2024 Lobbyist Registration Form - 1691 Michigan Ave (Robert Rivani) i��► � n P�, ,�,,, ,��
DocuSign Envelope ID:FS4EF1B3-21]FAF6C A992-1889ASE32336
,�ECEIVED
�� ��� ° 1 � ��' ^� � Officea(�heCityClerk '��� 262024
1700 Convention Center Drive
Miaml Beach, FL33139 �_il"Y O� MIAMI 3EACH
305.6737477 JFf'��..- �.' "�h r'T"CLFRK
LOBBYIST REGISTRATION FORM
Lobbyisl means all persans employed or re�ainetl, whethar paid or not, by a pnncipal who ueks la encourage the passage, tlefeat or
modifca�ion af any ortlinance, resolNion, aclion or tlecision a(any commissioner, any ac�ion, tlecision, recommendatian of Ihe Ci�y
Manager or any Cily board or committee;or any aqion,tlecision or recommendation of any City personnel tluring Ihe�ime periotl of�he
en�ire tlecision-making process on such aclion, tlecision or recommentla�ion Ihat foreseeably will be heaN or reviewed by the City
commission, or a Ci�y boartl or commiLLee. The �ertn specifically indudes the principal as well as any employee engaged in lobbying
activi�ies. The�erm"Lobbyis[s' has specific enclusions. Pleasa re(er lo City Cotle Chapler 2. Artide VII, Division 3, enlilletl"Labbyists,"
for additional in(orma�ion.
Instmctions: Please complele all sections of Ihis Form antl submi�Ihe comple�etl fortn,with the applicable fee, to�he Office of Ihe City
Clerk. If you neetl more space to complete an answer, use a separa�e shee�(s)of paper. If you have nothing b repotl in a parlicular
sec�ion, you musl wrile "none" or "n/a" in thal sedion. Any change lo any informa�ion originally fled, or any aatli[ional Ci�y
Commissioner ar personnel who are also saught�o be lobbied shall require�hat Ihe lobbyis�file an amentlmenl lo Ihe regisba�ion form.
The lobbyist has a conlinuing tlNy �o suppty in(ormalion antl amend Ihe fortns filetl �hroughou� the periotl �ha� Ihe lobbying occurs.
Separate regis�2tion forms shall be required for each principal represen�ed an each speci(c issue.
I. LOBBYIST INFORMATION:
Rivani Robert
NAME OF LOBBVIST (Lest) (FrsQ (Mitldle Nama)
RK Rivani LLC 201 S. Biscayne 81vd.,Suite 1440, Miami FL 3313]
LOBBVI3TBUSINESSNAMEANDADDRESS (Numberend3lreet) (Ciry) (Sta�e) (ZipCotlaJ
azo-zaa-na� robertOO blacklioni�.com
LOBBYISTBUSMESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS
II. PRINCIPAL INFORMATION:
2iva�i 2obert
NAMEOFPRINGIPAL (Last) (Flrs�) (MItl4laNama)
RK Rivani LLC 201 S. Biscayne Blvd., Suite 1440 Miami Florida 3313]
aair�aan�eusiNess NnMe nrvo nooaess ��uunear a�a snaap �a�y7 �s�a�e� �z�p coee�
424-254-7787 robert@blackli�nig com
PRINCIPALBUSINESSTELEPHONENIIMBER CELWLARTELEPHONENUMBER EMAILADDRESS
Pursuant�o Clry Cotle Section 2-082(M1)(1)(a): A D��cipal of any mryoration, par�nersM1ip, or o1M1er entiry wM10 appears as a lobbyis�on be�alf of[M1at
enti�y,wl��oW special compensalion o��eim�ursamen�forlM1e appea�ance.vRielM1er tlirecl, Intlired,or conlingent to express support of or op0osilion�o
an item s�all register wi��tM1e Clerk as repulretl by�his suLsec�ion Lul s�all no�be requiretl ro pay any regis[rallon fees.
� If the principal is a Corporetion, Partnership or Trust, the following infofmation MUST be provided
- pursuan[to City Code Section 2-482�c):
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARV�itnone,wrih N/A�: I2. IZiVani
• NAME OF ALL PERSONS HOLDING, DIRECTLV OR INDIRECTLV,A 5%OR MORE OWNERSHIP INTEftEST IN SUCH
CORPORATION, PARTNERSHIP OR T6U5T(if none,write N/A�: IZOVf�[ RI V dlll- 1��"/0
Page 1 of 5
� �� . o . :���H ,szz ,e�_��,.n ,��d3C��'� �
�ocuSign Envelope ID'F54EF183 29F-0F6GA992-1884ASE32334
III. ISSUE TO BE LOBBIED:
Describe with as much tletail as is prectical, including but not limited to a speciFc description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development Approvals & Permitting fssues, i�cluding bat not Iimited to the Historic Preservation
Board, Design 2eview Board, Plannin� Board, Board of Ac�justment Land Use Development, City
Commission, and any City Workshops or Committees, if necessary, relating to the property located
at 1691 Michigan Ave in Miami 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 generel nature of the subject contrectual relationship.
