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2024 Lobbyist Registration Form - 7410 Collins Ave, 7401-7425 Harding Ave (Abraham Bergman) 79�e L.��t�s i�lvenvo , ' DowSi9nEnvelopelD�0240C]D5-03E6�6F�B-BCO6-A69]1569C]CA 7y0� �� "� �`� �r_�,ENED Ava��. ` ' ' � � � BEACH ��, 28zoz4 � J I ` � � , . Offce o(the City Clerk 1700Comen�ionCenlerDrive " " ` �' :�� . Miami Beach, FL 33139 �r� � � . , . 305.673J411 LOBBYIST REGIS7RA710N FORM Lobbyist means all persons employed or retainetl, whether paid or not, by a pnnci0al who seeks �o encourage ihe passage,defeal or motlifira�ion of any ordinance, resoW�ion, adion or tlecision o!any commissioner, any action, tlecision. recommentlation o( �he Ci�y Manager or any Ciry board or commitlee;or any action,decision or recommandation of any City personnel dunng the time period of the en�ire tlecisionmaking process on such action, decision or recommentlalion that foreseeably will be heard or reviewed by ihe City commission, or a City board or commi��ee. The lerm specifically inclutles Ihe principal as well as any employee engagetl in lobbying activi�ies.The�ertn"Lobbyis�s"has specific exclusions. Please refer to Cily Cotle Chapter 2, Article VII, Oivision 3, entitled "Lob�yists,' for additional informa�ion. Inatructions: Please wmplete all sec�ions oRhis form and submil tlie comple�etl fortn,with�he applicable fee,�o the Office of�he City Clerk. If you neetl more space�o complete an answer, use a separate shee��s) of paper. If you have nolhing �o reporl in a pahicular sec�ion, you must write "none" or "nla" in Iha� sedion. Any change lo any infortnatian originalty �led, or any atltli�ional City Commissioner or personnel who are also sough��o be lobbied shall require�ha��he lobbyist file an amentlment to the regis�2tion form. The lobbyist �as a con[inuing tluty �o supply iniorma�ion antl amentl tha forms filed �hmughout the periotl tliat �he lobbying ocmrs. Separa�e regis�re�ion fortns shall be required(oreach principal repiesemetl on each specific issue. I. LOBBYIST INFORMATION: Velez Sebastian NAMEOFLOBBVIST (Last) (Flrs�) (MltltlleNema) Urban Robot Associates 420 Lincoln Road,6th Floor Miami Beach Florida 33139 LOBBYIST BUSINESS NFME AN�AODRE35 (Number antl S[reeQ (Gly) (S�eteJ (Zip Cotle) 786-246-4857 sebastianQurbanrobot.net LOBBVIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Ber¢man Abraham NnMe oF paiNaan� ��asq (cl�p (M�aaia Name) 7410, LLC 839 Flatland Avenue, Suite 211 Brooklyn Florida ]7234 PRINCIPAL6USINESSNAMEANpADDRESS (Numberantl3Vee�) (Qty) (Sla�e) (ZID�tle) 718-5674922 abebQeastemunion.com PRINdPALBUSINE55TELEPHONENUMBER CELWIARTELEPHONENUMBER EMAILA�DRESS = Pursuan��o City Cotle Sec�ion 2-0ffi(�)(1)(a): A pnncipal of any m�po�a�ion, parNersM1ip, o�o�her en[i[y w�o appears as a IOL�yis�on be�aR of�M1at ' en�iry,wit�oN special compensation or reimbursemenl hr�M1e appearance,wM1etM1er tlirecl,InGired,or con�ingen�,�o express suppotl ol or opposi�ion to ` an ilem sM1all registerwilh��e Clark as requiretl by Uis suEsection bu�shell nol be reduiretl b pay any regishelion/ces. � If the principal is a Corporetion, Partnership or Trust, the following information MUST be provided - pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICEq,PARTNER,OR BENEFICIARY(if none,write N/A): /�. Ber£man = • NAME OF ALL PEfi50N5 HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEHEST IN SUCH CORPORATION,PARTNERSNIP OR TRIlST(i7none,write N/A�: Please Gee the attached Page 1 o(5 � � ... _ .._"-_ -' - _. .