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Michael W. Larkin - EBJ Sagamore LLC . • DocuSign Envelope ID:2A13ADCF-03E3-419B-98D3-77020FAB9491 �ti • &o le• ft-el RECEIVED 1\/\I A/ v 1 I BEACH Office of the City Clerk MAY 2022 1700 Convention Center Drive Miami Beach, FL 33139 305.673.7411 CITY OF MIAMI BEACH OFFICE OF THE 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"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: Larkin Michael W. NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin&Tapanes,PLLC 200 South Biscayne Blvd.,Ste.300 Miami,Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)374-5300 mlarkin@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Granda Tavier NAME OF PRINCIPAL (Last) (First) (Middle Name) EBJ Sagamore LLC 4100 NE 2 Avenue,Suite 202 Miami Florida 33137 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 ; t ' 2=482( 1p a.;'L$principal t a any corp"o`ration;partnership`or°tner entity% apPeffrstilS lobbyist B I 2 t1T ZEIZIMECIIIK)=20compensationQi'rei •ursement fora;appearance,_whethercJJir ;indirect ( contingent to e .ress_su•-portofalop_positionil% 0 J I reg sterna th-i re•wire' b o• - tie of but shall not be required to''•a 'an ,re•istratlon{i 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): J. Granda • 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. Page 1 of 5 Docverify ID:60DD1C29.6F4811430-8658-50C117144D81 Page 1 of 5 150C117144DB1 _ ,III MOR,I III www.docvenfy.com • DocuSign Envelope ID:2A13ADCF-03E3-419B-98D3-77020FAB9491' 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 1 Lincoln Road 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 a N 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): $715 per hour Page 2 of 5 DocVerify ID: I Page 2 of 5 I 250C117144DB1 I www.docverifycom DocuSign Envelope ID:2A13ADCF-03E3-419B-98D3-77020FAB9491 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 x No: 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 x No: If.yes;ohasr it.been lesstthanr-1)2+1,months,since the elected official).whomi„vouiprovidedk.campaign� r-x x-tea,-- , - },.—�.._ t- -_ - - - — -- - — - �ConsultingGserVicee.Was swormlin 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 0 O _Yes_No: fcwes,veerea yodopromasedlliorMidiivou freceiue"economrc�consideratronrninaexchange for,.campaign, �Consulti n^' ervi"�cen U TO BE COMPLETED BY CITY CLERK'S STAFF ONLY q Annual'Registration fee: [ ]Yes[�.No, Amount Paid$ �� MCR# 1 ��� I Date,'Paid cc 0 l'Z Z 'Lobbyist Registration_Form received and'verlfled by: L :F:\CLER\$AkL\aE.ORMS\LOBBYIST FORMS\Lobbyist Registration Form,Revieed.b9-20-18 REG.doc " - Revised,09/20/2018 N o Page 3 of 5 DocVerify ID:60DD1C29-5F484430-8656-50C117144DB1 Page 3 of 5 350C117144DB1 ,III r 'I III —� www.docverify.com tl 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 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 all reporting requirements. Signature of Lobbyist: Date Signature of Principal: /L/ Date 54/61.Z VII. NOTARY S GNATURE 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 qphysical presence or 0 online notarization, or 0 online notarization, this day of 20_, by this t day of IsO11 , 20_, by Michael W. Larkin Javier Granda NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION X Personally Known X Personally Known • Signature of Notary Public Signature of Notary Public cuts Me.Ss, Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SEAL) (NOTARY SEAL) NIr�P�e,, LuisAdolfQMejia : .` Comm.:HH 184366 •E. Expires:Oct.10,2025 The term"lobbyist"specifically excludes the following persons: % ,°u„" �� Notary Public-State ofFlon a. • 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 DocuSign Envelope ID:2A13ADCF-03E3-419B-98D3-77020FAB9491 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 COMPENS TPGNCUR1NG THE REPORTING PERIOD.' Signature of Lobbyist: v Date 05/05/2022 3c62Eo3vD9ee401.. 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 al repR9Ft1 'YIt(uirements. Signature of Lobbyist: 3QDYD3 o3Co o Date 05/05/2022 Signature of Principal: 71--"/14------ Date 5421/422— 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 Iyphysical presence or CDronline notarization, or❑online notarization this 5 day of May ,20�, by this day of MAGI ,20_,V,by Michael W. Larkin Javier Granda NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally K?