HomeMy WebLinkAboutTab 20 - Magic City Properties X, LLCCOMPREHENSIVE PLAN APPLICATION
DISCLOSURE OF OWNERSHIP
1. List the owner(s) of the subject property and percentage of ownership. Note: The Miami City Code
requires disclosure of all parties having a financial interest, either direct or indirect, with respect to a
presentation, request or petition. Accordingly, disclosure of shareholders of corporations,
beneficiaries of trusts, and/or any other interested parties, together with their address(es) and
proportionate interest are required. Please supply additional lists, if necessary.
Owner's Name(es) MAGIC CITY PROPERTIES X, LLC
Percentage of Ownership See attached corporate ownership chart.
Subject Property Address(es) 365 NE 61 st Street
2. List all street address(es) and legal description(s) of any property located within 500 feet of the
subject property owned by any and all parties listed in question #1 above. Please supply additional
lists, if necessary.
Street Address(es): Legal Description(s):
N/A
NEISEN O. KASDIN, its Attorney
Owner(s) or Attorney Name
STATE OF FLORIDA -- COUNTY OF MIAMI-DADE
Owne (s) or Attorney Signature
foregoing knowledg bef a is day of
who is a(n) individ al/partner/agent/corporation of a n
OO
individual/partnership/corporation. H /She is personally nown to me or who has produced
as identification an who did (dirk-+net-)tae = ri oath:—
(Stamp)
Sig
Diana Perez-Gata
NOTARY PUBUC
STATE OF FLORIDA
Comrn# FF233833
Expires 6/8/2019
Rev. 07-2013
AAA 2012 Trust
BENEFICIARIES:
Alexa, Ashley &
Amber Zangrillo
1624 4th Ave., Ste. 400
Seattle, WA 98101
42.49%
Robert
Zangrillo
11 E Dilido Dr.
Miami Beach, FL
33139
54.2%
Neil Kadisha
9420 Wilshire Blvd.
Ste. 400
Beverly Hills, CA 90212
3.31%
MCD Dragon, LLC,
a Delaware limited liability company
1209 Orange St.
Wilmington, DE 19801
The Akai Tsuki
Family Trust
BENEFICIARIES:
Guy Laliberte
Naima M. Laliberte
Kami M. Laliberte
Moani Taini M. Laliberte
Noa Taima B. Laliberte
Ina Kai B. Laliberte
2200 Rue Stanley
Montreal, H3A 1 R6
Canada
1%
MAGIC CITY PROPERTIES X, LLC
OWNERSHIP CHART
Guy Laliberte
2200 Rue Stanley
Montreal, H3A 1R6
Canada
99%
Lune Rouge Illusion CT Inc.,
a Delaware corporation
251 Little Falls Dr.
Wilmington, DE 19808
Anthony Cho
3737 Collins Ave.
Apt. 1104
Miami Beach, FL 33137
100%
•
CHO MCD, LLC,
a Delaware limited liability company
1209 Orange St.
Wilmington, DE 19801
MCD Miami, LLC,
a Delaware limited liability company
One SE 3rd Ave., Ste. 2110
Miami, FL 33131
The Anthony Burns
Revocable Trust
BENEFICIARY:
Jessica Lynn Burns
2675 Hunter Ct.
Weston FL 33331
George Helmstetter
550 Sabal Palm Rd.
Miami, FL 33137
Charles & Valerie
Rennert
156 Bal Cross Dr.
Bal Harbor, FL 33154
31.281%
17.444%
Neil Fairman
180 Palm Ave.
Miami, FL 33139
100%
•
Magic City Properties X, LLC,
a Delaware limited liability company
One SE 3rd Ave., Ste. 2110
Miami, FL 33131
48.725%
0.428%
Howard & Amy Vogel
2127 Brickell Ave., Apt. 1002
Miami, FL 33129
0.428%
0.847%
0.847%
Jose & Sandra
Rodriguez
498 SW 27th Road
Miami, FL 33129
Jeffrey & Rebecca
Mandler
12525 SW 69th Ave.
Miami, FL 33156
PEP Magic City Development, LLC,
a Florida limited liability company
One SE 3rd Ave., Ste. 2110
Miami, FL 33131
25%
Owns:
365 NE 61 st St.
WRITTEN CONSENT
OF
MAGIC CITY PROPERTIES X, LLC
The undersigned, being the Sole Member and Manager of Magic City Properties X, LLC, a
Delaware limited liability company (the "Company"), does hereby consent and agree to the adoption
of, and does hereby adopt, the following resolutions of the Company in lieu of holding a meeting in
accordance with the governing documents of the Company, and directs that these resolutions be filed
in the records of the Company:
WHEREAS, in regard to the Company's properties at 365 NE 61st Street in Miami, Florida,
the undersigned Sole Member and Manager deems it advisable and in the best interests of the
Company for the Company to join in and submit an application to the City of Miami seeking
approval of the Magic City Innovation District Special Area Plan and related Comprehensive Plan
Amendments, generally prepared in accordance with the application forms published by the City of
Miami (collectively, the "Application"); and
WHEREAS, in connection with the preparation, filing and formal review and processing of
the Application, including without limitation the execution and delivery of any and all documents
and forms required for the Application, the undersigned Sole Member and Manager deems it
advisable and in the best interests of the Company for the Company to grant Neisen O. Kasdin, T.
Spencer Crowley III, Steven J. Wernick and Benjamin O. Hedrick a power of attorney pursuant to
that certain Power of Attorney attached hereto as Exhibit A (the "Power of Attorney").
NOW THEREFORE, BE IT RESOLVED, that the Application and the Power of Attorney
are hereby authorized, approved, adopted, confirmed and ratified in all respects;
FURTHER RESOLVED, that any member, manager, officer or other authorized
representative of the Company (each being referred to herein as an "Authorized Person"), including
without limitation Neil Fairman, Anthony Burns and George Helmstetter, acting alone, be and hereby
is, authorized and empowered to execute and deliver on behalf of the Company any and all
agreements, instruments, certificates or documents necessary to consummate or effectuate the
Application and the Power of Attorney, in the name and on behalf of the Company;
FURTHER RESOLVED, that each Authorized Person is hereby authorized, empowered
and directed, in the name and on behalf of the Company to make or cause to be made, and to execute
and deliver, all such agreements, documents, instruments and certifications, and to do or cause to be
done all such acts and things, and to take all such steps, as he or she may at any time or times deem
necessary or desirable in order to carry out the intent and purposes of the foregoing resolutions; and
FURTHER RESOLVED, that the authorities and approvals hereby conferred shall be
deemed retroactive, and any and all acts authorized and approved herein that were performed prior to
the passage of this resolution be, and they hereby are, approved, ratified and confirmed in all
respects.
[Signature on following page]
IN WITNESS WHEREOF, the undersigned has executed this Written Consent as of the 0
day of Aipve4 44. , 2017.
COMPANY:
MAGIC CITY PROPERTIES X, LLC
By: MCD Miami, LLC, its Sole Member and
Manager
By:
Name: George Helmstetter
Title: Authorized Representative
EXHIBIT A
Power of Attorney
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that MAGIC CITY PROPERTIES X, LLC,
a Delaware limited liability company, has made, constituted and appointed, and by these presents do
make, constitute and appoint NEISEN O. KASDIN, T. SPENCER CROWLEY III, STEVEN J.
WERNICK, and BENJAMIN O. HEDRICK its true and lawful attorneys in its stead to execute all
documents and instruments required with respect to applications for a Special Area Plan and
Comprehensive Plan Amendment, in connection with the Magic City Innovation District Special Area
Plan, under the requirements of the City of Miami Code of Ordinances and Miami 21 zoning code,
submitted to the Office of Hearing Boards, for the properties located at 365 NE 61 st Street in Miami,
Florida, giving and granting unto NEISEN O. KASDIN, T. SPENCER CROWLEY III, STEVEN J.