� , ., ,,. ae"o�,� ,��.,� �n��wi . � DoaSign Envelope ID:0240C]OSD3E4-0FDB-BC06A6991569QC4 III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specifc description where applicable of a pending request for proposal, invitation to bid, or public hearing numher. Development Approvals &Permitting Issues,including but not limited to the Historic Preservation Board, Design Review Board, Planning Boazd, Board of Adjustment, Land Use Developinent, City Commission, and any City Workshops or Committees, if necessary, relating to the properties located at 7470 Collins Avenue,7401-7425 Harding Avenue in Miami Beach, Florida. IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482�a)�4), list [he 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 contrectual relationship. Full Name of Intlivitlual and Con[ractual Relationship (If yes,explain) YES No Title of Person to be Lobbietl Staff for the Planning&Building Deparhnent None X Public Works &City Administration, PB, HPB, BO None X DRB, City Commission, and Mayor as necessary None X Land Use&Sustainabili Committee None X Pursuant to City Code Section 2d82�g), every registrant shall be required ro state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearonce of an impropriety, with any current City Commissioner or Ciry personnel who is sought to be lobbied as identified on the lobbyist registration form filed. ` List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise m an - a earence o/im ro rie if none write N/A : ' None = V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be SoeciTic. (Note that a - contingency fee is prohibited pursuant to City Code Sea 2-485.3): 0 S per hour Page 2 of 5 � _____,. �y�y ,� � .,.:i. ,,,,,,.i.,e� - ��@S6lWl�� ' DocuSign Envalope ID:0240C]D5-D3E4-4FDB�8C06A69)�569C]G The tollowing aix(6)Questions MUST be answeretl: 1) Pursuan��o Gity Code Sec�ian 2-d88,enti�led'Pmhibiletl Campaign Contnbutions By Lobbyisls On Procuremenl Issues": _Ves X No: Are I bb ' u t d' n b'd( G b t � cendina awartl tor aoods.eouioment or serv'ee? 2) Pursuant�o Cily Code Section 2-49U, an�illed'Pmhibitetl Campaign CONnbutions By Lobbyis�s On Real Es�a�e Developmen� Issues": _Yea X No: Are I bb ' d' I' f t Ue I t A t lh ih CN I' f tor chanae of zon"n A f h t [h C'N' F tu L 0 0 M T 3) Pursuant �o Ci�y Code Seclion 2-482�h�, any person (except Ihose exempt fmm �he tlefini�ion of "lobbyis�" as se� torth in Section 2-081)who only appears as a represen�ative af a no4(or-profi�mrpora�ion or entiry wi�hou�special campensation or reimbursement for I�a appea2nce,whe�her Girect or indirect to express support of or opposition to any ilem,shall regis�er wilh �he city clerk as required by�his sec�ion,bul shall no�be requiretl to pay any registra�ion fees. _Vea x No: Are Yo f 4t - ft t 1'tv 'th t ' I F reimbursement? 4) Pursuan� �o City Cotle Section 2-487, �he �erm 'lobbyisl" specifically exclutles �he follaxing persons: Ezpert wi�nesses who proviGe onty scien�ifc, [echnical or o�her specializetl intormalion or�estimony in public mee�ings;any person who only appears as a represen�a�ive o(a neighborhootl associa�ion wi�hou�mmpensalion or reimbursemen�tor�he appearance,whe�her tlirec�, intlirec�or con�ingen�,�o express suppotl o!or op0osition�o any i�em;and any Oerson who only appears as a represen�ative o( no4forvpmfi� community basad organiza�ian for Iha purpose of requesting a granl wi�hout special compensa�ion or reimbursemaN fo��he appearance. _VesXNo: Are vou orav'tl'no