2024 Lobbyist Registration Form - Lot Split for Lagorce Circle (Anand V. Khubani) lo� 5�1; � s,o�
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RECEIVED
� � ��t�. `''`�'' � � orr�ce or me cay cie�k JUL 2 9 2024
1700 Convention Center Drive
Miami Beach, FL 33139
3o5.6�a.�aii CITY OF MIAMI BEACH
LOBBVIST REGISTRATION FORM OFFlCE OF THE CIN CLEqK
Lobbyis� means all persons employed or relainetl. wM1e�her paitl o�not by a pnncipal who seeks to enwurage�he passage. tlefea�or
moQRiwiion of any ortlmance resolution. aqion or deasion of any commissioner: any adion. decisioq recommentlation of �he City
Manager or any Qty board or commiflee�, or any aclion tlecision or.ecommendation of any Gity personnel during�he�ime perio0 o(�he
entire tleasiommaking pmcess on such action. decision or recommentla�ion that foreseeably will be hearC or reviewztl by the City
Cammission, or a City boartl or comminee The�erm specificalty ��ncludes Ne pnncipal as well as any employee engagetl m IoObpng
ac�rvities The term"LobOyis( has soecific ezclusions. Please reter m CitV Cotle Ghapter 2. A�ick VII. Drvision 3, en�itletl "Lob�yisls,
�or atlditional Information.
InsVuctlons: Please complete all seqions of thls form antl su�mit the comple[etl lorm, wi[h the appl¢a�le fee, to t�e OHice o/I�e Ciry
Clerk I�you neetl more s0ace to complete an answer. use a separate sheet(s) of paper. If you �ave no�Nng ta repo� In a particula�
sec�ion. you musl wrile "none' or "nla' m that section. Any change to any mfartnation originaly filed. ar any aGtli�ional Ci�y
Commissioner or personnel who are also soughl to be labbietl shall require�hat�he labbyis�file an amenEment to�he registration form.
The lobbyisl has a cantinumg tlury ta supply Informatian antl amend ihe forms filetl t�mughout ihe period that fie IoObying occurs.
Separale regis�rehon fortns shall be reqmred for eac�pnncipal representetl on each specific issue
I. LOBBYIST INFORMATION:
Alexande�l.Tachmes
NAME OF LOBBTIST (Las�) (Flrsq (MI�OIe Name7
Shutts 8 Bowen LLP 200 S Biscayne Boulevard Suite 4100 Miami Florida 33131
LOBBVIST BUSMESS NAME ANOAOORESS (Number eM 91reet) (Giryl (5�ale) (ZID Coael
305347-7341 atachmes@shutts mm
�ABBVIST6USINESSTELEPHONENUMBER CEILULARTELEPMONENUMBER EMAILADDRESS
II. PRINCIPAL INFORMATION:
Anand V. Khubani
NAMEOFPRWQPAL I�st) IFrst7 (Mi4tlleNeme)
18 La Gorce LLC 584 Van eeuren Roatl Morrisrown. NJ 07960
PRINCIPALBUSWESSNAMEAN�AODRESS (Numbe�anGSVeep (Clry) (S�a1e) (ZipCotle)
^ 973-865-3492 andy@ideavillage.com
{'RINCIPAL6USINESSTELEPHONENUMBER CELLULARTELEPHONENl1MBER EMFILAOD(iESS
Pursuanl to Glry GOtle Secllon 2<ffi(b)(�)(a)�. A prinolpal of erry corporailon_pa�rers�lp. or o1M1er antity uMo app6ers as a Io00yist on be�elf of�hat
en�iry.wilM1oul spxial compensa�ion or reimbursemen�fo��he appea�ance.wTel�e�tli�ed.Intllrec[.o�confngenL ro express suOPoh of or opposi�ion to
an i�em Shall�egls�et wi�h Ihe Q¢tk as�e0uve4 Oy��is subsecllan OW shall nol be reQUVe010 pay am/registra�ion fees
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-082(c�:
• NAME OF CMIEF OFFICER,PARTNER,OR BENEFIpARV(i!none,write NIA�: Anand V. Khubani antl Neeta A. Khubani
. NAME OF ALL PERSONS HOL�ING,�IRECTLY Oft INDIRECTLY,A 5°/a OR MORE OWNERSHIP INTEREST IN SUCH
CORPOftATION,PARTNERSHIP OR TRUST(if none,write NIA�:
Anand V. Khubani (50%) and Neeta A. Khubani (50%)
Page 1 of 5
�
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific tlescrip[ion where
applicable of a pending request for proposal, invita[ion to bid, or public hearing number.
