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Adrian Dabkowski - Sobe Sky Development, LLC
lotnccl+, 144- U i I Col), A41.. DocuSign Envelope ID:F08F44E3-56D4-4635-944E-30940401C86E RECEIVED M AM B EA( OCT 20 2022 Office of the City Clerk 1700 Convention Center Drive oFFTMEOF MIgMI BEACH Miami Beach, FL 33139 OF 7' 305.673.7411 HE CITY CLERF( 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 lime 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: Dabkowski Adrian NAME OF LOBBYIST (Last) (First) (Middle Name) Kimley-Horn&Associates 8201 Peters Road. Suite 2200 Plantation Florida 33324 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 954-535-5144 Adnan.Dabkowski@kimley-hom.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Granda Javier NAME OF PRINCIPAL (Last) (First) (Middle Name) Sobe Sky Development, 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 Pursuant to City Code Section 2-482(h)(1)(a)_ A principal of any corporation, partnership, or other entity who appears as a lobbyist on behalf of that entity,without special compensation or reimbursement for the appearance.whether direct,indirect,or contingent,to express support of or opposition to an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees. 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 Page IC o124 164'D5i)Ii,Cl1 ��I 'III III DocuSign Envelope ID:HU8F44E3-56D4-4635-944E-30940401C8BE 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. Lincoln Road Improvements,Development Approvals&Permitting 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 properties located at 1 Lincoln Road and 1671 Collins Avenue 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 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): $355.00 per hour Page 2 of 5 IIDoc tlorv0i N CCC7D788,4732-43C8-3B58-4DeD1882Lrot Page 17 0124 174oso1e82E70E ,III NMI II DocuSign Envelope ID:F08F44E3 56D4 4635-944E-30940401C86E 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 2LNo: 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 Ey Lobbyists Or Rea 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? 31 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 Lilo: 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 x No: 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, has it been less than 12 months since the elected officials)whom you provided campaign consulting services was sworn in? 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 x No: 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 rnernber(s)of the City Commission: —Yes x No: If yes, were you promised or did you receive economic consideration in exchange for campaign consulting services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ I Yes[�No Amount Paid S 50 , (', MCR# LI 3°`1 S^ Date Paid l 1 t 2- 1 Lobbyist Registration Form received and verified by: J_) F•1CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Revised 03/11/2020 Page 3 of 5 1 \'ei iF1 r it) 7-,:7I178B.4777.4 3r8.a5 '1 NN2!S84DF0711 .1 III Pape 13 o124 134D6D1 BB2E 70E iir DocuSign Envelope ID:F08F44E3-56D4-4635-944E-30940401C86E 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: ,---oocosignad by: Date Signature of Principal: � Date 10.19/2nz2 � rr�a,aFnwna 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 U physical presence or® online notarization, or® online notarization, this day of October , 20 22, by this 19 day of October , 20 22, by Adrian Dabkowski Javier Grande NAME OF LOBBYIST NAME OF PRINCIPAL Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENIIFICAI ION x Personally Known x Personally Knot. Signature of Notary Public Signature of Notary Public Diana Ramos Diana Ramos Name of Notary, Typed. Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SEAL) 5u13-dlav'c`411� —--- Diana Ramos Commission#GG 308355 Notary Public-State of Florida ' The term "lobbyist"specifically excludes the following persons: My Commission Expires Apr 10,2023 Expert witnesses who provide only scientific, technical or other special' aMtir"h�r/n'rhrr^-Thah'tgim,a 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 I DocVerily ID 7CC70789-4732-43C8-8B58.4D6D1882E70E 1111 ;.III II www UOLw:IIN CUI❑ Page 19 0124 194D6D1882E70E IS k_■ DocuSign Envelope ID ACBE9352-A65A-452A-93FE-FC4A262F8202 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 CO M-5NSATION DURING THE REPORTING PERIOD.' Q Signature of Lobbyist: �t�lAtn VatIOLDWS�Ct Date —!o6 rr-aerua5w3.. ..TO/1.3'LIlaL..-___--_ 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 repartrw__c itternnents. Signature of Lobbyist: a '/�DS�t Date ton sr7a22 `—SncBTreerJeaaae 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 LJ physical presence or El online notarization, or III online notarization, this 19 day of October ,20 22, by ' this_day of October ,20 22, by Adrian Dabkowski Javier Grande NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Know x Personally Known ,,,--t...— Signature of Notary Public Signature of Notary Public Diana Ramos Diana Ramos Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped tur' mi),- .,,,_,,, - _ _ _ e _ . ., __ (NOTARY SEAL) J Diana Ramos �Commission#GG 308355 .Notary Public-State of Florida 1 The,My Commission Expires Apr 10,2023 persons: Exper-74. ^^ ^`.7---�/I-'T--- .-F r z-----1 or other specialized infomiation 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. x Page 4 of 5 IDocVerlry ID.80EeFD24-7060-47E8-B068-B5CAADP1134A • ,III www J w nb j11 rape 19 of 20 19B5CAAD81334A DocuSign Envelope ID-ACBE9352-A65A-452A-93FE-FC4A262F8202 MAM BEACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miomibeachfl.gov Office of the City Clerk Rafael E.Granada,City Clerk CityClerk@miamibeachf.gov Tel:305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Adrian Dabkowski 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. ---Docusigned by. CQ Adji Ail, Ved/ICDWSEI soomr�oroo�ao3 10/19,2022 Signature of Lobbyist Date F:ICFER\SALl\aFORMSU ORRYIST FORMS\I oftbytst Registration Form Revised 03-11-20 Rt(i.AOC Page 5 of 5 I ccVerilV ID N)1'Hf IJ.7060 47F8-nOtift C MDR'.334A Page20 o120 2305CAAI11.1 4 fvP I IJ III A e docv'erify. ' 'T �° O°CVE t Lobbyist Registration Form - A. Dabkowski - Ritz Carlton Combined Forms - executed by JG.pdf DocVerify ID: 7CC7D78B-4732-43C8-8B58-4D6D1882E70E Created: October 19, 2022 U 7:18:39 -8:0U Pages: 24 Electronic Notary: Yes / State: FL His document is a DocVerify VeriVaulted protectee ve•sion of the document named above.It was created by a notary or on the behalf of a rotary.and it is also a DocVerify E Sign document.which means this document was created for:he purposes of Electronic Signatures and/or Electronic Notary.i ampered or altered documents can be easily venfied and validated with the DocVerify veriCheck system. So to www.docverify.com at any time to verify or validate the alithen'icity and integrity of this cc any n'her DocVerify VeriVaulted document. E-Signature Summary E-Signature Notary:Diana Ramos(dra) October 19,2022 0721'46-8:00[61 FD2DC81676][162.244.152.118] dramos©brzoninglaw com I 'Pi' err � ,1, 5 ,M�•••t 'j • 11111111111111111111111111111111111111111111111111111111111111111111 DovVerdy docurnents cannot as altered or tamperer win in any way once tney are protected by Ins DocVenly VenVault System.Best viewed wilt-Adobe Reader or Acobe Acrob.