2024 Lobbyist Registration Form - 3009 Pinetree DR (Tomas Philipson) 300°1 f',i,s.T�w �D�.
�ocu5ign Envelope ID:F9]�FOO2-91EC48C6-ACB%5F0350E2fi01
RECEIVED
. � � � r, � �� g E AC H sEP �� �oza
, .
, ' ' ORice af Ihe City Clerk
1700 Convention Center Drive
Miami Beach, FL 33139 C�7y OF MIAMI BEACH
305.6737411 9FFICE OF TNE CiN cLERN
LOBBYIST REGIS7RATION FORM
Lobbyist means all persons employatl or retained, whether paid or nol, by a pnncipal who seeks lo ancourage ihe passage, tlefeal or
modificalion of any ortlinanca, resolNion, aclian or tlecision of any commissioner, any ac�ion, tlecision, recommentla�ion of �he Ciry
Manager or any Ciry board or committee;or any aclion,decision or recommentlation of any City personnel tluring �he�ime penod of the
emire tlecision-making pmcess on such ac�ion, tlacision or recommentla�ion �hat foreseeabty will be heartl or reviawed by �he City
commission, or a Ci�y board or commitlee. The term specifically indutles Ihe principal as well as any amployee engagetl in lobbying
ac�ivities. The lertn "Lobbyisls" has specific ezclusions. Please refer�o Ci�y Cotle Chaptar 2, Article VII, Divisian 3, entitletl "Lobbyists,"
foratltli�ional information.
Instmetions: Please complele all sec[ions of this torm ana submil Ihe completed form,with Ihe applicable fee,to the Office of�he Ciry
Clerk. If you need more space to comple�e an answer, use a separate s�aet�s)of papec If you have no�hing to repoh in a patlicular
section, you mus� wri�e "none" or "n/a" in �hat uction. Any change lo any information originally NaQ or any adtli�ional City
Commissioner or personnel wha are also sought lo be lobbied shall require ihat ihe lobbyist file an amentlment lo the regist2tion form.
The lobbyisl has a mNinuing duty �o supply informa�ion and amend �he fortns filetl �hroughoul �he periotl �hal �he lobbying occurs.
Separate registralion forms shall �e requireC for each principal representetl on each specific issue.
I. LOBBYIST INFORMATION:
Balter Emily
NAMFOFLOBBVI3T (Las�) (Flrs�) (MiGElaNeme)
Bercow Radell Fernandez Larkin &Tapanes PLLC 200 S. Biscayne Blvd., k300, Miami, FL 33131
LOB8YI3iBUSINESSNAMEANDADDRE55 (NumberantlShee�) (Cl�y) (S�a�e) (ZlpCode)
305-374-5300 ebalterQbrzoninRlaw.com
LOBBVISTBOSMESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILAD�RE55
II. PRINCIPAL INFORMATION:
Philipson Tomas
NAMEOFPRINGIPAL (Las�) (Firsl) (MitltlleNeme)
TJP FL Residence LLC 3009 Pine Tree Drive Miami 8each Plorida 33140
PRINQPAL BtI51NES5 NAME Ml�A��RESS (Number anE Slreet) (Cily) (State) (Zip Code)
773-502-7773 tomasiphilipson�.?gmail.com
PRINCIPALBUSINESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS
� Pursuant to Ctly Cotle Section 2-082(M1�(1�(a)'. H pnncipal o(any mrporation, patlnersM1lp, or olher entiry who appears as a lobbyist on �eM1al�of�hal
entity,witM1ou�special compensa�ion o�reim�ursement for�M1e appearance,w�etM1er dVect InGirec�,or mnlingent,to express suppotl of or opposition lo
- an item sM1all regsler wit�iFe CIeM as reQuired�y IM1is su�section but sM1all not be redui�ed�o pay any regishation�ees.
� If the principal is a Corporetion, Partnership or Trust, the following information MUST be provided
- pursuant to City Code Section 2-462(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,wriM N/A): T. PhilipSOn
- • NAMEOFALLPERSONSHOLDING,DIRECTLYORINDIRECTLY,AS°oORMOREOWNERSHIPINTERESTINSUCH
CORPORATION, PARTNERSHIP OR TRUST(it none,write N/A): Tomas Phll�son -100%
�- Page 1 of 5 '�
,�v.��rvm -._ -�_ — —_�...,,.
