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Michael Llorente - Roy Donahue Peebles �, . i‘:F13 C)'°d1 .113.q<3 RECEIVED tV\IiVv\iBEACH MAR -3 2022 Office of the City Clerk 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MI�.MI BEACH . 305.673.7411 OFFICE OF TIDE CITY CLERK 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"Lobbyist"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: Llorente,Michael NAME OF LOBBYIST (Last) (First) (Middle Name) LSN Partners 801 Arthur Godfrey Rd, Suite 401, Miami Beach,FL 33140 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) michael.Ilorente©Isnpartners.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Peebles,Roy Donahue NAME OF PRINCIPAL (Last) (First) (Middle Name) 2222 Ponce De Leon Blvd.,3rd Floor, Coral Gables,FL 33134 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.993.5050 rdp3@peeblescorp.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS :ursuarit::o:,.. Olikti.Seit(oa.24t82(ii)0).(a)::::A:priricipat4Opy.,corporatio ;.par#nersM`°;er_otfiet en who appears;as:a.lobti l'st ori:b tot(of00 entity,wtthout special.compensation,or reimbursement for the appearance;whether direct,Indirect,or contingent;Ca express support.ofor apposition`to an ftem shail'rdgister unth the Clerk as iequfreby thls.subsectlonauf shall not be:requiredao pay:any regl`strationfees If 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(if none,write N/A): Lincoln Road Holdings LLC • 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): R.Donahue Peebles,Scott Robins, Philip Levine Page 1 of 5 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. hcol v► uu01. 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 Historic Preservation Board N/A X Planning Board N/A X City Commission N/A X City Staff N/A 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): N/A V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION - Be Specific. (Note that a contingency fee is prohibited pursuant to City Code Sec. 2-485.3): 74 0.15 Iotr vvv,Aitel ( p- 'w o -ctnh- prenccsc Page 2 of 5 • 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": .. Yest►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 cNo: 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 No: 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 o: If`yes:has(t been.lessi than:-12 mionths'since`.ttie°elected:offiatal(s)whom.you provided:ca• •`'mpalstn consultln as®rvlces was suyorn lfl? 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: —Yes XNo: If:ves.!were you-prornlsed'::or did vou'.receive ecoriomlc 'conslderatiow In"exchange•for campaign cofsultiitst servicai? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY• (' Annual Registration fee: [ ]Yes[tdbNo Amount Paid$3504 C' MCR# q 2 lQ ( ,J 9 Date Paid 0 gf Oti'2Z. Lobbyist Registration Form received and verlfled by: W F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Revised 03/11/2020 Page 3 of 5 VI. SIGNATURES:UNDERSOATH: • -, ON kifituArty,tg EACH.po,,EAtit,,yEAR;_, LoOsirisrsHALL.sOiiiiiit'l•b THE OFFICE eS-iiii,CITY CLERK A , . SIGNED STATEMENT:;UNDEWOATICLISTINGt.LOSEIYING-EXP4NDIVRESil-AS-7',WELLT-AS"--;COMPENSATION ,. ,RECEIVED.:FOR THE'PRECEDING:,CALENDAR YEAR.WITWREGAIWIVIVE SPECIFIC 4SSUEIONWHICH3HE. LOBBYIST,HAS BEEN ENGAGED TO':L91313Y:,,A'STATEMBIT HALL BE EVEN IF THERE.HAS BEEN NO EXPENDITURE1ORVONIPENSA ONDURINGTHE,REPORTINGPERIODA , .,..._.,_________......._ . _ . Signatureof Lobbyist: - • _ ._. _ . .__ _..... _..._ 'Date _ r?" 0- 4‘ ' 00, -,` .. . , • , * -I do solemnly swear cirOlfirMII*(#1.