� Full Name of Individual and Contractual Relationship(If yes,explain) YES ' No
Title of Person to 6e Lo66ietl
StaEf for the Planning& Building Departme�t � None X
Public Works & City Administratio�, PB, HPB, BOA None X
DRB,Citv Commission, and Mavor as necessary None X
Land Use &Sustainabilitv Committee None X
�
Pursuant to City Code Section 2-482�g), every registrant shall 6e required to state [he 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 sough[ [o
be lobbied as identified on the lobbyist registration form filed.
= List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
= a earanee of im m riet if none,write N/A :
' None
- V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soecific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2485.3):
- $ 0 perhour
Page 2 of 5
� � �,.�,. ,, .� ,�r� „A�,�„ a ,�,�„ti —�ql���ll lll
�owSign Envelope IP.F54EF183-21]FSF6C-A992�iBB4A5E32336
The following six(6)questiona MIIST be answereE:
1) Pursuant m Ciry Code Section 2-488,enti�letl"Prohibilad Campaign Con�nbNions By Lobbyists On Pmcuremen[Issues":
_Ves XNo: Me o lobb 'n t E' b'd f tl t (
oendina awartl for aootls eau'oment or servi ce4
2) Pursuan�ta City Cotle Section 2-490,en�itled "Pmhibitetl Campaign Con�nbWions By Lobbyisis On Real Es�ale Developmenl
Issues':
Ves X No: Are y I bb ' d' f f 1 D I t A 1 'ih th C'lv f f
for chanae otzon'nu mao des'onafon or chanae to the Ct 's Future L tl U M 7
3) Pursuant to City Cade Sec�ion 2-482(h), any person (except those exempl hom tlie definition of "lobbyisf' as sel fotlh in
Section 2-481)who only appears as a represenla�ive af a noblar-profi�co�0ora�ion or en�ity withou�special compensation or
reimbursement for Ihe appearance,whelher direct or indirect to express suppotl of or opposi�ion�o any item,shall register with
Ihe ciry clerk as requiretl by this sectioq but shall no�be requiretl to pay any registration(ees.
_VesXNo: Are you reoresentino a nobfor-orofit comoration or entitv withoW soeial comoensaCon or
reimbursement4
4) Pursuan� �o City Cade Section 2-661. the lertn "IobbyisP'specifically exdudes Gie bllowing persons: Experl witnesses who
pravitle only scienlifq technical or ather specialized infortnalion or�estimony in public mee[ings;any person who anly appears
as a represenla�ive of a neighborhootl associalion wiUiaul compensation or reimbursemen�for the appearance,whether direcf,
indired or can�ingent,to express suppotl of or opposi�ian la any i�em;and any persan who only appears as a representative of
nobfor-profil community based organiza[ion for the purpose of requesting a grent wi�hout special campensation or
reimbursement for Ihe appearance.
_YesXNo: Are vou orovidino onlv scientific technical or other soec'al'zed 'ntormafon� aooear'na as a
reoresentative of a neiahborhood assoc'at'on w'ihout soec'al comoensat'on o� �e'mbursement ar
reoresenfinu a nobfororo(it basetl oraanization (or ihe oumoae ot reauesEno a oront w'ihout
soecial comoensation or reimbursementi
5� Pursuant lo City Cotle Seclion 2J91�1�, no campaign consul�ant shall lobby Ihe Gily Commission for a penotl of�2 mon[hs
following �he sweanng In of any elected oHlciaqsJ for whom [he cempaign consultanl pmvidetl campaign amsW[ing services
wi[hin�he past eleclion cycle. See Secpon 2-691 for more informa[ion.
_Ves XNo: Have you orovitleO camoaian consultina services to an incumbent member of the C'tv Comm'ss'on
within Ihe oast election wcle?I(ves,olease list fhe incumbent memberlsl of ihe Gitv Commiss'on'
_Ves X No: It ves has 't been less t�an 12 moNhs s'nce ihe elect tl (1" ' I( 1 h 'd tl 'q
consultina services was sworn in7
6) Pursuant�o Ciry Code Sectian 2-d82�a�(4)a., a lobbyis� who has within Ihe pas[elec�ion cycle provided campaign cansul�ing
services lo an incumben�member of Ihe City Commission(which lobbying aclivity is no�o�herwise pmhibi[etl by Code section
2�91) shall disclose such pahicular service on his/her lobbyisl registralion (arm antl shall orallv tlisclose such oarfcular
ce before lobbvina the Ci�v Commission al a ou�lic meelina.
