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Liana M. Kozlowski - EBJ Sagamore, LLC J RECEIVED c l i t/s AAI Am I .BEAcH Office of the City Clerk MAY 19 2022 1700 Convention Center Drive CITY OF Miami Beach, FL 33139 OFFICE MIAMI BEACH 305.673.7411 l-E 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: Kozlowski Liana M. NAME OF LOBBYIST (Last) (First) (Middle Name) Bilzin Sumberg, 1450 Brickell Avenue, Suite 2300, Miami, FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-2415 305-323-2685 lozlowski@bilzin.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Granda Javier A. NAME OF PRINCIPAL (Last) (First) (Middle Name) EBJ Sagamore, LLC, 10295 Collins Avenue - 2nd Floor, Bal Harbour, FL 33154 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-728-8240 javier@lionstone.net PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS "ursuant m Chi`jj mode Section 2-482(h)(1)(a):b . i •.I cflas9 corporation, partnership,CIF 0:137GAZ cap Fi 030 lobbyist E11 1:r110Fc2tha 3LI ,without co ensationtgtAaluf«maYauraoft orQb �t 1traL , direct,indirect, contingent,lb express sup.ortCQ o•positi•n n 1113'lu d>0D re.ister c2E1 tie @I=53 re.uired b tinfbanagEin17vfIF lin In required lt]pa an l) 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): Javier A. Granda • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): Please see attached Page 1 of 5 Scan E t:`` #9469389 lay 2 5 2027 J� 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. 1 Lincoln Road Redevelopment of Site before City Boards 1669 Collins Redevelopment of Site before City Boards 1671 Collins Redevelopment of Site before City Boards Negotiate a development agreement and possible code amendments with the City regarding Lincoln Road improvements and project development 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 of 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 Board of Adjustment, Dept. of Public Works x Historic Preservation Board x City Commissioners and Mayor x " City Manager, City Attorney x Planning Board, Design Review Board x Building Department, Planning Department 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): $660 per hour 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": _Yes XNo: 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 XNo: 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: YesX No: f yes, has it been less than 12 months since the elected official(s) whom you provided campaiq ,consulting services was sworn in?4 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 yes, were you promised or did you receive economic consideration in exchange for campaign co s I'tingTservices TO BE COMPLETED BY CITY CLERK'S S TT A�fFF ONLY Annual'Registration fee: [ ]Yes[lallo Amount Paid$' ©' MCR# "L V� Date Paid Os 2-Ai �' Lobbyist Registration Form receivedand verified by: 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 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 COMPENSATI•N DURING THE REPORTING PERIOD.' Signature of Lobbyist: r �/2.2. Date 5 / aM. Koz s 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 and a reporting r q 'reme; ts. • Signature of Lobbyist: r Date 5/i g/1.2. n zlo ki Signature of Principal: Date SI 12l22 r . Granda,VP and General Counsel VII. NOTARY SI ATURE AND SEAL: LOBBYIST: PRINCIPAL State of F\`OY'% do. State of Fltia1Q A County of: k1.6.VV4 . a County of: M11%Nl\- 111416 Sworn to(or a Firmed)and subscribed.before me, Sworn to(or affirmed)and subscribed before me, by means of- hysical presence by means of 13fphysical presence or 0 onli tie notarizatio , or 0 online notarization, this tZday of CLija-- .2O—by this l a day of M p. ,20 V , by NAME OF LOBBYIST Liana M. Kozlowski NAME OF PRINCIPAL Javier A. Granda,VP and General Counsel _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION er -Known 17 )(Personallyy Known 1. L--____.