-:91410tfgreOlfdiatiO,stE_ItfOetitg.anddisclosures0 fhiS'i:Cfrn'aMtruiAr4"Pqrrect. Od.thiittriaife',iedd:AtiftgaahijliOiWith VitiOliiifiii0.4,!leoh!iiiied in Chapter .'kt..911, D.i'v.101Ori.3,,:0_rititliftilitAbiriStk'iif" ttia.fdiariliMeaoh„DitYtOde and a .reporting requirements. _..r ., .•, , ,,.., .: ,., it -.... . ..:,._-,....,. oe .. ,.....0.7i,...x.-... .“ , .. Signature of Lobbyist: - --:.:— .. -- .g-!. /g-‘41 1.9'9, : • ,•, .,,---... ..,., --ea...--_, •.Z.-. ......,..--,... .. Signature of Pitinaigal: - _.1_-_____ ..._ _..„.__ _ . Date.,,..._,,.2......2/.4 I 21.:,_____;„ ..„_._. . • .._.,....,_._..4,.,„.....,..s.-___--- . . .,- VI);: NOTARY SIGNATURE AND SEAL: „.. .. . , ...____. _ ..__... , . • _.. LOBBYIST:, ..,,, , PRINPPAk : . . , . gtetitivt,_:_Fk04/1.aUt -------- State of 1:4eloildot, _____-_. ..,__ .............„ .,. tilunti-of:;MiCt.VY11--r-tbd-C... County of: VI iavvvi r-Dscle. ,.... ,„.........,......„_ ,,.... ..........-4 ..1..-..J, ,n,_,e -..2 .__ „ •, _ . . . , _ . Sworn to,(or affirmed)and subscribed before me, Stkorti.to(Or Eiffi7Ed)and subscribedbefore me by means Pf.... physical presence by means o_f-erpitysioatpresente, . ,- or 0 online notarization or Ei'drilina notarization, this:,ja day of .Ctioitizter—--- . -_.,20D-iiy' this-2A day-Or_ itorOar _ . _.__. :__.. 202).1)y , ..___ ,.._.. _.. _ Mitviael _LAcliceii-C,__ 2..ponconif Peebles NAm-E:OF-LOBOYIST NAME OF PRINCIP/b, : Pigiiiitedif lb..—.._._ .___.__ .._, ___ , ,. :Produced-6 ----, - -- , —— -- . - FORM OF IDENTIFICATION FORM OF IDENTIFICATION • . 4113. , . . . ,eta holly Known . 26:ii341.nally KnOwrf yemz(ite/ . ../' .../ . • Signature of Notary Public. •--- ----" ---- Sig _ :•el:of-Notary Pti O if . I -, - , ._...:, ,. ,- ,, ,, •. -,, , , _ . .. . : _ Name Notary,Typed, Pileite:s1Oi4 stamped• Name of Notary,Typed,Printed or Stamped - • ' .., ,.. „ . (NOT •1 ......, . (NOTARY S : !' :,.._,-.:,- :7----, -- , -- tr .. v Rotewpublio!.ato,:otplood. €RINt.',NENDRIX71 • P-.1° :: COMMI80.100 0 GIG 300142 ' -. 'ilr,4401,Nt"NPOIOtetii:Of'Mei .,: . • , - , _ ''.1k,,.c,. .; _MY Comffiltiidonitigre0 • . ,,, ,,,c'ternmleiiion COG 3009e2' ;-.“,,. My Commission Expire 'The term 14, •reOns: ,L_:. 111.• _ . ,:Februse •12;2033 " ''— _ ... .._ - Expert witnesses who provide Only scientific,technical or other specialized information or testimony in OdbliOmeetings;any person who only appears as a representative of a'neighborhdod 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 lai'd representative of not-for-profit community'based organization for the purpose of requesting a grant without special compensation-or reimbursement for the appearance. Page 4 of 5 , „ . MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 • NAME OF LOBBYIST: Michael Llorente 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. 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. pl„nn uu la--a— Sign rre f Lob is Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 Miscellaneous cash Receipt CITY OF MIAMI BEACH NO,429759 ek#,. . C. 'I- PI-Ctish , PICreditCard 1;1,Che °' '°‘ $ .,444 3 -.) i1 (-).,.,,,,- - „ : 20 , z LI. (f- tf r 4 ftliiiCglaneou -MCR-2022 t-',, 1 41 (1 ''' 1 - '( ''s ' ' ir I, e-N,,,..1 (::,° .' f i Ilaria A..03/04,-.02^01 "rcrt,", , . , , ,.., , --, ,'-. , / '- 7'-" '' ' V, '''''.r , ---,?(4‘4';')41, — i r),..)'' For . s.. , , f , ,i 14',, . , •*,'' ., Payment Amount. 4.' 350 00 THIS INFORMATION MUST SE COMPLETED) , , , .. , , _ Offic.of Flnsnc by AccountNumber (5.I,.1:„.. -.,:‘„- ,,)O ,„-_,(...,' t )I el ,,,--..-.. :c-s.-- , r... -,.-- .` , , ew` *-7-2 L f t--- 4,1 ' Dept: , , . . ,,,,, c,„__,.. --,, c,^1: . . . • i •