SBVes X No: Have vou orovided eamoaian consultina services lo an incumbent member ot the C'N Comm'ss'on
wilhin the oast election evcleP It ves olease list the'ncumbent membedsl ot the Ctv Comm'ss'on�
Vea X No: Ii ves were vou orom'sed or d'd vou rece've econom'c cons derat'on 'n ezchana f
consultinu servicea?
TO 9E COMPLETED BY CRY CLERK'S STAFF ONLY
- Pnnual Regis4ation fee'. [ �Yes�No Amoun[Paitl"}S�'� MCR p/ � �� � �� Oate Paitl b/�/� �7
Lobbyiat RagisVation Form recelvetl antl vetlfetl by:�` I C Y�.L)�C�l
F'.\¢ER�4ALL�aFORMS�LOBBYi5TiO0.M5\Lobbyist0.egis[a[ionPorm0.evisetl 09-30-18REG.doc RlVISld09/20/2018
Page 3 of 5
�,n�o ., o-eno-.eai .�.�n,.��„e „va�om .mmon�, �����������
DacuSlgn Emelope ID'FSOEF1B3d9F-0F6C�A992-0886ASE32334
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 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 CO ENBA ION Dl1RING THE REPORTING PERIOD.'
Signature ofLobbyis�'. ' pale 6-20-2024
I do solemnly swear or affirm that all of the foregoing tacls, statemenis, and disclosures in this form are ime and correct,
and �ha� I have read or am familiar with �he provisions contained in Chapter 2, Art. VII, Division 3, en�itled "Lobbyists" of
�he Miami Beach City s��9p�oRing requirements.
i -
SlgnatureofLo6byisl: � s��o-,i Date 6-20-202a
SignaWre of Principal: ` ��?PE�etE � � Date b-2o-2024
�-
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State af Florida State of Florida
Counry oC Miami-Dade Counry oC Miami-Dade
Swom to(or affirmed)and subscribed before me, Swom to(or affirmed)and subscri6ed 6efore me,
by means of O physical presence by means of� physical presence
or� online nolarizalion, or� online notarizatioq
�his 2� daY of June . 20_24 1 his Z�day of June , 20 Z4,
Robert Rivani Rober[ Rivani
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID Pmducetl ID
FORM OF IDENTIFICHTION FO
�
_.
x Personalty Known � x personally Kno /j� Q�
��Vl
' SignaWreotNolaryP .,..,.:,,.:.._. SignaWreotNota _„_-._....,.
VeitlY Montesino Perez VeitlY Mon[esino Perez
Na e oi Not i, Ty ed, P inte r t ed t ped
Veitly Montesino Varez Yeitly Mon@sina Pere
Commission#HH OBA2]3 Commizzion p HH 086Y93
- NotaryPUDlic-9(eteo�FlorNe No�aryPublio-S[e�eofFlontla
My Commission Expires Jan 24.2025 My Commission Expi�es Jan 24,2025
� ' Th , g persons: ,,.
Expert witnesses who pmvitle only scienti(c,technical or other specialized infortnalion or les[imony in puGlic meetings;any person who
only appears as a represen�ative of a neighborhootl associa�ion withoN compensation or reimbursemen�for the appearance,whether
- tlirect, intlirecl or canlingenl,�o express supporl of or opposition ta any i�em;antl any person who only appears as a represenla�iva of
- nat-forymft communiry basetl organiza�ion for Ihe purpose of requesting a granl wilhoN special campensation or reimbursement for
= Iheappearance.
Page d of 5
,,,.�� � a��HM�, �,e�r�.s r,a< ��s , x�.na.�, 111���l:�1����
DocuSign Envelopel0'.F54EF183-21]F 4FfiC�A992-0880ASE32334
Ciy of Miomi Beoah, 11001Convennm Ce�rer Dr�ve,Mlaml Beoch, Flonda 33139,www.miamibea<hN.go.
OHice of the Ciy Clerk
Rafael E. Gmnada, Ciry Gerk CiryClerk@miami6eachfLgov
TeP. 305b73741 I, Fax�. 305.6737254
NAME OF LOBBYIST: Robert Rivani
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 Statements filed 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 S[atement or pay the
assessed fines after notifcation.
Any lobbyist, who fails lo file the required Statement by April 30�" of each year, shall be
automatically suspended from lobbying until all fnes 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 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 fle a Notice of Withdrewal 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.
_ �oo. sq'"�
s-zo-zo2a
Signature o��o� yist Date
1 .O HRSAI I1nlORMS�I OpBViS i hOHMS�W��nA HepaDaoon!nim Rcoera rp�i¢V H[G doc
Page 5 of 5
ve�Hm i.eeeeza.er�o.maz.eoeaazseeoe�n r,wesms sac>erseaaee ������r������