Lot split applications for 16, 18, 22 & 24 La Gorce Circle and related matters.
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a�(4J, list the Ci[y Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said Ci[y Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, s[ating the general naWre of the subject contrectual rela[ionship.
Full Name of Intlividual and � Contrectual Relationship Qf yes,explain) VES NO l'
Title of Person to be Lobbietl
City of Miami Beach Committees and Boards X
City of Miami Beach Attorneys Offce and Administration X
City of Miami Beach Mayor and Commissioners X
Pursuant to City Code Section 2-482(g), every registrant shall be required to s[ate [he ex[ent 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 sought to
be lobhied as identified on the lobbyist registration form filed.
List any Business, Financial, Familial or Professionel Relationship, or other relationship giving rise to an i
a earonce of im m rie if none,write NIA : _
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-065.3):
$835.00 per hour _ _, _
Page 2 of 5
The following aix(6�Questions MUST be anawered:
17 Pursuant to Ciry Code Section 2i98 entilletl"PmMbRed Campaign Conlributions By Lobbyists On Prowremenl Issues"�.
Ves�✓}lo: A I bb ' t d b'd t tl [ r erv"res o�on a oresenl or
d' af a torservicet
2� Pursuant�o City Gode Section 2J90. en�itled "Pro�lbi�etl Cempaign ConUibulions By Lobbyists On Real Es�ate Developmenl
Issues".
_Yes�lo: A I bE ' P d Df C t Oe I t A r ement w'[�Ne C'N or aoolicalion
( h A f p C ti h t M G'N' F Nre Land Use Mao7
3) PursuaN to Ciry Cade Sec�ion 3483�h�, any person (except Nose exempt hom �he tlefinl0on of 'lobbyisl" as set (oeh in
Section 2-481)who only appea5 as a representatrve of a nob/or-pro(it coryoration ar entity wit�oW special compensa[ion or
reimbursemenl for t�e appearence,whe�her direct or intlirect to express support ot or opposition b any item. shall regis�erwith
�he city clerk as reqwred by ihis sec�ion.but shall not be requlretl�o pay any registration fees.
_VesQlo: A C t f f� C t'N 'th t ' 1 enaaCon or
reimbursementt
4) Pursuant to Clty Gotle Section ]181, t�e �ertn "Iob�yisC' speci(cally eecluEes Ne Pollowing persans Expert witnesses wM10
pmvi�e anly scien�i(c, lechnical or other specialixeC informa0on or tes�imony in public meetings.any person who only appears
as a represen�a�ive o(a neignborhaatl association without compensabon or reimbursemeN Por�he appearance,wneNer tlirec[.
intlireq or con�ingent to express suppart of or opposilion to any i�em.and any peroon who ony appears as a represenlative of
no6(or-pro(t communiry basetl orgamzalion for the puryou of requesbng a grant wilhout speaal compensation o�
reimbursement for the appearance.
_Yes�lo: A 'd' I �f t h ' I th ' I' A "nfortna[Ian' aooearina as a
o �p f ' hb � tl ' C th t 'al com al'on or reimbursement or
p t' tt ft b tl C f ih f C a rant wlMout
50 ' I nsationorreimbursemen�?