onlv seenCfc tech ' I th ' I' tl ' i f reOresenWfve of a ne'ahborpootl assoc'afon w'ihout ' I f ' b t re nf 4t d't ba d ' C t ih ( f t 'th t soecial comoensation or reimbursement7 5) PursuaN to Cily Code Section 2<97�7�, no campaign consul�ant shall lobby the City Gommission (or a penotl of 12 mon�hs following �he sweanng in of any elecletl official(s)for whom the campaign consultant pmviaetl campaign consul[ing sarvices wi�hin tlte pas�election cycle. See Seclion 2<91 for more informalion. _Yes xNo: Have vou orovided camoaian consulCna serv'ces ta an 'ncumbent member of the C'tv C within!he oaet election cvcleT If ves.Dlease lis[ihe incumDent memberlsl o(Ihe C'N Comm'ss on� _Yea x No: IT ves han 't been less Ihan 12 months a'nce the el t tl oH' ' 11 ) h 'd d consultina sarvices was sworn inT 6) Pursuant�o Gity Cotle Section 2-d82�a)�4�a., a lobbyis�who has within the past elec0on cycle pmvitlatl campaign consulting services�o an incumben�member o/Ihe City Commission(which labbying activiN is nol otherwise pmhibitetl by Cotle seclion 2>91) shall tlisclose such particular servica on hislher lobbyist registration (ortn and shall oralN tlisclosa such oarfcular b f I bb - q�h CNC t bl f _Ves%No: Xave vou orov Aetl camoa on consultina serv'ces to an 'n be t be o(th CN C within the oast election cvcle7 If ves.olease liat the inwmbent memberfsl of the C'Iv Comm'ss on� - _Vea x No: I( ves. were vou orom'setl or tl'd vou rece've econam� cons'tlerafon 'n h a f consultina servicea9 � = ��J :�VS � 25�u'O TOBELOMPLEfEDBYCRYCLERK'SST/FFONLY AnnualRagisVatlonfae: �Yea[ ]No AmouniPaltl{3+ 'S� MCRNy33�/�/3 DatePald �� - Lobbyirt Regichation Form receivetl antl varifiM by: �M F.�[LER\SALL�aiORMS\LOB9YISTFORMSLLobbyis[RcqlsbationFnrnRroisctl09-30-180.EG.tlo� Ild�9ldW/20�2018 Page 3 of 5 — _�.___ _._ _ _ ry °. ��,�,...,. ,;�,. „:.� .. _ — __. _ .. n..ro n_ � ,� seaasarAv ,II��III DomSign Envelope IP�240C]OS-D3E4-4FD8-BC�6-A69]1569L]C6 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR- EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITV 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 EXPENDITUREORCOM 7A0-N�y:DURINGTH�/EREPORTINGPERIOD.' SignaWre of Lobbyis�'. S`��as I I�N V'�''�p Da�e ovio/2024 I do solemnly swear or affirm that all of ihe foregoing facis, statemenis, and disclosures in Ihis form are irue and correcl, and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, enlitled "Lobbyisis" of �he Miami Beach City C Pltl"&p^F6p'orting require/�meNs. SignalureofLobbyisf. S"��JaS�QNU �h4.,Map,: Date ovmrzoza Signature of Principal�. Q4�� `�' Date ovivzoa4 xe��enirae� VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida Counry of: Miami-Dade Counry of: Miami-Dade Swom to(or affirmed)and subscrihed before me, Swom to (or aKrmed)and su6scribed 6e(ore me, by means of 0 physical presence by means of O physical presence or Bonline notarizalion, or q�online notarization, Ihis_day of nvmmroa . 20_, by this_day of nvinnroa .20_, by Sebastian Velez Abraham BerQman NAME OF LOBBVIST NAME OF PRINCIPAL _Produced ID _Produced ID F �xPersonally Kn � X personalty K � SignaWreofNoleryPublic� M SigneWreofNotary�u�ilic�� - Diana Ramos Diana Ramos , Name of Nota , Ty ed, Prinled or Slam ed Name o/Nolary, Typed, Printed or Stamped Oiana Ramoa Dlana Ramos Gammission#HH 38692] Commission M NN 38692] Notary Public-S�ale ot Floritla No�ary Public-State of Flontla My Commission Expires Ap�16,202i My Commissian Expires Apr 1fi.202] ' Th e._..a....,, .., ,....,..,9 