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2024 Lobbyist Registration Form - 7410 Collins Ave, 7401-7425 Harding Ave (Abraham Bergman) -7Hb co11 s ns J�v� LbcuSign Envelopa ID:0240C1D5-D3E4-4FD8-BCOfi-A6991569C1C4 �1��+I . �yas Ne�a:�9 ��V �. ��V��, � • ,°�, ��.^�� BEACH o��eaF,ne��y��e�k �� z� zoz4 1700 Convention Center Drive Miaml Beach, FL 33139 '-:I ' '�� i�,111\MI BEi�,�;;i 305.673J417 �'i-� �' . ��Ir (;;iP'('; rq�: LOBBYIST REGISTRA710N FORM Lobbyisl means all persons amployetl or re�ained,whe[her paitl or nol, by a pnncipal who seeks to encourage ihe passage, tlefeat or modifcation of any ortlinance, resoWtion, ac�ion or tlecision o(any commissioner, any action, decisioq recommendation of the Ciry Manager or any City boartl or commi�tee;or any aclion,decision or recommendation of any Ciry personnel tluring the�ime period of Ihe en�ire tlecision-making process on such aclion, tlacision or recommentla�ion �hat foreseeably will be heaN or reviewetl by [he City commission,or a City boar0 or committee. The term specifically includes the principal as well as any employee engagetl in lobbying activities.The�erm "Lobbyis�s"has specific exclusions. Please refer to City Cotle Chap�er 2, ANcle VII, Division 3, en�i0ed"Lobbyists; for atltli�ional information. Insiructions: Please complete all sections of t�is fortn and submit the completeG form,wilh the applicable fee, [o ihe Office of ihe Gity Clerk. If you need more space to complete an answer, use a separa�e sheet(s)of paper. If you have no�hing m repoh in a patlicular sedioq you must wrile 'none" or "n/a" in �hat section. Any change lo any information originalty filed, or any adtlitional Ciry Commissioner or personnel who are also sough��o be lobbied shall require lha��he lobbyist file an amantlmen��o�he regislra�ion form. The lobbyis� has a coNinuing duty to supply information antl amend �he fortns filetl �hmughou� t�e periotl iha� �he lobbying occurs. Separate registration forms shall be required for each principal represeNed on each specific issue. 1. LOBBYIST INFORMATION: Wood D NAME OF LOBBYIST (Lasl) (Fl�st) (Mltldle Name) Urban Robot Associates 420 Lincoln Road, 6th Floor Miami Beach Alorida 33139 LOBBVISTBUSMESSNAMEANDADDRESS (NumberantlSVee�) (Giry) (Sla�e) (ZipCo�e) 786-246-4857 jj@urbanrobot.net LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: BerQman Abraham NAME OF PRINCIPAL (Lasf) (Flrs�) (MlJtlle Neme) 7410 LLC 839 Flatla�d Avenue Suite 211 Brooklyn Florida 11234 PRINCIPALBUSWESSNAMEAN�HDDRESS (Numbe�antlSVee�) (Gl�y) (Sla�e) (ZipCode) 718-567-4922 abebQeastemunioacom . PRINCIPALBUSINESSTELEPHONENl1MBER CELLULARTEIEPHONENUMBER EMAILADORESS I - Pursuant to Wy Cotle Sec�ion 2-0B2�M1)(1)(a�: A pnncipal of any co�poralon, patlnersM1ip, o�o1M1er enOty wM10 appears as a Io�Oyis�on �eM1aH of t�a� . en�i�y,wi��oN special compensa�ion or reim0ursemen�fort�e appearance,wM1e�M1er direcl,intllrect,o mn�ingenl,lo axpress suppotl W or opposi�ion m - an i�em s�all register wi��M1e CIeM1 as reQuireE by��is su�section Out shall no�be requlretl�o pay anyrregislrzdon fees. It the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2•482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(it none,wrih N/A�: A� BeiQm8i1 . NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLV,A