"'�" " '."" aeesono .rorrr ,II���,IIII
DocuSign Envelopelp'.F9]DF4D2-81EC-0eCfi-qCB5-65F0350E2fi01
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is prectical, including but not limited to a specific description where
applicable ot a pending request for proposal, invitation to bid, or public hearing number.
Developme�t Approvals &Permitting Issues, including but not limited to the Historic Preservation
Board, Design Review Boazd, Planning Board, Board of Adjushnent, Land Use Development, Citv
Commission, and any City Workshops or Committees, if necessary, relating to the property located
at 3009 Pine Tree Drive in Miami Beach, Florida.
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)�4), list the City Commissioner or City personnel sought [0 6e
lo6bied, and whether the lob6yist has entered into any contrectual relationship (paid or unpaid) with
said City Commissioner or City personnel from 72 months preceding such commencement of service
witb [he City to the present date, stating the generel nature of the subject contrectual relationship.
Full Name of Indivitlual and Contractual Relationship(Hyes, explain) YES NO
Title of Person to be Lobbietl
Staff for the Planning& Building Department None X
Public Works &City AdministraHon, PB, HPB, BO None X
DR$ City Commissioq 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 rela[ionship, or other relationship giving rise to an
appearonce of an impropriety, with any current City Commissioner or City personnel who is sought to
. be lob6ied as identified on the lobbyist registration form filed.
- List any 8usiness, Financial, Familial or Professional Relationship, or other relationship giving rise to an
- a earance o(im ro rie if none,write N/A :
None
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):
= $535.00 per hour
Page 2 of 5
. T.. _—__ _._
. � . _
��.�:. , ..�,�.,h� ��..���� �y�{
� erona rezna�cro�et ����1�������
DowSign Envelope I��.F9]OF4D2-81EC<BCfi�AC85-65F0350E2601
The following six(6)questions MI15T be answeretl:
1) Pursuan��o Cily Code Sec�ion 2d88,enli�leE"Pmhibi�ed Campaign Contnbu�ions By Lobbyisls On Pmcuremen[Issues":
_VesXNo: Arey I bb ' t d' b'df d t t
pendino award fo�aoods.eouiomen�or sery ce7
2) Pursuan�to Ciry Cotle Section 2-490, entitletl 'Prohibited Campaign Coninbutions By LobbyisLs On Real Es�a�e Developmen�
Issues":
_Vea X No: Are vou lobbv' d' I' E f D I t A � lh ih C'iv f F
tor chanae ot zoninn mao desionation or chanae to the CitYs Future Lantl Use MaoT
3) Pursuant �o Ciry Code Sectian 2�482�h�, any person (encept those exemp� from Ihe defini�ion af"IoObyisC as se� fohh in
Section 2-081)wha only appears as a represen�ative of a nobfor-pmfil corporation or en�ily without special compensa�ion or
reimbursement(or the appearance,whe�her tlirect or indirec��o express suppoh of or opposi�ion�o any item,shall register wi�h
�he ciry clerk as requiretl by�his section,bul shall no�be requiretl�o pay any regisbation fees.
_VesXNo: Are vou reoresentina a nobfoo-oroTi! corooration or entiW w'thout soec'al comoensal'on or
reimbursementl
4) Pursuant to Ciry Cotle Sec�ion 2-487, Ihe �erm "lobbyisf' spacifcally excludes �he bllowing persons: Expeh witnesses who
pravitle only scienli(c, �echnical or o��er specialized information or[es�imony in public meelings;any person who only appears
as a representa�ive af a naighborhood associa�ion wi�hout compensa�ion or reimbursemen�for tha appea2nce,whe�her tlirec�,
indirec�or con[ingent,to express support of orapposition lo any item;and any person who only appears as a representa�ive o(
no4for-pmfi� communi�y basetl or9anizalion for the purposa o( reques�ing a gram withoul special compensation or
reim0ursement for�he appearance.