Persons: Espart wi�nesses who provitle only scian�ific, technical or o�her specializetl in(orma6on or�es[imony in public mee�ings;any person who � onty appears as a representa�ive of a neighborhootl association wilhout compensation or reimbursement for ihe appearance,whe�her ' ` tlirect, indirect or contingent,to ezpress support of or oppasition to any item;antl any parson who onty appears as a represanlative of not-for-proft communiry based organization for�he purpose of requasling a gran�wi�hou� special compensa�ion or reimbursemenl tor - the appearance. Page 4 ot 5 — �.-,___ -. _.—.— ..— ..—— .��. , n �., :,_ o.o�,i ss.�� DocuSign Envelope ID:0240C]DS�3E4-4FDB$W6�A69]1569C)C4 Cify d Miomi Beach, V00 Cmve�nm Cemer Dnve,Mlaml Beoch,florida 33139,www.mlomibeachil.go. Office of ihe Ciry Clerk Rafael E. Granadq Gry Clerk CiyClerk�mlami6eachf'�,.gov Tel: 305.6737411, Fox: 305 673J254 NAME OF LOBBYIST: Sebastian Velez 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 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 lhe failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notifcation. Any lobbyist, who fails to fle the required Statement by April 30'^ of each year, shall be automa[ically suspended from lobbying until all fnes are paid, unless lhe fine has been appealed lo the Miami-Dade County Commission on Elhics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the Ciry 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 Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE - I understand annual registretion of all lobbyists shall be required for each 12-month period ; commencing October 1 of each year, and the fee for such annual registretion shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. - �'E17QS�QN V�'E� o,noizaza = r ,au - Signature of Lo`b�'yis��"" Date - � ,��a�sa��„��A�..��,d��e�roxm�,�oewm�R�s�,Pa�n��,.m�,a.� w, .o��,ao� �� Page 5 of 5 �w.ieni Ni.,.. ,. , „ .�,.i.� �`...." . ,� , � Paeoeoi+e eroetrsssarai ,II��III q ' DocuSign Envelope 10'0240C1D5�WEAAF�B-BCO6-A69]1569C]C4 EXHIBIT B 7410, LLC DISCLOSURE OFINTEREST Abraham Bergman 50% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 Charles Hoffman 50% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 k - _ ...n__ .._...-.. .„""� .,�,,.,,, ,,,....��,.� ,aeso�a FFSA»,�,�M ��0� EXHIBIT B �aio, uc DISCLOSURE OFINTEREST Abraham Bergman � 50% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 Charles Hoffman SO% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 City of Niami Beach City Hall � 1700 Conventlon Center Dr. Miani Beach , FL 33139 305-673-7420 Welcome � O7/02/2024 02:02PM Carmen V. ° 007122-0025 v 'o NISCELLANEOUS o d x Reference 1 : MCR433443 "'� "� c °' MCR OPEN (MCR) M c 2024 Item: ML'R � '� 1 @ $700,0000 � MCR OPEN (MCR) $700.00 O � Z yi � O I5700.00 m Su6totad i100.00 �Total 5700.00 a o CHECK $350,00 Check Numher001146 CHECK $350.00 w Check Num6er001147 � w a ChanBe due 50.00 � g Paid by: BERCOW RA�ELL FERNANDEZ LARHIN & � O � v s m TAPANES PLLC a t V f- � Q � � �Z '�.��I��I��I��1�� N m � � � � V ry . � .. w IIp � � ._ � rww+ru. .i..� m g a � � Q m RaR'^' �4 ' r�r o m rc a I � ... I', c � V � m � € c�i - � � ,��.. ...,..----.._ , � � LL ❑ a N � V � f ` O c .. �3:� �� w O r i v ,� o w d� � c � I � _�_ V N �- V N a � q [�' � N O a I ' � o v � U � K Q fi .� •- rc E = y � . u F �- ^ U o � o � a " ¢ a . ___.. _'W�� ' � �ir1r ll w. �'�icwr '-' r II I � F.:'C�" ._.,� a� �.�. . �� I Thank you for your payment CUSTOMER COPY