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2024 Lobbyist Registration Form - FAR related legislation (David Martin) oowsie�e��ioPe io-oos�wsa-szei<�so-sni-iaeaicoeae�s �ykCEIVE� FEB 09 2024 MIAMI BEACH off�eo„„e�;,Y�1efk 1700 Convenlion Center Drive � � . Miami Beach, FL 33139 305.673.7411 L08BVIST REGISTRATION FORM Lobbyist means all persons employetl or retaineQ whether paia or no�, Dy a pnncipal who seeks to enmurage Ihe passage, defeal or motli/ica�ion of any ordinance, resolution, adion or Cecision of any commissioner, any action, tlecision, recommentlation of the City Manager or any City boartl or committee;or any action, tlecision or recommendation of any Ciry personnel tluring the time penod of the entire tlecision-making process on such ac[ion, decision or rewmmentlation ihat foreseeably will be heartl or reviewed by ihe City commission, or a Ciry boartl or committee. The term specifcally inclutles ihe principal as well as any employee engagetl in lobbying activities. The term "Lobbyisis° has spxifc enclusions. Please refer to Ciry Cotle Chapter 2, Article VII, Division 3, entitletl "Lobbyisis," toredtli(ional informa[ion. Instructions: Please complete all sedions of this form and su�mit the mmple�ed fortn,with the applicable tee,to ihe�ce of ihe City Clerk. If you neetl more space�o complete an answer, use a separate sheet(s)of paper. If you have nothing to report in a particular section, you must wnte "none" or "n/a" in that sedion. Any change to any infortnation onginalty fleQ or any adtli�ional City Commissioner or personnel who are also sough[to be lobbietl sha0 require Ihat ihe lobbyis[file an amentlmen�to the registrdtion(orm. The lobbyist has a continuing dury [o supply information antl amentl ihe farms fled ihroughout ihe periotl ihat Ihe lobbying occurs. Separate regisiration forms shall be requiretl for each pnncipal representetl on each specifc issue. I. LOBBYIST INFORMATION: Martin David NAME OP LOBBYIST (Lasl) (Firsl) (MiOtlle Name) MB Mized Use Investment, LLC 3310 Mary Street Suite 302 Miami Plorida 33133 LOBBVISTBUSMESSNAMEAN�ApDRESS (NumOererMShae1) (Gty) (State) �p�¢) 305-416-4556 davidC�3tecraQroup com LOBBVISTBUSINESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS II. PRINCIPAL INFORMATION: Martin David NAME OF PRINCIPAL (Lasp (Firsp (MiEtlle Name) MB Mixed Use Investrnent, LLC 3310 Mary Street Suite 302 Miami Florida 33133 PRINCIPALBUSMESSNAMEANOADDRESS (Numbe�antlSVee�) (City) (Sta[e) (ZipCoae) 305-416-4556 davidC�+Jterra¢rouo com RINC L BUSINESS TELEPHONE Nl1MBER CELLULhR TELEPHONE NUMBER EMAIL ADDRE55 _ Pursuant m Ciry Catle Sxtion 2-a82(M1)ry)(a): A pnncipal of any coryord�ion, patlners�ip, or o�her en�ity who appears as a lobbyisl on behalf of�hat enlity,witM1oul special wmpensalion or reimbursemenl br iM1e appearance,wM1et�er Girecl,intlirect or contlngent,�o express suppotl of or opposi�ion to an item shall regisier wi�h�he CIeM as repui�etl by IOis subsec�ion but sM1all no�be mpuiretl�o pay any regis�ra�ion fces. - If the principal is a Corparetion, Partnership or Tmst, the following information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARV(i(none,write N/A�:_ D Mar �n • NAME OF ALL PERSONS HOLDING, DIRECTLY OR INOIRECTLV,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRl15T(H none,wnt¢NIA�: P1eaSE sce t112 attaChed Page 7 of 5 nP/ �� �V ,���...i i - . - . - . ...- .- _ _.. .- �. - <ao� , ���.�, ee„o.s ,a�,uF�000� �III���I III � �acu5ign EnvelopelD'.OD6"lC064-82Btd]6DW21-13Efi1FDE9895 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. 2023-24 FARaelated LegislaHon, including but not limited to the Historic Preservation Board, Design Review Board,Plannin� Board, Board of Adjustment Land Use Development City Commission, and any City Workshops or Committees. 