_Yes x No: Are 'tl' I t'f' t h ' I th ' I' tl ' f t oo ' a
reoresentative of a neiahborhood assaciatian w'ihout soec'al comoensa[on or re'mbursement or
reoresentina a nobforaro(it basetl oraanization tor the ouroose oi reaues[na a arant w'thout
scecial comoensation or reimbursemeniT
5) Pursuant�a City Cotle Seclion 2-097(1), no campaign consultant shall lobby Ihe Ci�y Commission for a penod of 12 mon�hs
following t�e sweanng in of any elec�etl of(cial(s) for whom �he campaign consulWn� p�ovitlad campaign consulting sarvices
wi�hin�he past elecdon cyde.See Sec�ion 2d91 for more infortna�ion.
_Yes XNo: Have vou nrovidetl camoaian consWtina services to an inwmbent member ot the C'N Comm'ss'on
within the past eleclion wcIellTves.olease list the incumbenl memberlsl o(the C'tv Comm'ss on�
Ves X No: If ves has 't been less �han 72 monlhs s'nee the elec�etl oT(' " II ) h 'd d
cansultino services was sworn in?
6) Pursuan[[o City CoOe Section 2-0BP�a��4)a., a lobbyist who has within the past election cycle provitletl campaign consulting
services�o an incumben�member o!I�e Ci�y Commission(which lobbying activily is nol otlierwise pmhibi�etl by Cotle sec�ion
2-491) shall disclose such parliwlar service on his/her lobbyis� registraGon form antl shall orallv d'sGose such oaKcular
. service before lobbvino��e G Iv Comm'ss on at a oubl c meef no.
Yea x No: Have vou orovitled camoaian consullina services to an incumbent member ot ihe C'N Comm'ss'on
within ihe oast election cvcleY If ves,olease list the incumbent memberlsl otthe C'N Comm sa'on�
Ves%No: If d dd 'd t h T
consultina services7
TO BE COMPLETED BY CITY CLERIt'S STAFF ONLY
- AnnualReglshaYonfw: [ �Yes[ �No AmouMFaItl�SU MCR#�/337�/�/ pa[¢paitl �7 �l
LobGyls�Regls�2tlon iwm�acaivatl and verifled��
' f.'�.QER\SALL\aPoRMS\L069YISTFOPMS\Lory�V�iti�PcglsbationPoin�Rcvnetl09�10-18RE6.tlnc RM'18lAOS�ZO�ZOIB
Page 3 of 5
�-T, � �� .,,,� �� , aao�,o � � ,«o��� �IIL���IIII
�oruSign EnveloDe I�:F9ppFAD2-81EC-0BCfi-AC85-65FWSOE2fi01
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 REGARO 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 A7 Wa RING THE REPORTING PERIOD.'
SignaWre of Lobbyisf. �`� �� Dale osnn2o2a
I do solemnly swear or aHirm ihat all o(ihe foregoing (acls, slatemeNs, and disdosures in this Form are ime and correct,
and ihat I have read or am (amiliar with lhe provisions conlained in Chapter 2, Atl. VII, Division 3, entilled "Lobbyisis" of
the Miami Beach Ciry Cod 9�ep�ie�oqing requirements.
SignatureofLo66yist ��� �`� Date ����i�o�a
SignaWreofPrincipaC � �as P�'GPSOw Da�e nemnroe
.�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
S�a�e o( Florida State of Florida
counryof�. Miami-Dade caunryof�. Miami-Dade
Swom lo(or affrmed)and subscribed 6e(ore me, Swom to (or afirmed)and subscribed before me,
by means of� physical presence 6y means of� physical presence
or q�online notarizalion, or C�online notarizalion,
this_day of r�nv�ma . 20_, by this_day of . 20_, by
Emily Balter Tomas Philipson
NAME OF LOBBVIST NAME OF PRINCIPAL
_Praduced ID _Produced ID
F
�Personally Kn � �Personally K �
SignaWre of Notary Public"��P�N Signature of Notary Public""LL�LL
Diana Ramos Diana Ramos
- am o o a , T d Prirled rr SI mped Name of Natary, Typed, Printetl or Stamped
_ Diana Ramos O�ana Ramoa
' Commisaion;Y HH 38692] CommlulonM HH]Bfi92]
Notary Public-Sfa[e of FloriEa No�ary PULIIc-S�a�e of Floritla
- My Commissian Expires Apr 16,202] My Commission Expires Apr 16,202]
` ' Th , , g pereons:
Expert wilnesses who provide only scientific, technical ar other specializetl infortnation or testimony in public meetings;any person who
_ only appears as a representative of a neighborhootl association wilhoW mmpensatian or 2imbursemen�for�he appearance,whether
direc[, intlirecl or contingent, ro express suppotl of or opposition �o any item; and any person who only appears as a representative of
' - no4forvpmft community based organization (or[he purpose of reques�ing a grant wi�hou�special compensation or reimbursemanl for
- the apPearance.
