Adele Valencia - Todd Rosenburg �SCI C61lids 4.14z,
RECEIVED
/\1\I/\1\/\I B E/\( El NOV 142022
Office of the City Clerk
1700 Convention Center Drive CITY OF MIAMI BEACH
305.673.7411
Miami Beach, 33139 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 "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:
. Valencia, Adele
NAME OF LOBBYIST (Last) (First) (Middle Name)
LSN Partners 3800 NE 1st Ave, Suite 200, Miami, FL 33137
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-673-2585 avalencia@Isnpartners.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Rosenberg, Todd
NAMEEOF PRINCIPAL (Last) (First) (Middle Name)
•
1501 Collins, LLC 7900 Glades Road, Suite 540, Boca Raton, FL 33434
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
561-490-3113 1501 @pebbcap.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Ib(§V lattig @ARM 2-482 h)(1}X Q principal dew corporation partnership, oar Mgr GM .++ m p obbyist Cabghla cfl that
entity dringl special compensation Cop o tr 1It -1 to) ,indirect,t p con ingent, o o Kg;d/0.7+o o+ + t
an item shall ,egister with the®Jerk as required by this subsection but shall not be riequiried to fay 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):
• 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 attached
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.
Development approvals & permitting issues, including, but not limited to Member of City Administration
Members of City Staff and Members of HPB, PB, DRB, and BOA, City Commission and Mayor
relating to the property located at 1501 Collins Ave
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
Members of City Administration and Members of City Staff n I r l
Members of Historic Preservation Board (HPB) I/ _
Planning Board (PB), Design Review Board (DRB) _ ✓
Board of Adjustment (BOA), City Commission and Mayor ✓
n
n
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):
Co 5O Kerr VW(
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 Iobbvinq 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 been less than 12 months since the elected official(s) whom you provided campaiq
onS'eltinci seriuices was sworn iEi
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: I yes, were you promised or didyou receive economi conside ration in exchange for campaiq
consilfiing se:rvicesi.
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY� / c
Annual Registration fee: [ ]Yes[ No Amount Paid$ 35°"6d MCR# 3 d 7 I _ Date Paid l f( '-jJ 7
Lobbyist Registration Form received and verified by:. V3 VVV
F:.\CLER\$'ALL\aFORMS.\LOBBYIST FORMS\Lobby,ist 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 COMPENSATION� a
� DURING THE REPORTING PERIOD.'
Signature of Lobbyist: V,�-` �./ G'-��' Date I I I t Z,U
• 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 repor
tingrequirements.
Signature of Lobbyist: C�ww Date 1
Signature of Principal: � Date 10/z s/2Z
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
PRINCIPAL
State of f1UI State of Flo I ikG'-
County of: j1,UWV County of: ?Qlrn j3egc'}
Sworn to (or affimed) and subscribed before me, Sworn to (or affirmed) and subscribed before me,
by means of C7physical presence by means of l hysical presence
or 0 online notarization, or 0 orre notarizatipn,
this q day of NWC ' ( , 201Z.by this ZS day of CCIO1.7eC ,20, by
Eke&\Xi Ifecta ' To d► R vSe 6117n
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION / FORM OF IDENTIFICATION
� Personally Know V Personally Known
Signature of otary Public Si re of Notary Public
URvOA, 124M �a �� ;�►S
Name of Notary, Typed, Printed or Stamped Name d�otary, Typ Printed or Stamped
(NOTARY ' T VIVIEN RIVERO I . ►i u'• MEGHAN DUGGINS
I (NOTARY SEAL) °:°/ �ti� Notary Public•State of Florida
NotaryPublic-State of Florida ..:,�
Commission#HH 230193 l A; Commission d HH 240608
' o ...... My Comm.Expires Feb 17,2026 , ?'oF c. ' My Comm.Expires Apr 2,2026 `
•• _-gh National Notary Assn. ( Bonded through National Notary Assn.
1 The term"lobby]"Y'"gpscirrcany�xorumeni itiffeti ersons:
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
MIAMI 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 CityClerk@miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: Adele Valencia
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.
°ALL v LI/1 ��z�
Signature of Lobbyist Date
F:\CLER\SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc
Page 5 of 5
1501 COLLINS AVENUE ORG STRUCTURE AS OF 02-08-2022
BENEFICIARIES: BENEFICIARIES: BENEFICIARIES:
Barbara Rosenberg 33.33% Fara Horowitz Todd Rosenberg
Fara Horowitz 33.33%
Todd Rosenberg 33.33%
Nctweisfisch RranWelslioch Todd Rosenberg Barbara Rosenberg 2016 Trust I are Noronha 2o18Teust Toddnosanbeta2016 Trust
(kArilool) (individual) FL n FL
EIN:306555183 FIN:B34113815 EIN:30.65551e5
3,750.000 1.25403 1,350.0oo 450,000 450000
75.0% 75.0% . 0.0% 60.0% 20.OA 20.0%
Managin6Memner .•e ;^.Non Member Manager.,
- _
PCM Holdco LLC Todd Rosenberg
DE
EIN:87-1390663
2,250,000
100.0% 0.0%
No additional members or
indirect beneficiaries own 5%
or more of the Property Owner
6aom Maedcostas Pebb Copltai Management,LLC vinous Employees
160viduall DE (Individual)
EIN:46.5680624
3,000,000 2,250,000 250,000
loam 90.096 10.0%
Managing Member_.t,
No members or indirect No additional members or
•
beneficiaries of RonRuss owns 5% Indirect beneficiaries own 5%
or more of the Property Owner r more of the Property Owner
1501 Beach,LLC 805003s Investments),LLC Aiken,LLC All other Limited Members 1501 Beach,LLC - 1501 Collins Pebb Manager,LLC
DE FL NV various high net mall DE DE
EIN:87-2165015 EIN:97-2342968 EIN:46-4376836 madvats E15:87-2165015 EIN:87-1697900
2,560,000 2,500,000 3,000,000 1,650,000 2,500,000 2,500,000
50.0% 50.0% 64.5% 35.5% - 50.0% 50.0%
' Major Decision Member "`Managing Member
No additional members or
indirect beneficiaries own 5% • /
or more of the Property Owner
Ocean Five Beach,LLC 1 1501 Collins Peet Equity,LLC All other Limited Members 1501 Collins Manager,LLC
DE FL formed 6/8/2021 Various Mph net north DE
EIN:87-1132149 individuals EIN:87.1431270
5,000,000 4,650,000 7,350,000 5,000,000
22.73% 21.14% 33.41% 22.72%
Managing Member.
1501 Collins Holdings,LLC
OE
EIN:87.1404713
22,000,000
100%
1501 Collins,tic
OE
EIN:N/A Passthrough
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