---- 0 Li.cil Signature of NotaryPublic Signature of Notary Public Li V\eS ot4VeYrS LuIS Mel' Name of Notary, Typed rjpted or Stamped Name of Notary, Typed, Printed or Stamped io,:::..: INES BERNAL (NOTARY SEAL) * -,(.2.)-2 * Commiulon#HH228883 (NOTARY SEAL) a��Y!?6 LuiS Adolfo Mafia +'.ofa/ Expires February15.2026 °�'ANA, Comm.:HH184366 4.. • Expires:Oct.10,2025 'The term"lobbyist"specifically excludes the following persons: �,,,°;, % Notary Public.State of Florida 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. Page 4 of 5 MI.AM I B-EACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachA.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: Liana M. Kozlowski • 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. 5 , g/ z. tg -ture of b i Liana M. Kozlowski Dat F:ICLERI$ALL1eFORMSILOBBYIST FORMS1Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 EXHIBIT "A" Organizational Chart of ER!Sagamare LLC Rag Dl Lido fiat Di lido Uonstnne Di Udo 1 lionstone Dl Lido EBJ properties,tic EDI Oiler a Crop.(far) ' Ventures,ltd.(fy UP,U.0(a) GP,Inc.(FL) (M Sagami*JV UC .67%; 29.5% 35% L5%1 31.06% I 1,6796 I Di Udo Beach Resat Managers of(I)Di Udo Beach Resort Parent LLC,and Parent Ul(DE) (ii)EBJ Sagamore LLC: Lionstone Group: 1. Diego Lowenstein 100% 2. Javier Grande ✓ - -- - • E91 Sagimore tlC Kanavos Group: Imo) 1. PaulC.Kanavos 2. Dayssi Olarte de Kanavos L - - / Ben-Josef Group: L Ron Ben-Josef 2. Ronen Ben Josef • Uonstone entities on page 2. - Kanavos entities on page 3. • Ben-Josef entities on page 4. 1 , . - - - • - - - - ,. . . PAUL% • JOHN W. , BRUCE E. CARLA RAMA DIEGO Lionstone Group CooNEY LAZAR : LOWENSTEIN LOWENSTEIN , LIDWEN51814. • • LOWENSTEIN LOWENSTEIN -- , 3.81% 3.81% 10.48% 10.48% 10.48% 10.4896 . 100% Lowenstein Faintly Trust , (Revocable)019/1) • ' 100% . . _ , . Unfasten Holdktss Ltd. 100% ' - tionstone Holdings (lialbadOs)Ltd- J 100% . . (R3 _ - 59.46% limestone&cup,inc. • _ _ - - 100% N N UMIStOffe DI lido LP 11,C Limestone DI Lido GP Inc. (FL) (R) v - - .V _.• 35% 3-5% • - - e - _. -• Kanavos entities on page 3; DI LidoBeadi Resort ' _ Ben-Josef entities on page 4. Parent U.0(2E) .. .., 2 Kanavos Group . _ pm.c. . i PETER ' PAUL C .... •- --- . . PETER ,. C 1..•, 1GARA:05 , ' KANAVOS ; - MT:VOS '. " ,- - • 50% I 5°96 50%.1:- 50% - • .- -. • -1,_ 1. 1_ -- -. - -1 r. 1../. -- -- - - - ,`,, f-- - -.: :,, - - - - •- '- „ Flag DI Lido :f. URI 134 Fanilly Sheldon Louie • Loses Funding, Mine cie i - Rag IN Udo Bananas Dynasty . . lupe , . OLARTE ... en.C. PETER °Palling GNP- Compare!U.0 Dedaradon of(FU L1C • Kanaros Dynasty : Ventures'h't* ' 1.010.0Et , DE . Keireot , KAA Trust 2(01 INT) Trust , • - ..1. \- -J.- - ./ 'v. - -- —- / • i • i \ RVOS . . ._ . . . .67% 238866% 4.50328% : 6.78% 1239452% 5..0553296 .93214% 2.25293% 27.93632% . 27.93632% 9.30810% . - . . : . ., . - ' - - 1 Flit 6 Ude VentirreSiltd.• [tp1(4. .. _ ..., 29_5% : lionstone entities on page 2; _. Ben-Josef entitles on page 4. t DI Udo Beach • - - - -" Resort Panne lit (DE) Ben-Josef Group ROW RON BEN- RONEN CDRAvrrNEUMRN JOSEF BENJOSEF 25% 25% 25% ;. - ._- - 25% 25% _ _- — = 25% f The Edeed 68n- 1- • Josef and lldia Ben- Ben-Josef Group Josef l rrevocabl� Holdings 11C Each of (I) Ronk Neuman, (IQ Ron Ben-Josef, n 'fruit Konen Ben-Josef and(iv)Ravit Kraus are the trustees / ` ,, of The Edeed Ben-Josef and Lidia Ben-Josef - Irrevocable Trust 100% 100% t • f- 1 EBJ Biopertl s,LLC EB N (DE) LLC J L - -- J 31.66% 1.67% DI lido Beach a tone a page 2; Resort Pai+entELC Kanavos entities on page 3. L 1 . t t MIscellan ous Cash Receipt ..• CITY Cf MlAMF BEACH _, No�428627 �o Cash CI at Card chew# $ Itk $`' : 2a . B � osnczaz2 . - ,. , l 'dnalle2Q Adrian- ' n5�9ti77.19 j7Pae •', k. 1.t. A n.ri_ ' .. , a ;r '[H • ^M1RORMATION'MUST BE,COMPLETEDj Qf� F p{ p� :' t .Hw :. Off". . -M t(. /i� _ . c' •,,s ` . c"° . m • 6'4 „✓yef\ Y s ti.Y w' : A.T^ ii _� � , / _ k j} < 6 -r