2024 Lobbyist Registration Form - Conditional Permit (Salem Mounayyer) �n� ��-rw�w.l �e�r,: }
� - - RECEIVED
� ' Offce of the City Clerk
� 1700ConventionCenterOrive ��� 3120ZQ
Miami Beach, R 33139
305.6737411 CITY OF MI.4pol BEACH
LOBBYISTREGISTRATIONFORM �FFICLi:FTw�-��IrvCLERK
Lobbyist means all persons employetl or retainetl, whelher paid or not, by a principal who seeks lo encourage Ihe passage, tlefeat or
motliFlration of any ortlinance. resoWtion, action or tlecision of any commissioner, any action, tlecision. recommenaation of lhe City
Manager or any Ciry boartl ar commiltee; or any action,tlecision or recommendation of any Cify personnel tluring the time periotl of the
entire tlecision-making pmcess on such aclion, decision or recommendalion Ihat foreseeably will be heard or reviewed by the Ciry
Commission, or a City boartl or wmmittee. The term specificaly includes Ihe pnncipal as well as any employee engagetl in lobbying
activities. The tertn "Lob6yisf' has speci(c exdusions. Please refer to Ciry Code Chapter 2, Article VII, Division 3, entitled"Lobbyists,"
for additional information.
Instructions: Please complete all sec�ions of Ihis fortn and submit ihe completetl form,with ihe applicable fee, to�he Offce of the Ciry
Clerk. If you neetl more space to complele an answer, use a separate sheet(s) of papec If you have no�hing �o report in a particular
section, you must write "none" or "n/a" in that section. Any change to any infortnation originally fled, or any atltlitional City
Commissioner or personnel who are also sought to be lobbied shall require that the IobCyisl file an amentlment to Ihe registration fortn.
The lobbyist has a continuing dury ro supply information antl amentl the forms filetl throughout Ihe period Ihat the lobbying occurs.
Separate registration forms shall be requiretl for each principal represented on each specifc issue.
I. LOBBYIST INFORMATION:
de la Fuente Bob (Domingo) de la Fuente
NAME OF LOBBYIST (Las�) (Flrst) (Mltltlle Name)
Lehtinen Schultz PLLC, 1200 Brickell Avenue, Suite 507 Miami FL 33131
LOBBVISTBUSWESSNAMEANDA�ORE55 (NumberantlStreep (Gry) (State) (ZipCodej
305.760.8540 BdelaFuente@Lehtinen-Schultz.com
LOBBYISTBUSINESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS
II. PRINCIPAL INFORMATION:
Maunayyer Salem
NAME OF PRINCIPAL (�ae�� (Flrs�) (Mitltlle Name)
1350 Collins Owner LLC. �q00 Broadway, 15th Floor NYC NY 10018
PRWqPAL9U51NESSNAMEANDAD�RE9S (NumberantlSireep (CiYy) (State) (ZipCoee)
305.760.6540 salem@jordache.com
PRINQPALBOSMESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS
Pursuant to Ciry Cotle Sedion 2<82(h)(1)(a): A pnncipal of any mrporation, paMership, or o@er enttly wfio appears as a lo�byist on be�alf of[M1at
entiry,without special compensation or reimbursemertl for ihe apDearance,whe�her tlirecp intlirect,or conGngen�.�o express suppotl of or opposi�ion�o
an item s�all register wiN ihe Clerk as requimtl by Ihis subsection bW shall not�e reqWreO to pay any regisVation fees.
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 OFFICER,PARTNER,OR BENEFICIARY(it none,write NIA�: NIA
• NAME OF ALL PERSONS HOLDING,DIRECTLV OR INDIRECTLV,A 5%OR MORE OWNERSNIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A�:SEE ATTACHED
Nakash 1350 Collins LLC 45% V 8 E 7350 Collins LLC 45% Ginqer 7350 Collins LLC 7%
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III. ISSUE TO BE LOBBIED:
� Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Conditional Use Permit
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
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 Contrac[ual Relationship (If yes, explain) �ES NO
Title of Person[o be Lobbietl
Planning Department x
Planning Board x
Pursuant to City Code Section 2-462�g), every registrant 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 registration form filed.