- All visible electronic signatures conlainec in t-iis document are symbolic reoiesentations of the persons signature.and not intended to be an accurate depiction of he persons acic❑ . as definer by yarns Act,and nr Laws • D ,___•..ecVerfly ID:7CC7D78e,4732-43C0-Op50-4D6D1002t:701. „I ,I III I Generated Cover Page 40001882E70C It i�ttss... wee f.LicwnN cow • DocuSign Envelope ID:F08F44E3-56D4-4635-944E-30940401C86E EXHIBIT "A" Organizational Chart of 1' Eat Sagamore LLC' F r 1 nag Di Lido FLsg Di tido 1 tlonstone Di lido Uneaten,DI Lids Ea,0race}irs,ULG E133 S.isrerore 1V LLC Operating Carp.(n.) Verrtur ,Ltd.(Ft) 1 tr,uc(Ft) GP,tat.(r tof7 l .67% 29.5% 35% a.S% 3L66% 1.67% 1 DI Lido Mach R.LKare Managers of fit)Di Lido Beach Resort Parent LLC,and ` Parent Lir(OE) n)E915agamore LLC: lionstone Group: 1. Diego Lowrenstern IQO% 2. Javur Grande r KanavosGrouF: I IZi aaa-aorc LLC 1. Paul C.Kanavos (D9 2_ Dayssi'Warta de Kanavos 7. Ran-Josef Group_ 1. Ron Ben-loses 2. Rouen Sen-;csef i • [ionstone entities on page 2- - Kanavos entities on page 3. I Ben-Josef entities on page 4. T. Docverily ID:/LC TD18k341J2-4Jc8-BB58-aD6D1882E70E Page 71 of 74 714D6n1887F70F III 'I III _ www d: :vm N x � cmu DocuSign Envelope ID:F08F44E3-56D4-4635-944E-30940401C86E aaww, Clesee E (... \ / 1y i �Avu�1 DIM �,r"��'\ Lionstone Group �COOr4�f� IJ17AR is '\ IDNENSTEIN / 1\ LlywetorE1Ni � �r ( LQYIEtwohl 3.81% 3.81% 10.48% 10 45% j/ 10.48%/I 10.48% 100% I / �, ern TrustT+ \ % I [Revocable)sue) I 100% Lovessen►ioldings Ltd. (8w) \\ / //7 - i00% I y saes 4 ////// jetarbados)Lec�\ 1 c 100% cv.- i Llonsoc oeirto2.loc. Ft - 100% uaaeaR DFUde L'Ur , l3oastowe Di lido fiP Inc. (R) (Fg 35% 1S% 7,1 Kanavoc enalies on page'.3 1 DIUde:Beech ReSort Ben-ia of aKi Cis on page a_ Parent LLC www clot wn N corn 8EL4732-43C8-81358-413607882E7OE Page 22 of 24 224061)1882E/OE III e::. II II DocuSign Envelope ID:F08F44E3-56D4-4635-944E-30940401C86E /Th Kanavos Group 1 K4fuvnt \ KuuWc Wet� Taut t t 'MP 50% I 50%I 1 50% Poi DI iltio i UM134 kr* ekb.,taan: i to...Funding, ' Norte* 1 I. Opener.Cap. I 1 a UX Declaration of 'i LLC I i M,eM,gmMr ` 1 Kae.wn°MC° ' vwm.i.Mc. I( No. i ouuE {I PAW C. vEru \, POJ\ WI Truett j�` (Fl} �` Tn�t 2011 ,. MT]fR � �) \ of i l KANRr06 i IUWtvM / .67% 234866%I, 450328% ; 6.7CMS, 1239452%j 5.05632%1 93214%' 225249% • 27.93532%i 27.936)%1 9 80A3ti%. i IFlag Di Lido f ventures.Lid. N'I(FL; I 293% Livrstone entitles on page 2; Berr_Jvref entities on page 4. I do en* IImrS N1�*uc I` Di lido We / DocVerlfyID:7CC70788-4732.43C8-131358-4D6D1882E70F Page 23 of 24 234D6D1882E70E IN 'I�) wow;to.^.wa iN cam 1 DocuSign Envelope ID:FO8F44E3-56D4-4635-944E-30940401C86E Ben-losef Group t Korn .. rf MO BEN- �{O,� �. / FU.vrr NEUMAN / t't JOSEF /' I BM-JOSEF �i KR.AUS 25% 25%N\_ 25% 75% 25%\ � 25% 25% `� i 25% `---_ f The Edeed Ben- r Jose;and Utile Ben- iilen,losef6oiip Each of(i) Ronk Neuman, (ii) Ron Ben-Josef, (ifi) Josef I lloidi�silC Rouen Ben-Josef and(iv)Rauh Kraus are the trustees 1 Trust J , I►ni of The Edeed Ben-Josef and Lidia Ben-Josef !( J f irrevocable That 1100l6 100% 1 i1 I `. te ''} TB!Properties,tIC I E!i►so.orraMlti (DE) I Lit Me I \ 3L66% 2.67% El 5, r` Lionstane entities on page 2; Di ludo%each ? I 'Wart Pam*tiC Kaentitiesvos en on page 3. i y ` (DE) J 3 F. DocVenf ID:7CCTD76B-O7S2-43C8-BB58-40bu18S2t70E Pa 24 0124 244D6D1882E70E ,III �.6C�c'I II �vrviw�h nw wet psc Miscellaneous Cash Receipt CITY OF MIAMI BEACH No. 430782 fn El Cash D Credit Card EICheck# 20 Received of Address For Mit F tahitellaneous-MOR-2023 G4751-0008 Adrian V... 10/21/2022 11:30AM kiffr.OPEN(MCR) Partin-lent Ainount: 1.900 00 (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director .1014, 441 Account number: By Preparer: Dept: EXT:- I 0