not-fwprofit communily baseE organization for Ne purpose of requesting a qrant without spetial conqensadon «
reimbursemm�for Ne appea2rice.
YesxNo: Ar orovitll I c' ntifie behn'cal or Nhsr wa�al¢etl inform�lion: aouarino u •
— — tti ' hEa '•ti 'M n ^'^I I �f 1 b�xn�nt or
rcorasentim. a m4Sro�l b�s�A onr.niz•tion tor M� o�mw� e( na�_abna � anM withoul
soeelal eamosnutbn or roimbure�m�nl?
5) Pursuanl ta City Code Section 2d91�1�, rro campaigm m�sultant s�all bbby Me City Commisaion br a penotl of 12 monMs
followirg ihe awmnnB in of any electeA olficial(s)Por whan Ne wmpaign conwltanl provided nmpeign wnsultlng serncea
within Me past ebctlon cyGe.See Sectim 2�91 for more iMormation.
_V�a�No: ' ' 4 L: IE t M � b� M th G'N G ' i
ilhin M t I� 6on evebl H rn.oleaw I'st ih�incumbent memb�rtsl o/Ifr CiN Commiulon:
V�sxNo: ba N tha 12 th s'n M I cIM oRi I II I hom ou 'C d amwl
ton�ulllno axvicea was awom in?
6) Punuant to City Cotle Section YJ82�a��q�., a bbbyist wtio tas within Me past ebction cycl�pravitletl rampeign wnsul6rg
aervices to an incumbenl memCer of Ihe City Commission(which lobbying activiry is not oMervnse prohidtetl Oy Code section
2�91) s�all dixlose auch partiwlar service on hislher IobCyiat registration fortn a d shall II d'sdose uch rt la
I 'n t i mmi ion t Gli meeti
Y�t x No: _- -'�4 - - '� �III to an 'ncumMnt m�mbv of IM CIN fammissbn
khi M - t I f Mi H I +� I' t th ' umbent m�mbM�l ei IM C'N Commiuion:
Vq%No: - - _ ^-1 E r did veu rteNv� �cenomie eansidxatbn In �xehana� Ter umoeian
oonsultina aavipsi
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VI. SIGNATURES UNDER OATH:
nu cc >a no a�r a ceru i gy15T SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
eirNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
wcrwryED FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
�OBBYI57 HAS BEEh EhGA ED TO LOBBY A STATEMENT SHALL BE FILED EVEN If THERE HAS BEEN NO
T R R OMP A110NdJURING THE REPORTING PERIOD.'
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Signature of Lobbyisl�. � Date oznz�osa
I do solemnly swear or eifrtm ihat all of the foregoing facts, statements, and disclosures in this fortn ara true anA corted,
and lhat I have read or am familiar with Ihe provisans contained in Chapter 2, Ah. VII, Divisbn 3, entitled 'Lobbyiata" of
the Miami Beac�Ciry Cod a1 mg requiremenis.
SigraWreofLobbyisl '���� �_.• �«e� Dale ��y�o2�
SignaturoofPrincipal: �� Dale oviznos�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Siate d Florida S�ate of Florida
Counry of: Miami-Dade County of�, Miami-Dade
Swom to(or alfrtmed)and subscribed before me, Swom to(or affirmed)anC subscribed before me,
by means of O physical presence by means of O physical presence
or C7�onlina notanza�bn, or pmnline rwtanza�ion,
ihis_Cayof mnnranoa . 20_, Oy this_dayof . 20_,Dy
JusHne Velez Marisa Galbut
NM1E OF LOBBYIST NAME OF PRMqPAL
Producetl ID _ProEucetl ID __..
FO FO (� �
�Personally Kno � � �Personally Kn �y�-
Signa�ure of Nolary ublic� Signature of No�ary PuGlic �
Diana Ramos Diana Ramos
Name of Noqry, Typed, Printed or S[ampe0 Neme of Nota , TypeO,Printed or SlempW
� w.�.�.mo. oi.�.rt.mo.
Lanmlubn�XH LN]] Canml��lon�HH tlq37
Nolary Wdk-Sut�W Fbritla NoOry PubFc-Ststs of Fkrqe
My Lommisaion Eepiros Apr 18,P01] My Cwnmisslon ExOirn Rp 16,XI2�
� T _....,....,m..... ,.�... 9 P°rnona: _.............,_. ..o...
= ERpert witneaaes who proWEe only acienlific,technical a o1Mr specielizeC inbrmation a lestirtwny in public meetlngs;any parsm wlio
only eppears ea a ropraxntative of a roiqhborhootl aasoualion without mmpensa�on or roimbursemsnt for Me eppwanw,whetMr
= Eirocl,irMlrect a contingenl,lo exprasa eupport W a oppositian lo any ilem;arM any perwn who only eppsers as a�spnxntntive of
rwl-forqrofit canmunlry baaed orgenizatim for th�purpoa�of repueslirq e grant without aparial companaalion n rNmCurs�rt�ant fur
" ttroaPOwranca.
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Ciy ef Miami Beo<F, V00 Convenron Cen�er Drlve,Mlomi Beoch, Florida 33139,www.m�iambaochfl.gov
OHlce of the Ciry Qerk
Rakel E Gwnada Clry Clerk CiryClerk@miamibeachNyo�
Tel�. 305.673 741 1, Fax: 305 673 7254
NAME OF LOBBYIST: Justine Velez
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to Ciry 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 SWtement
(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 fled 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 notifcation.
Any lobbyist, who fails to file Me required Statement by April 30'" of each year, shall be
automatically suspended from lobbying until all fnes are paid, unlass 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 specifc 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.
- o�..wMeIa��.'. •
- �'�� V� oviznoz�
- Signature of Lobby�s4 Date
v rierrs�uu.Foawsvoxeris.ronersumeyn r+wo,m,�ram no-,..a w-��-zo nec ro�
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Miscellaneous Cash Receipt
. CIN OF MIAMI BEACH No. 433029 � ����
❑Cash ❑Credit Card '6�Check N ���� �� � $
i � 20
Received of . r" C r�
Address
For ��� . �c_ ,7 ,c�-�
MBF �Mlsoellapeous-MCR-2024
006]44-0053 Carmen V... 02/i4/2024 09:55AM '-
a�ce oaeN�Mcrt� Office of Finance Director
Payment Amounf. 350.00
� (THIS INFORMATION MUST BE COMPLETED) By .__
Accountnumber: �� � � � - �� ';�
Preparer. �� � � � � Dept: -,� EXT:�.i��
�� ' ��� `x������
_ _ -- _ _ _ _ n�r _ __ - _ _
City Hall
1100 Convention Center Or.
� Miaai Beach , FL 33139
� �15-673-7420
Welcame
�02/14/2024 02:55PM Carmen V.
006744-0053
NISCELlANE0U5
Reference 1: MCR433029
MCR OPEN (MCR)
2024 Item: MCR
1 � $350.0000
MCR OPEN (MCR) 3350.00
5350.00
Subtotal 3350.00
Total 5350.00
CNECN $350.00
Check Numher00009251
------------ .
Change due i0.00
Paid hy: BERCOW RAUELL FERNAN�EZ LARKIN &
TAPANES PLIC
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