-" ^ X Personally Known Iii.- O 9 Z/447 ' . g Signature of Notary Public Signature of Notary Public 0 w Diana Ramos LULS tAQS3 AI 0 a Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped Diana Ramos (NOTARY SEAL)`\\1�pVPotiiii�e, LuisAdolfoMejia 0 Commission#GG 308355 =a° �'c.- Comm.:HH 184366 F.:- , Notary Public-State of Florida S'*••�!,d Expires:Oct.10 2025 7. My Commission Expires Apr 10,2023 :,fri, fl1: • 1 The o arsons: �iq,rFf`�\\ Notary Public-State of Florida ; Exper{"wiu iCbsag wnu NiuviuC urny suCnunu, ICU nrnHIM i ur 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 i 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 Ch the appearance. o Page 4 of 5 0 O Docverify ID:60DD1C29.6F46.4430.6658-50C117144DB1 Page 4 of 5 450C117144DB1 ,III gA,I II I www.docverify.com - - �;.•.t DocuSign Envelope ID:2A13ADCF-03E3-419B-98D3-77020FAB9491 I AMv1 I BEACH 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 CiyClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Michael W. Larkin 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. 0 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 cDocuSigned by: 05/05/2022 o ---32 2Is3a3e9ee4 e... Signature of Lobbyist Date LL F:ICLERISALL1aFORMSILOBBYIST FORMS1Lobbyist Registration Form Revised 03-11-20 REG.doc m Page 5 of 5 DwocVerify ID:ww.docverify,co,,,D1C29-6F48.4430.8656-50C117144D61 Page 5of5 _ 5509117140E11 ,III HINEIII EXHIBIT "A" Organizational Chart of EBJ Sagamore LW ( f , Flag DI Lido flag Di Lida hailstone Di Udo lionstone DI lido EBJ P ope ties,LLC EBI tit °Pontine Cogs- PO(ill Vens,Ltd. LP,LLC(Ft) GP,Inc.(FL) t�l (DEL >V .67% 29.5% 35% L5% 31.66% 167% II Di Lido Beach Resort Managers of(1)Di Udo Beach Resort Parent LLC,and Parent UL(DE) (ii)Eli Sagamore LLC: !Ironstone Group: 100% L Diego Lowenstein 2. Javier Granda EBI Sagamore U[ Kanavos Group: (DE) L Paul C.Kanavos 2. Dayssi Olarte de Kanavos Ben-Josef Group: L Ron Ben-Josef 2. Ronen Den-Josef • Uonstone entities on page 2. - Kanavos entities on page 3. • Ben-Josef entities on page 4. JoHN W. BRucE E. ELAvIA Pauu` DIEGO ALFRtvo Lionstone Group LowENsTSN- COONEY LAAAR - LOYVENSTEiN o IAWENSTFJN LOWENSTEIN Borw 3.81% 3.81% 10.48% 10.48%/ 10.48% 10.48% 100% Lowenstein Fondly Trust (Revocable)(BYQ 100% !Greaten Holdings Ltd. 100% • llonstone Holdings (Barbados)Ltd. 100% 50.46% Llonstonep•IOC' (R3 100% Wastage Di lido LP LLC Lio stare DI Udo GP ins. (FL) (RJ 1 35% • 1.5% Kanavos entities on page 3; Di Udo Beactl Resort Ben-laser entities on page 4. Parent MC(DE) l J 2 Kanavos Group PAUL C Peru PAUL C PC KmAvos Kanavos Kowa& KAtrAvos 50% 50% 50% 50% Nag Di Lido LJ8N 134 Family ! Sheldon Lowe , / Loire Funding, Mete de ' t / ♦ flDArsv OPerlitine Coq. Company LLC Declaredon of UL Kenn Dynasty K Dynasty Ventures, OtAsttE PAULG P Trust �� KAtAVOS KANAvo(R) fwm Tctst v \ (Fq Tust2011KAnAvos .6796 2.38866% 450328% 6.78% 1239452% 5-05532% .93214% 2.25299% 279363296 27.93632% 9.30810% r ♦ Flat Di Lido Ventures;Ltd. (LP)(L3 %. -1 295% Uonstone entfties on page 2; Ben-Josef entitles on page 4. --- Di Udo Bench Resort Patent UC \ 1 Ben Josef Group RONIT RON BEN^ RONEN RAvrr NEUMAN JOSEF BEN JOSEF KRAUS 2S% 2S% . - 25% 25% 25% ILWIII--"°—__,.•111111111111111111 25% The Edeed Ben. Josef and lidia Ben- Ben-JosefGroup Each of(I) Ronit Neuman, Op Ron Ben-Josef, (tii) Josef Irrevocable FloldingsLC Ronen Ben Josef and(iv)Ravit Kraus are the trustees Trust of The Edeed Ben-Josef and Lidia Ben-Josef Irrevocable Trust 100% 10b% EBJ Properties,11C EBJ ri (DE) WC (DE) 3L66% 1.67% 1 DI lido Beads Lionstone entities on page 2; Resent Parent LLC -Kanavos entities on page 3. — — — — '—-- (DE) Miscellaneous Cash Receipt . . CITY.OF MIAMt BEACH' .. • 7 5 i . ' - ' No,428601 - , ., Cash, Credit Card , p Cheek,# -.- ,b-1 _ 1 i 00,.. O ,: - MBF • • ) ' t 20 )7 `A009 Esther ... 05jf01i022 Chi PM r-�. '` F0r Li s � ' c 11_ k .. f 4. _ (YHt$P4F+ORMAy Mr ea CONPLEREp) OA1cr of Fhana�pNrcta. Account Numbit- O,1 ' 5000 14'e41 fir: ,- ,�, � , ,; �. .. € .,