51 PursuaN fo Ciry Cotle Section Y>91�t�. no campaign consW[an�shall lobby�he Qty Commisson br a penotl of 12 months
followinq iha swearing in of any elected official(57 for whom t�e campaign consW[ant pmvidetl campaign wnsultmg services
within i�he p'ast election qcle. See Section b491 for more informa�ion
VeaLrvo: H 'd tl I[' t b � mber af ihe C'lv Commiasion
lh' t� t I f I 71f I I' tN ' b [ b rlslo([heC'HGommissmn:
YesE]Jo: � h 't G 1 th tY th th I t tl HI ' 11 1 whom wu orov'tlatl camoaian
consullina services was sworn in7
6) Pursuant ro Clty Code Section 3dB1�a��C�a. a lob�yist who M1as wiNin the past election cycle pmvided campaign consulting
� services to an Incumben[member of Ihe City Commission !which IobGying activity is not otheiwise prohibiletl by Cade section
2-491) shall dlsclose such part:cular service on hislher IobEyist regisVa[ion fortn tl h II rall tl�sclose such oa�icular
b f I bb [� C�� C t bl� eetn .
_Yes�o: N �a a If [ b t m mber o�Me CN Commiasion
't�' th t I C I If I I' t ih " b [ E d 1 f N CN C mm'ss on'
Yes�No: If ' d d'tl 'tl C n 'n exchanae for camoaian
consultino services?
� s � �'S �3T0 BE COMPLETEO BV QTT 0.E0.R'S STAFF`O''N�LY ��/
Ann alReplal [onNe [�Ves� ]No AmounlPald��/�� MCRt�� /�� oamvaia � ��/
LOCEyIstRapaVa[IonFo�mreuivetlanOverNlatlby �l-1
Revixetl 03/11/3030
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBeYIST SHALL SUBMIT TO THE OFFICE OF 7HE CITY CLERK A
SIGNED STATEMENT UNDER OATH. LISTING LOBBYING ExPENDITURES. AS WELL AS COMPENSATION
RECEIVED. FOR THE PRECEDING CALENDAR VEAR 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 COMP S TION DU ING T ORTING PERIOD.'
Slgnature of Lobbylst �-- Date � ��� � ��
I do solemnly swear or affrm that all of the foregoing facts, sta(ements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Di�ision 3, eptitled "Lobbyists" of
the Miami Beach City Cod�and all� � g r ents. � ?3 ir� �%
/1(1 .
Signature of Lobbyist: I�A���v\ �. Dale
Signature of Principal�. Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYI�: PRINCIPAL
State of �� State of
CountyoP. I�1�lA� Il�'� Countyof:
Swom to(or aHi etl) and subscribed before me, Sworn to(or affrmed)and subscribed before me,
by means of physical presence by means ot O physical presence
or 0 o I' e notarizatio or O online no[arization,
this day f 2�, by this day of 20_, by
`� �
NAME OF LOBBVIST NAME OF PRINCIPAL
_Prpduced ID _Produced ID
iFORM OF IDENTIFICATION FORM OF IOENTIFICATION
V Pers ly Kn _Personally Known
Sig ure f Nota Public Signa�ure of Nolary Public
ame of Notary,Typed, Printed or tamped Name of Notary, Typetl, Prinled or Stamped
(NOTARY SEAL) �""�"+3u�: SUS,W C.IAACEf OTARY SEAy
::� MY COMMISSION M HH 18tEW
.: F.%PNiES:FabuuY17�107E
'The term"lobbyist"speci(call i o wi g persons:
Expeh witnesus who pmvide only scientifq technical or other specialized information or testimony in public meetings; any person who
only appears as a representalive of a neighborhood association without compensation or reimbursement /or the appearance, whether
tlired, intlireIX or conlingent, to express support o(or opposition to any item; and any pereon who only appears as a representative of
nob�or-pro(t wmmuniry based organization for the purpose of requesting a grent wilhout special compensation or reimbursement �or
lhe apPearance.