List any Business, Financial, Familial or Professional Relationship, or other relationship 9iving rise to an
a earance of im ro rie if none,write N/A :
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-085.3):
$550lhour
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The following six(6)questions MUST be answered:
' 1) Pursuant to Ciry Code Section 2d88,en�itled"Prohibited Campaign Coniributions By Lobbyisis On Pmwrement Issues":
YesX No: Are vou lobbvina on a oresent or oendina bid for aoods. eauioment or services, ar an a oresent or
oendina award tor aoods.eauioment or service7
2) Pursuant to Cily Cotle Section 2-090, entilled"Prohibited Campaign Contnbutions By Lobbyists On Real Estate Development
Issues"'.
_Ves XNo: Are vou lobbvina on a cendina aoolicatlon for a Develooment Aareement with the CiN or aoolitation
for chanae of zonina mao desianatian or chanae to the CiN's Future Land llse Mao7
3) Pursuant to Ciry Code Section 2-482(h�, any pereon (except those exempt hom the tlefinition of "IobbyisY' as set forth in
Section 2-081)who only appears as a representative of a not-for-pmft coryoration or en�ity without special compensalion or
reimbursement for lhe appearance,whether direct or indirect to express support of or opposition ro any item, shall registerwith
lhe city cierk as required by this section.but shall not be required to pay any registration fees.
_Ves�No: Are vou reoresentina a not-tor-orafit corooration or entitv without soetial comoensation or
raimbursement7
4) Pursuant lo City Cotle Section 2<8'I, lhe term "IobbyisT' speci(ically exclutles Ihe following persons'. Expert witnesses who
provide only scientifq lechnical or other specializetl infortnation or testimony in public meetings; any person who onty appears
as a representative of a neighborhood associa�ion wi�houl compensation or reimbursemenl for the appearance,whether direct,
indirect or contingent, m express support of or opposition to any item; and any person who only appears as a representative of
not-for-proft community basetl organization for the purpose of requesting a gren� without special compensation or
reimbursement for the appearance.
_Ves�No: Are vou orovitlina onlv scientific. technical or other soeeialized in(ormation: aooearina as a
reoresentative of a neiahborhood association without soecial comoensalion ar raim6ursemenl or
reoresenlino a not-for-orofit based ornanization for Ne ouroose of reauestina a annl without
soecial comoensation or reimbursement9
5) Pursuant to Ciry Code Section 2-097�7�, no campaign consultant shall lobby the Ciry Commission for a periotl of 12 months
following the swearing in of any electetl official(s) Por whom Ihe campaign consultant providetl campaign consulting services
within the past eleclion cyde. See Section 2-49� for more information.
_Ves�No: Have vou orovided camoaian consultina services la an incumbenl member ot the CiN Commission
w'[h'n[he oast elecCon cvcle?If ves olease I'st lhe incumbent memberls)of[he CiN Commission:
Ves No: If ves has 't bean less than 12 monihs since the electetl officiallsl whom vou orovitletl camoai4n
consultina services was sworn in9
6) Pursuant to City Cotle Section 2d82�a�(4�a., a lobbyist who has within the past election cycle pmvided campaign consWting
services to an incumbent member of the Ciry Commission (which lobbying activiry is nol otherwise prohibited by Code section
2-091) shall disclose such particular service on his/her lobbyis� registration fortn antl shall oralN d�sclose such oarticular
service before lobbvino[he CiN Commission at a oublic mee�ina.
_Ves�lo: Have vou orov'tletl camoa'an consukina services to an ineumbent member o(the CiN Commission
'lh' [h t I f le7 It es DI6a5 f [[� ' b t beHsl of Iha CN C
Yes No: If ves were vou orom'setl or dtl vou reca'va economic eonsiEeration in azchanae for camoaion
eonsultina services?
