Oscar Vanegas - FG 801 Arthur Godfrey Owner, LLC 113 ill S'Ir'e4,4
DocuSign Envelope ID:A943B2F8-E507-4969-938C-9F76F1E3036C
RECEIVED
fv\I.AMI BEACH Office of the City Clerk MAP 2022
1700 Convention Center Drive
Miami Beach, FL 33139 MIAMI
• 305.673.7411 OFFICE op TH v"D CAOPP
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or
modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City
Manager or any City board or committee;or any action, decision or recommendation of any City personnel during the time period of the
entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the. City
commission, or a City board or committee. The term specifically includes the principal as well as any employee engaged in lobbying
activities. The term"Lobbyists"has specific exclusions. Please refer to City Code Chapter 2,Article VII, Division 3, entitled "Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Vanegas Oscar
NAME OF LOBBYIST (Last) (First) (Middle Name)
OTJ Architects 169 East Flagler Street,Suite 727 Miami Florida 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-598-7260 vanegas@otj.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Sanders* Mark
NAME OF PRINCIPAL (Last (First) (Middle Name)
*Authorized Signatory of FG 801 Arthur Godfrey Owner LLC
FG 801 Arthur Godfrey Owner,LLC 47 NE 36 Street Miami Florida 33137
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-938-4321 msanders@fifteengroup.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
▪ PursTuant to ei y ec de Section 2 '"82(fl'( ) principa CUM corpora'on part ership,(Tr other entity dip EVE:2313 t73 t7 lot oyiet Cp beh.I of that
,c specialcompensationOP appearanceIt ,ar 9 d arcail 11
emit a a a - - for nQ`'D- di a-, a o eontin ent,Q7 +.o a a a o 0 0 0 0
▪ an Item tall r-qis er with le Ole as required by his subsection but shall not,e requnred to aay an registration fees:
N
• If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
• pursuant to City.Code Section 2-482(c):
N • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): M.Sanders as authorized signatory
• NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): Please see the attached.
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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.
Development Approvals &Planning Issues,including but not limited to the Historic Preservation Board,
Design Review Board,Planning Board,Board of Adjustment, Land Use Development,City Commission,
and any City Workshops or Committees,if necessary,relating to the property located at 801 W 41
Street 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 general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship (If yes, explain) YES NO
Title of Person to be Lobbied
Staff for the Planning&Building Department None X
Public Works &City Administration, PB,HPB,BOA None X
DRB,City Commission, and Mayor as necessary None X
Land Use &Sustainability Committee None X
Pursuant to City Code Section 2-482(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
appearance 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 giving rise to an
appearance of impropriety(if none,write N/A):
None
0
N
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION - Be Specific. (Note that a
coal
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
220
$ .00 per hour
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The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
_Yes x No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or
pending award for goods,equipment or service?
2) Pursuant to City Code Section 2-490, entitled 'Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
_Yes x No: Are you lobbying on a pending application for a Development Agreement with the City or application
for change of zoning map designation or change to the City's Future Land Use Map?
3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in
Section 2-481)who only appears as a representative of a not-for-profit corporation or entity without special compensation or
reimbursement for the appearance,whether direct or indirect to express support of or opposition to any item,shall register with
the city clerk as required by this section,but shall not be required to pay any registration fees.
_Yes xNo: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement?
4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific,technical or other specialized information or testimony in public meetings; any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
_Yes XNo: Are you providing only scientific, technical or other specialized information; appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant,to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services
within the past election cycle. See Section 2-491 for more information.
_Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
_Yes XNo: If yes, has it be n less than 12 months since the elected official(s) whom you provided campaign
consulting services was sworn inf.
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
_Yes xNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
0
O
Q _Yes XNo: I yes, were you promised or did you receive economic consideration in a change for c•mpaiq
consulting senyicesr
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TO BE COMPLETED BY CITY CLERK'S STAFF ONLY� 7
Annual Registration fee: [pi Yes[ `1 No Amount Paid$ U 50'POMCR# ! 7-1 1 S� Date Paid -0 -G Z
LL VV Lobbyist Registration Form received and verified by:,
Fe\CLER\$ALL\aFORMS\'LOBBYIST FORMS\'lobbyist Registration'Form Revised 09-20-18 REG.doc Revised 09/20/2018
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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 COMPENSActOMOURING THE REPORTING PERIOD.1
O4c4,t.