Page 4 of 5
I
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR FACH L08BVIST SHALL 5UBMIT TO THE OFFILE OF THE CITV CLERK A
��'NED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
REGEIVED FOR THE PRECEDING CALENOAR YEAR 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
E%PENDITURE OR COMP TION DU NG R71NG PERIOD. � � 23 I ��
SignaWreofLobbyisc Dete k
I tlo solemnly swear or affirm Ihat all of the foregoing facls, statements, and disclosures in tl�is iortn are true and corracl
and iha� I have read or am tamilier wHh the provisions containeE in C�apter 2, Art. VII, D isian 3, e tiHetl "Lobbyists' of
the Miami Beac�City C antl all repo ' t ien�s
Signature of Lobbylst � Dale � ��3 �� �
'�` �-d3- a
Sigreture of PnricipaP. Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: 1 � PRINCIPAL
`�{�i Q.(}i Stare of � Q.\.l� SQSSC-V
Stale o(�_,
]�� PCaSS C�. L
�a��ry o� M�r�rn� �ut, caunty ot
Svrom to(or aRi[r�ied)antl subsaibcb befwe me. Swom lo(ar aK¢meE)and subscnbeE behre me,
by means of�Dhysical presence by means of�physical presente
or❑ I' e notanzatio or�online nolar¢ation,
this day f Z�.by t�is�tlay of�ZQ�bY
�. rnP� A�v„„t h�ha�,
N OFLOBBVISt NNAEOFPRINCIPAL
PrpUuced ID _ProtluceC 10
—/ FORMOFIOENTIFlCNTION � FORMOFIDEMIFlCATION
/
(�Pere ly Kn J`��Personally Known
\ �� L� � � G�-Cr% _
Sig ure ( ot Public ignetufeotNotary ublic
r1r� �1Z1 1l�lG-�1]
ma of Nolary,Typed,Pnntetl or amped Nama o Notary,Typed, Printad or S[ampetl
(NOTARV SEAL) �7("�'"i'n,_ gU9NIC,EUCEf OTARV SEAL)
MY Gp.W ISSpN t HH1lNM nNITa MnREC
F� � FY➢pE3:FMiryfl,]01! �voteryv�Elic.Staveo��iew:ersey
. _ �%^g' My Commissim ExpPes May 1,303G
'The lertn"labbylsf'spedflcall �
E�part witnesses w�o pmvide ony stien�ifi4 technical or ot�ar speciel¢e0 inbrtnation or testimony a puGlic meetinga any penon who
anty appears as a reD/esentative of a neighboihaatl associalion v.+t�oN compensa�ion or reimEursemeni kr tAe appearance, whetM1er
Eiretl, intlirect or conAngent. to evpress suppotl ol or opposttion lo any item;antl any person who onty appean as a 20�asentaUve ol
mhfor-0�oft community basetl or9anixation for Ihe purpose of�ep�esling a grant w�thaut speaal compensallan or re�mEurxment for
IM1e appearance.
Page 4 of 5
� � � R � ,n r !--�
Ciy of Miami Beaah, 1]OC Co��e��lo�Ce��er Dri�e,Mloml Beach, Florida 33139,wwwmlamibeachfl.go�
Offlce of ihe Cay Clerk
Rofoel E. Gmnodo. Cly Clerk GtyCle�k�miam�ibeachN.gov
Tel�. 305.6�3 7411, Fox�. 305.6737254
NAME OF LOBBYIST: Alexander I. 7achmes
1) IOBBYIST 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 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
automatically suspended from lobbying until all fines 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 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 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.
� o ,�m�� ,n�a�- � �? 2
Si ature of Lobbyist^ Date
F�G1E0.�5PLLAeF➢RMSLLOB�YISi FpPM5LLo�0y�a ReguuaAm Goim RpvqeO 0}t�_20 P W tloc
Page 5 of 5
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