Sq OR MORE OWNERSMIP INTEREST IN SUCH �� CORPORATION, PARTNERSHIP OR TRUST(ii nona,wrile N/A): Pl �PP+hP attaChed � Page 1 of 5 � � � ,,� ,a,��, �,.. Ao P.e„o,,, ,Esaz,�.FM �II�[�Pl�1111 . [JowSign Envelope ID-.0240CiD5-D3E4-0FDB-BLOfi-A69P1569C]C4 III. ISSUE TO BE LOBBIED: Describe with as much detail as is proctical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number. Developme�t Approvals & Permitting Issaes, including but not limited to the Historic PreservaHon 8oard Design Review Board Planning Board, Board of Adjustment,Land Use Development, City Commission, and any City Workshops or Committees, if necessary, relating to the properties located at 7470 Collins Avenve, 7401-0425 Harding Avenue 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 to be 1o66ied, and whether the lob6yist has entered into any contrectual 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 contractual relationship. Full Name of Intlividual antl Contractual Relationship(If yes,explain) YES No TiHe of Person to be Lobbietl 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 Committee None X Pursuant to Ciry Code Section 2-482(g�, every registront shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearence of an impropriety, with any current City Commissioner or City personnel who is sought to - be lobbied as identified on the lobbyist registretion form filed. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise lo an a earanee of im ro 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. 2d85.3): _ $ 0.00 Per hour Page 2 of 5 - -_.- __._ — _.�_ _ _ _ _'_ p n��i ��..,. , ,.,��., .oeone rysc<ow �Y�� DoaSign Envelape ID�.02COC]D5�03E4-4FD8-BCO6�A6911569C]C4 The following six(6)questions MUST be answereA: 1) Pursuan��o City Cotle Sec�ion 2-488,entitled"Prohi�i�ea Campaign Conlnbutions By LobOyis�s On Procuramen�Issues": Yes xNo: A I bb ' o t ce tl' b'd for pootls eau'oment or servicea or on a oresent or D d wardioraootls eou'omentorserviceT 2) Pursuanl�o Ci�y Code Sac[ion 2-490, antilletl'Pmhibitetl Gampai9n Con�nbutions By Lobbyis�s On Real Es�a�e �evelopmenl Issues": Yes x No: A I bb ' E' I' f f D I [A t 'th th C'tv I' f 7 h t d 'p f or chanAe to the C'N's Future Lantl Use Mao7 3) Pursuant �o City Code Section 2-C82�h�, any person (except those exemp� from Ihe definilion of "lobbyisC' as set fohh in Sec�ion 2�81�who only appears as a representa�ive of a nobfor-pmft corpora�ion or en�iry wit�ou�special compensa�ion or reimbursement for Ihe appea2nce,whe�her tlirec�or intlirect to express suppotl of or opposition to any i�em,shall regis�er with �he cily clerk as required by�his sec�ion,but shall no�be requiretl to pay any regis�ra�ian fees. VesXNa: !ve V D f tfo a!'t ip �' t'W 'th t ' I f or reimbursement7 4) Pursuan� �o Ciry Gotle Sec�ion 2<81, lhe �ertn "IobbyisP' spaciFlwlly excludes �he following persons: Expetl witnessas who provide onty scientific,�echniwl or olher specializetl infortna�ion or tes�imony in public mee[ings;any person who only appears as a representative of a neighborhootl association without mmpensation or reimbursement for ihe appearance,whethar tlirect, indirecl or con�ingenl,lo express supporl of or opposilion to any i�em;antl any person who only appears as a represenlaliva of no4for-pmfi� communi�y