GG' �•�� � � TO BE LOMPLETED BY CITV CLERK'S STAFF ONLY
� �
Annuel Registralion fee: [`�]Yes� ]No Amoun[Paitl������� MCR% /33S'o8 Oata Paitl 3� �
Labbyisl Ragistration Fo�m recelvetl antl veAOetl by: U/"�
i:\CLER\fRLL\dFORMS\LOBBYISTFORMS��obbyi4Heqistrd[iOOFO�TN¢VIS¢tl03d1QOREG.Em Revisetl03/11/]020
Page 3 0(5
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. VI. SIGNATURES UNDER OATH:
ON FEBRl1ARY 28 OF EACH YEAR. EACH LOBBVIST 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 CALEN�AR YEAR WITH REGARD TO THE SPECIiIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL 9E FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENS ION URING THE REPORTING PERIOD.'
SignaNre of Lobbyist: Date �" l 3� f�Z'9
I do solemnly swear or affrm that all of the toregoing tacts tatements, and Oiscbsures in this form are true and correct,
and that I have read or am familiar with the provisions co ined in Chapter 2, Art. VII, Oivision 3, entitled "Lobbyists" of
the Miami Beach Ciry Code and�qreporting requirements.
Slgnature of Lobbyist: � Date � �� � 2 1.��..
Signature oi PrincipaC Date�5.142024
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
stateof �O���L Stateof ��U (�� U r
cou�ryot N11GiVti�� "�r((' co��ryor: l��QV✓�i �G(I-P
Swom to (or affrmed)and subscribed before me, Sworn to(or affi�r ed) and subscribed before me,
by means of�hysical presence 6y means of Colphysical presence
or 0 online notarization or O online notarization,
this�day of ✓I 20_, by this f1 day of l�`� U�20�by
Bob de la Fuente S�ll�yv� �(/i/y����,�
NAME OF LOBBYIST NHME OF PRINCIPHL
_Producetl ID _Producetl ID
Fo F ioEr�riFicnrior� FoaM oF ioENnFicnTio�u
JPerson Kn ✓ Pefsonally Known
L�'�
�
Signature o tary u ic Signature of Nolary Public
�. y� r AVVI�I �IU�`(�i(�
Name of Notary, Typed, Pri ted o e of Notary, Typed, Printed or Stamped
,.�,p.,,, SOFIA M. CAMPO
(NOTAftY SEAL) /J\ Notery Pubfic5tete o�Flor� ARY SEAL) ;
����J ` Commieaion �HH PH12Y4 „d'J4���.,, AMBER PINEIRO
','r`IIW� M Commisalon Ex0lrea 'P �Notary Publlo-5iete oi Fia�in,l%
, �'R4,'.�� SeDtember 10, 2028 ?���` CoV mission M HH 4bG212 I:.
M Commisslon Explres
' The term"lobbyisf'specifwlly ext�)IIES wing persons'. Jenuary 2a, 2028
Expert witnesses who provitle only scientifiq technical or other specializetl information ar testimony in public meetings'.. any person who
only appears as a represenfative of a neighbarhootl association without compensation or reimbursement for the appearance, whether
direct, indired or contingent, ro express support of or opposition to any item: and any person who only appears as a representative of
no4for-pmft community based organization for the purpose ot requesting a grant without special compensation or reimbursement for
the appearance.
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Ciy d Miami Yaah, V00 Convention Cenror Drive,Mioml Beoch,Fbndo 33139,www.mlomt6eochH.gov
Office of Ihe Ciry Cled
Rofoel E. Granado. Ciry Clerk CiryClerk�mlomibeachfl.go�
Tel�. 305 6737411, Fax: 305.6737254
NAME OF L08BYIST: Bob de la Fuente
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2�85(d), the City Clerk shall notify any lobbyist (or
principal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In adtlition to any other penalties that may be imposed as provided in
Section 2�85.1, a fine of $50.00 a day shall be assessed for Statements filed after the
due date. The City Clerk shall notiry 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
automaticalty 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 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 file 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 OMober 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2�82 ot the Miami Beach City Code.
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gnature of Lobbyist Date
FICIFA3NLHFC(bISY.C9pY6TGIXULSIL4pyYpppbi}�Fmnppytl 0-11-]OREfr.Js
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