Signature of Lobbyist: • 65223CD5n5r54D Date 02/25/2022
I do solemnly swear or affirm that all of the foregoing facts, statements, 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, Division.3, entitled "Lobbyists" of
the Miami Beach City Code arrchaticr@putting requirements.
Signature of Lobbyist: Date 02/25/2022
g y -85223CB5A5F54D8...
Signature of Principal: Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: Miami-Dade County of: Miami-Dade
Sworn to (or affirmed)and subscribed before me, Sworn to (or affirmed)and subscribed before me,
by means of❑ physical presence by means of 0 physical presence
or❑Yonline notarization, or 0 online notarization,
this 25 day of February ,2022, by this_day of February ,2022, by
Oscar Vanegas Mark Sanders*
NAME OF LOBBYIST NAME OF PRINCIPAL
*Authorized Signatory of FG 801 Arthur Godfrey Owner LLC
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
X Personally Personally Known
Signature of Notary Public Signature of Notary Public
Diana Ramos
N Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
03 Diana Ramos (NOTARY SEAL)
Commission#GG 308355
Notary Public-State of Florida
U Igy Commission Expires Apr 10,2023
• 1 The frg persons:
• Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who
• only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether
A direct, indirect or contingent,to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
03
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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 COMPENSATION DURING THE REPORTING PERIOD.'
Signature of Lobbyist: Date
•
I do solemnlyswear or affirm that all of the foregoi facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the pro ' ions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all reporting r irements.
Signature of.Lobbyist: Date
Signature of Principal: * Date OZ 08 22
*Autho ' ignatory of FG 801 Arthur Godfrey Owner LL
• VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of ' Florida
County of: Miami-Dade County of: Miami-Dade
Sworn to(or affirmed)and subscribed before me, , Sworn to(or affymed)and subscribed before me,
by means of 0 physical presence by means of If physical presence
or 0 online notarization, or 0 online notarization,
this ' day of February ,2022, by, this t5 day of February , 2022, by
Oscar Vane as Mark Sanders*
NAME OF LOBBYISM NAME OF PRINCIPAL
*Authorized Signatory of FG 801 Arthur Godfrey Owner LLC
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
X Personally Known Y Per ally Known
Signature of Notary Public Si na e o NotaryPublic
Diana Ramos Gt, an 1/
Name of Notary, Typed, Printed or Stamped N me of Notary, Typed,Printed or Stamped
(NOTARY SEAL) (NOTARY SEA +/010 Notary Public Stated Florida
Marcus Wander
4My Commission GG 950909
"eawf Empires 01f2612024
1'The term"lobbyist"specifically excludes the following persons:
Expert witnesses who provide only scientific,technical'or other specialized information or testimony in public meetings;any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
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DocuSign Envelope ID:A943B2F8-E507-4969-938C-9F76F1E3036C
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E. Granath:), City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: Oscar Vanegas
•
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 Statement or pay the
assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th 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 file a Notice of Withdrawal with the Office of the City Clerk.
O
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.
DocuSigned by:
02/25/2022
o.,223CD5A rs4D6...
Signature of Lobbyist Date
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F:ICLER\$ALL1aFORMS\LOBBYIST FORMSLLobbyist Registration Form Revised 03-11-20 REG.doc
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DocuSign Envelope ID:A943B2F8-E507-4969-938C-9F76F1E3036C Exhibit B
Disclosure of Interest
Interests in FG 801 Arthur Godfrey Owner LLC
Percentage of Interest
FG 801 Arthur Godfrey JV LLC 100%
47 NE 36th Street—2"d Floor
Miami FL 33137
Interests in FG 801 Arthur Godfrey JV LLC
Percentage of Interest
FG 801 Arthur Godfrey Investors LLC 100%
47 NE 36th Street—2nd Floor
Miami FL 33137
Interests in FG 801 Arthur Godfrey Investors LLC
Percentage of Interest
Mark Sanders 48.75%
Ian Sanders 48.75%
Justin Toal 2.5%
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