based organization for Ihe purpose ot reques�ing a gran� withoW special compensation or reimbursement�or fie appearance. YesXNo: A 'd' I t'f t h ' I th o ' I'zetl 'niormat'on� aooear'na as a Wf / ' hbo h d 'aCon w'thout soec'al comoensatian or reimbursement or p E t fo oi't ba tl ' f f th f re f a arant without p¢o'�� f orre'mbursementT 5) Pursuant�o Ciry Cotle Section 2191�7�, no campaign wnsul�ant shall lobby�he Ciry Commission for a penotl of 12 months following lhe sweanng in of any elec�etl offcial(s) for wham ihe campaign consultan� provided campaign consulting services wi[hin�ha pas�election cycle.See Sedion 2d91 for more infortna�ion. Vea XNo: H 'tl tl If rv'ces to an 'ncumbent member of Ihe CiN Commiasion 'th' th ua t I f I 7 If I I' 1 the'ncumbenl member(sl of ihe CiN Commission: Ves X No: ` h '1 be I th 72 th th lected off'c'allsl whom vou orovided camoaian consult na serv'ces was sworn in1 6) Pursuan��o City Cotle Sec�ion 2-482(a��4�a., a lobbyis�who has wi�hin �he pas�elec�ion cyda provided campaign consul�ing services to an incumbent member of�he City Commission(which lobbying activi�y is no�o�herv✓ise prohibitetl by Cotle sec�ion 2�91) shall tlisclose such patlicular service on his/her lobbyis� registra6on form d hall orall d'sclose such paM1cular b fo I bb ' oth Ct Commssona�aoubl'cmee�ino. Ves xNo: H o 'tl d mo � Il' n to an 'ncumbent member W the Citv Commission 'th' th t I f I 91f I f [ih ' umben[memberls)ofiheCilvCommisaion: - y�s X No: I! tl d'd ce've econom c cons'derafon in exchanae for eamoaian - consultina serviees7 _ � � ' i0 BE COMPLETED BYCRY LLERK'S STAFF ONLV Annual Regis4ation fae: [�1 Yes[ �No NnourR PalTtl f �1I�� MCR k �l3 s 4�/3 pne Paid -?- a -�� LobGyist RagiatMlon Fo�m r«elvetl antl variflatl by: ✓M F�.�CICP'SBLI\dPORMS\LOBBVISTFORMSLobbVlSfRegiS[m[ion t mRc�rsetl 09-]0-1BPCG.tlac Qd�6lEOSI20�2018 Page 3 of 5 . . .__. -,.._._ _..___ _ . ,Nllla��,llll n � . "^^— rae<.o v aeirew.�u. �^ { . uoms�y�Enveiove io�ozaoc�osoaea-aFoe-acos-newisssc�ca 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 LOBBVING EXPENDITl1RES 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 E%PENDITURE OR COMP R'NMfM<BURING THE REPORTING PERIOD.' SlgnaWreoFLobbylsP. '�'� �� Date ovioiwza I do solemnly swear or affrm that all of the foregoing fads, slalements, and disclosures in lhis(orm are �rue and correct, and Ihal I have read or am familiar wilh the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyisls" of the Miami Beach City C g71't€�(7orting requiremenls. Signalure of LobbyisF '�'� �� •a Date ovimzo2a Signa�ure of Principal'. a�r� Y�� Dale m��nnn>a aeemmnencs-- VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida County oP. Miami-Dade Counry of: Miami-Dade Swom b (or affrmed)and suhscribed beFore me, Swom to(or affrtmed)and subscribed before me, by means of� physical presence by means of O physical presence or C�online notarization, or[3online notarization, lhis_day of ninnnma . 20_, by Ihis_day of . 