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 ot Individual antl Contractual Relationship (If yes, explain) �ES NO Title o(Person to be Lobbied Staff for the Planning&Building Department None X Pvblic Works &City Administration, PB, HPB, BO None X DRB,City Commission,and Mayor as necessary None X Land Use&Sustainabili Committec 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 cuvent City Commissioner or City personnel who is sought to be lobbied as identified on the lobbyist registration form filed. _ Lisl any 8usiness, Financial, Familial or Professional 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 Soecific. �Note that a contingency fee is prohibited pursuant to City Code Sec. 2-485.3): $0.00 per hour "� Page 2 of 5 Ctyl�. a9ptOq5AB0 BBE 35IC�fq� � �- -��� ' �'� �'-- �a - m P.9eza,= ��,��0000 �III���11111� , DowSignEnvelopel0:OD6]COfi4-8281A1fiD-W21-13E61FOEB8]5 The tollowing six(6)quesYons MUST be answaratl: 1) Pursuant to City Cade Section P-488,entitletl"Pmhibitetl Campaign Coninbutions By Lobbyis�s On Pmcurement Issues": _VesXNo: Are I bb ' t d b'tlf tl t t oenGina award for aoods eau'omen[o�serv'ce� 2) Pursuantto City Cotle Sedion 2-490, en�itled 'Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues" _Ves x No: Are I bb ' d' f t f D I t Aq t 'ih th C'N o I' f for chanae of zon'na mao des'nnat'on or chanae to th C'N' F t L d U M ? 3) Pursuant �o City Cotle Section 2dB1(h�, any person (except t�ose exemp� fmm ihe tlefinition of"lobbyist" as set torth in Section 2-481)who only appears as a representative of a no4for-pmft wryore[ion or entity withoul special compensation or reimbursement for ihe appearance,whether tlirect or indirect to ezpress supporl of or opposition ro any item,shall register with the city clerk as requiretl by this sedion,bul shall not be requiretl to pay any registration/ees. _Ves%No: Are F 41 � ft [' fN "th t ' I C reimbursement7 4) Pursuant to Ciry Code Section 2d87, the term "IobbyisY specifically exclutles the following persons'. Expert witnesses w�o provitle only scientifq technical or other specialized informalion or testimony in public meetings;any person who only appears as a representative of a neighborhootl association vnthout mmpensation or reimbursement for the appearance,whether tlirect, intlirect or wntingent,�o express support af or opposition ro any item;antl any Oe�n who onry appears as a represenlative of nohfor-profit communiry basetl organization for the purpose of requesting a grant without special compensation or reimbursement for Ihe appearance. _VesXNo: Are vou orov'dna onlv sient'fc [eehn' I ih ' I' tl ' i [' r�resentative o( a ne ahborh d ' f 'ih t ' I f ' b t rep f t-t � ft b tl u ' f ( M o f f t 'th t soecial comoensation or re'mbunement� 5) Pursuant to City Code Section 2-497�1), no rampaigm m�sultanl shall IODby ihe Ciry Commission for a penod of 12 monihs following ihe swearing in oi any elecled oHcial(s)(or whom the campaign consWtant pmvitletl campaign consWting services within the past elec�ion cycle. See Section 2-491 for more information. _Ves XNo: Have vou oroviGetl camoaion consult'na serv'ces to an 'ncumbent m mb f th C'N C withintheoastelectioncvcle7lfves oleasel'stthe"neumb nt E 11 Tth C'NC _Ves x No: If Yes has it been less than 72 months s'nce ihe elect d (fi ' II 1 h o 'tl tl 'u consultina services was sworn"n7 6) Pursuant to City Code Section 2-0B3�a�(4�a., a lobbyist who has within �he past election cycle pmvitletl campaign consulting services to an incumbent member of�he City Commission(which lobbying activity is not othervnse prohibi�etl by Cotle section 8491) shall tlisclose such paMicular service on his/her lobbyist regisiration fortn antl shall orallv tlisclose such oartcular service bePore lobb ' [h C[ C t bl' f _Ves x No: Have vou orovitletl camoaion consultina sen'ces to an 'ncumEent member f�h C'�v C wilhin[he oast eleclion wcle?If ves olease fst the'ncumbent memberls) t[h C'N C _Ves x No: If yes, were vou oromised or d'd vou rece've econom c cons'tleraCon 'n e h a f oa'a consultina services? TO 6E WMPLETEO BY CITY CLERK'S ST F ONLY Aic-e�y �Lc9��eered Annual eglSUatlon : � ]Ves��No Amount P7a�itl S�MCR p ' C ocY—� Da[e Pai —� 9 '�.y Lobbyist ReglsUation Form rtteivetl antl verifetl byU� ��� K� � . . ...'ru� , „ ;� :.... . . , ,. <„ x�ationF.,,. , zraeoc ReviseE09/20/2018 �� Page 3 of 5 DucVerTyD�. �<9330>SJBOBBt8EnE6ll5FC�CiO � � - � � - do�,d, m Paee,o,s �� ���oo�, �III���11111 � DacuSign EnvelopelD'.ODB�W64-B2B1416D-9]21-13E61FDEB895 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR. EACH L08BYI5T SHALL SUBMIT TO THE OFFICE OF THE qTY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECEIVED. FOR TME PRECEDING CALENDAR VEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBV. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMP A7A eDURING THE REPORTING PERIOD.' Signature of Lobbyist � Date nvannma I do solemnly swear or affrm ihat all of the foregoing facts, stalements, and disclosures in this form are true and correcl, and tha� I have read or am familiar wilh lhe provisions conlained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Cod ia arting requirements. Signature of Lobbyist ���� �=.s�q.bs,� Date mi3onoz4 SignaNre of Principal: g� �� Da�e ov3orzoza VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State af Florida State of Florida Counry of: Miami-Dade Counry oE Miami-Dade Swom to(or aHirmed)and subscribed before me, Swom to(or affrmed)and subscribed be(ore me, by means of� physical presence by means o�O physical presence or�online notarization, or�online no�arization, this_day of mnm�ma 20_, by this_day of 20_, by David Martin David MarHn NAME OF LOBBVIST NAME OF PRINCIPAL _Produced ID Produced ID F — X Personalty Kno � � X personally K � � SignaWreofNotary ubllcT}� SignaWreofNolary�Public� Diana Ramos Diana Ramos - Name of Notary, T�ped, Printed or S�amped Name of Notary, TypeQ Prinled or Stamped _ Dlana Ramos Diana Ramos - ( Commission%HH08694] ( CommiSSlonpHH38693] Notary Public-Slale of Floritla No�ary Pu01ic-Slale of Floritla - MyCommissionExpiresAprt6,202] MyGommissionExpiresApr1Q202] � � The �_.�e..�..e,. ....-., Pefson5: _ Expert vntnesses who provide only scientific, technical or other specializetl�information or�estimony in public mee�ings;any person wha - onry appears as a representative oF a neighborhootl association without compensation or reimbursement(or the appearance, whether " direct, indirect or contingent, �o ezpress supporl of or opposilion ro any i�em; antl any person who onry appears as a represen�ative of no4forvprofit community basetl organization (or Ihe purpose of requesting a grant without special compensation or reimbursemen�for ihe appearance. Page 4 of 5 _.._.— _.. ... _ _. __.. _— . — _ ... _. � � ,o,.eo �����.: -- _ �III���1111� „.e.,�e aseaaas eeias�c0000 . DowSignEnvelopelD:OD6]CO6d-82Bid]fi0.W21-13E61PDEB815 � �f�� f. i Ciry of Miami Bsoch, I�00 Comennon Cenrer Drl�e,Mlaml Beoch, Florida 33139,www.miamibeachA.gov Office of the Ciy Clerk Rafael E. Gronado,Ciy Clerk CilyClerk@miamibeachfl.gov Tel�. 305.6737d11, Fax� 305.6737254 NAME OF LOBBYIST: David Martin 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principaq who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penallies that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shail 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 notification. Any lobbyist, who fails to file the required Statement by April 30'^ of each year, shall be aulomatically suspended from lobbying until all fines are paid, unless the fne 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 Section 2-482 of the Miami Beach City Code. - %�%j�- o„ao,zoz< SignatureofLobbyist c�`�`�����p'�.. Date r�aeaun�uzroamsaoeerisr roams�oeeµm aegiso-,uo��o,m ae.i:ee o��i zo aec aoc Page 5 of 5 _.—. __ .„ a . i .� ncsas<eoe��ee-nesnsrcooao � -'':r aae.sois e c uon ������'������ EXHIBIT B N6m�u.n���C.l��tanu.c- � 3310 Mary Street, Suite 302, Miami, FL 33131 rmRo�r.n.�nH WVIDPM�If11M , . ��ti I.M MRfED USE NVF5IMFM NOtO1NC+f MEMBEII OWMlII, LLC In MB MOQO USF p1VE5iMEM NOlD11V6f MFMlp1 PMENT. llt 1 • M�M11RpU5[IMVFSIMtryT ryMKCXDm MOIOM(3MFM�F11.LLC WVBIFIM.LLC . ._. �.IN.�. NML�l6NVR�YtA EOIIINR.LIS IWti j b MRm VY fMBIWM.LIG PR NCO�p F_ILryOERNV MfMQ( 3310 Mary Street, Suite 302, Miami, FL 33131 � o i..����:n�m,�P a�eN�wne,.,am.��.zo.nm�.rsn�m o, � r n i i �vi ��e w�e us or mo�eN�son., Imlkmr¢ry, �'�,�i:j one or more ol[ne lollmrl.g rtlanres ol lxo�-'Iw SOHer I4 Moov b0eq(vl Maa napmpon, inElelBqKpSpMeLdM/Or�iii�yn mObY«�o1lumCeery •mames:>mmeee tm�Ip�aY..bxv�nm�ow�n kae�rre OPK[n� (5%� a1 iB MCC Xo1N N�ea�mm� LLC intl �2� M 'in?vdua.oi Etrmvy or md�i.er.�ho.n mwe man�NM oercen� �µ^Y� ' ��(QUTy �� (30%IaIiBMBCCNa411TeNmenlLLC /' ' I \1 I I I � iMBMIXEDUSEINVFSTMENT � � HOl01NCSMfMBEP.LLC � I I I i � I . \ ______�� . wtr�m�� mMemee......