Page 4 of 5
� �,,� ��— � ��, � _ �o;o oa,«o«< �pIL���llll
, �ocuSignEnvelopel�:FWpF4W-81ECLBC6-ACB565F0350E26�1
Ciy of Miaml Beach, I]00 Co�re�fion Camar Dnve,Mloml Beach, Flando 33139,www.mmml6eochH.go�
OHice oNhe Ciry Clerk
Rafael E Gmnado, Ciry Qe�k CiyClerk@miami6eachfl.gov -
Teb. 305.6737471, Fax� 305.6737254
NAME OF LOBBYIST: Emily Balter
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 fle timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Seclion 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 the required Statement by April 30'" of each year, shall be
automatically 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 regislered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately fle a Notice of Withdrawal with the Office of the City Clerk.
- 3) ANNUAL LOBBYIST REGISTRATION FEE
_ I understand annual regislration of all lobbyisls 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�82 of the Miami Beach City Code.
��"+i� ��" osmizoza
- SignaWre of Lob yist�A i1��'�°.. Date
nu rre�sm iwr oaysv oeeris��oaMe��oe��ei k�.mx„�ro,m e�rorea o3 n so reea m�
Page 5 of 5
_ ___ —_. .__ _ __.
,. � „�„n� � „ ���.� � a,ma�m . . .�otee �����������
C9tY ot Minm{ ! .��.ti
fliY klil� lic
I/ilfi I:Wryrnl : , ,
" i
Miami ti�:e�:li . H�.�.1f:lle'3
3US-b13-7420
i�7eleanie
1 ui 1 i�l ��9 �e,d14 Carman V.
o � Gi i I uuoi
� � MItiIHIRNEOUS
° k� � rncs 1 ; Mf,Rd73744
°1 MI;H OFEN (MCRI
� � � 2024 I[am: MGR
M LL 1 �! �67i10.O000
� MCR I1PFN 1 MI:N I
a o . �I;Ou.00
w
Z o� � � . .. _ . .. . ..
� b700.00
m � � S�iht��tal g70U.00
lntal 3/00.(HI
CtI�Ch g350.(l0
. , Check NumbHr00005931
uiirtn �aso.uo
� � . �,i eck Num6ar00p05938
� F ., ....._. ._ . . . .
.. _ � ' Chan9e due 3b.OD
. tt � p � Pai�l r, . Hf.HCIIW. Np41Eil , F1-HNANDFC , LARR;Id
Y � 8 fal ANI.S PLLC
V � m
W
a V a o V~1
� � ° - � � IlBlilllllll'�I4.VIII!IIIIIIIIIINIIVUIiilllllllll�lilllliilillil
�
� �, Z
N W � � -
� m � o O ` . I �.`e. ��..-` +, . ... ..i1�T
V C iYi�
N � 'a . � � ¢ a � � �'w nau��u �v .,_. �
v
� � � �
'o a � .� a � � � � E ._ . I '
� �— �....o _ _
❑ a � E o " � = O � Y C�,,..^ ���p t �.
m O t > y m o w a � � IW � L_.�-.,...e�
N � c1Oi a v � q o � �` x � _
� V � K Q u � » `�' � q.H Q ._ _
U � O Sc G �- �� "YM'I
� ..��.q_m..:....`�.�.N[f.C1YYli �..�....� ` .��..
TRMfY
� ,. . ,« ��� ��I�
11wnk fu yu� Mv�t _