20_, by JJ Wood Abraham BerQman NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID _Produced ID F F (p �(Personally Kn � � �Personally Kn � SignaWre of Notary ublic�� Signature of Notary Public � - Diana Ramos Diana Ramos � Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped Olana Ramoa Diana Ramm - CommlaslonNHH38691] CommisslonNNH386911 Nolary Public-State of Flonaa Notary Publlc�S�a�e T Flontla My Commission Expires Apr i6,202] My Commissim Expiras Apr 16.202] ' The persons: - Expetl witnesses who provitle only scientifq�echnical or o�har specialized in(ortnatian or�es�imony in public mee�ings;any person who only appears as a represamaGve of a neighborhood associa�ion withau�compensa�ion or reimbursemen�for Ihe appearance,whe�her tlirec�, indirec�or conlingen[,�o ezpress support o(or opposi�ion�o any item;and any pereon who only appears as a represenGlive of - wb(or-proft communiry based organization for ihe purpose of requesling a gran�withou� special compensation or reimbursemen� (or � �heappearance. Page 4 of 5 ..-.._ _,_. _ _ .'___. - _ _.. .. p�g.�y �. ni v,�m� � ��.�,. oon. r.�v��ecar,v, �AI&7m14�� DowSign Envelope ID'.0240C105-03E4-4FD0-BCO6�A6W1569C9C4 Ciy ef Miami 9ea<h, V00 ConvenYon Cenrer Drive,Mlomt Beoch,Florida 33139,www.miamibeochll.gov Office of rhe Ciy Clerk Rofael E. Gmnada, Ciry Cle�k CityClerk@miomlbeochfLgov TeL 305.6737411, Fax� 305 6737254 NAME OF LOBBYIST: II Wood 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 lhat 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 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 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 Ihal 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 fle a Notice of Withdrawal with the Offce of lhe 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 pursuanl to Section 2-482 of the Miami Beach City Code. �.� w�� ouiaizoza B4vI8PP�9I9B1d".. = Signature of Lobbyist Date � r�,.ra�A��a�oaMy��od�Y�.,��a�,s��e..�Nde�,�a�o��ama��.oa �,,,��.ao� Page 5 of 5 ,inii . .��,.. . ..�.a..�, �.. aed o ,� usven.,.. ��1�6OM�� 'DocuSign Envelape ID�.0240C]D5-03E44FDB-BCO6-Afi9]1569QC4 EXHIBIT B 7410, LLC DISCLOSURE OFINTEREST Abraham Bergman SO% 3539 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 Charles Hoffman 50% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 � _�._...._ _.__ --_.--- ,�_�� „� ,-, .as..A� P,aa .o„ „��„�ss.FM �NE��INI � � EXHI8IT B 7410, LLC DISCLOSURE OF INTEREST Abraham Bergman 50% 3839 Flatlands Avenue, Sulte 211 Brooklyn, NY 11234 Charles Hoffman 50% 3839 Flatlands Avenue, Suite 211 Brooklyn, NY 11234 City of Niani Beach City Hall . 1700 Cmventian Center Dr. Miamt Beach , FL 33139 � 305-613-7420 Welcame � u7/02/2024 02:02PM Carmen V. ° 00'122-0025 � � MISCELLANEOUS d x Reference 1: MCR433443 � c 61 MCR OPEN (MCR) v � c 2024 Item: MCR M '� i � $700.0000 � � MCR OPEN (MCR) $700.00 O y Z N � � 1700.00 m Su6total i700.00 �Total i7oo.00 a o CHECN $350.D0 Check Numher001146 Cr1ECR $350.00 � Check Num6er001147 W F a Chanee due 50.00 � '� Paitl by: BERCOW RAOELL FERNANDEZ LARKIN & � � a w TAPANES PLLC a m 6 t � �L � `� o V � � a " a � ��V�II��I��R��N��WB��I��I��V�� o � s Q � o Z 'm m v � . O .. __. _:: :n.� ��I -� F- ,� .. 3 � W ¢ � a d I ��V �va � � O Q U O w � E �i � � � � , I I � p. n � � ❑ a N m ' � F `_ � c .. '�:��d....w..--�...._- .`. ��/ � > q 'o � z E Z � W m�_ � � m � 'o � = n p a 'n o a , � V V � a p a � � q F i' � � a LL U �2 0 � a a a � ..__—. _.____- __-. _ -- Tiif" . ��Nw�RUY ��r m` I. R{YI YII � � I � �;w� ._-� - � � �i Thank you for your paYment Cl1STOMER COPY