WERNICK, and BENJAMIN O. HEDRICK its said attorneys, full power and authority to do and
perform all and every act and thing whatsoever requisite and necessary to be done with respect to the
aforementioned Special Area Plan and Comprehensive Plan Amendment applications as fully, to all
intents and purposes, as it might or could do if personally present (including, without limitation,
preparing, executing and filing all documents and applications and attending all hearings and meetings),
with full power of substitution and revocation, hereby ratifying and confirming all that said attorney or
his substitute shall lawfully do or cause to be done by virtue hereof.
IN WITNESS WHEREOF, I have hereunto set my/our hand(s) and seal(s) this oc0 day of
December , 2017.
Signed and delivered in the presence of:
Witr3ess Signature
riG aDnZcthZ
Witness Name
ness Signature
,Toscf Ina
Cc s*
Witness Name
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
) SS:
Magic City Properties X, LLC
By:
Name: George Helmstetter
Title: Authorized Representative
The foregoing inst;yment was acknowledged before me this a0 day of beCeflihi Jl7 by
ieoge fie/ryl ersM
feK who is ponally known to me or who has produced a
"/ as identification
4i'B/c
`'aY "MARIA GONZALEZ
•�
w t , * MY COMMISSION # FF 909142
EXPIRES: October 22, 2019
Bonded Thru Budget Notary Services
NOTARY PUBLIC
Print Name:
My commission expires:
IIIIIIIIIIIIiii111111111111111111111111111111
Delaware
The First State
CF4 20"S R. 0 0 0 4 122
OR BK. 30314 Fs 1327-1323 (2Pas)
RECORDED 1/03/2018 11:36;27
W1IRVEY RUVTHy CLERK OF COURT
MIAMI-DADE COHNTYy FLORIDA
Page 1
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF THE LERTIFICATE OF MERGER, WHICH MERGES:
"365 NE 61ST STREET, LLC", A FLORIDA LIMITED LIABILITY
COMPANY,
WITH AND INTO "MAGIC CITY PROPERTIES X, LLC" UNDER THE NAME
OF "MAGIC CITY PROPERTIES X, LLC", A LIMITED LIABILITY COMPANY
ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF DELAWARE,
AS RECEIVED AND FILED IN THIS OFFICE ON THE TWENTY—FIRST DAY OF
DECEMBER, A.D. 2017, AT 4:03 O'CLOCK P.M.
AND I DO HEREBY FURTHER CERTIFY THAT THE EFFECTIVE DATE OF
THE AFORESAID CERTIFICATE OF MERGER IS THE TWENTY—FIRST DAY OF
DECEMBER, A.D. 2017 AT 5 O'CLOCK P.M.
5583564 8100M
SRU 20180008829
You may verify this certificate online at corp.delaware.gov/authver.shtml
•
Authentication: 201902639.
Date: 01-02-18'
OR BK 3081. 4 PG 13 a8
LAST PAG
STATE OF DELAWARE
CERTIFICATE OF MERGER
of a Foreign Limited Liability Company
into a Domestic Limited Liability Company
State of Delaware
Secretary of Stale
Division of Corporations
Delivered 04:03 PM 12/21/2017
FILED 04:03 P\1 12 21/2017
SR 20177726239 - Flie\unber 5581564
Pursuant to Title 6, Section 18-209 of the Delaware Limited Liability Company Act.
FIRST: The name of the surviving Limited Liability Company is Magic City
Properties X, LLC, a Delaware Limited Liability Company,
SECOND: The name of the limited liability company being merged into this surviving
Limited Liability Company is 365 NE 61ST Street, LLC. The jurisdiction
in which this limited liability company was formed is Florida.
THIRD: The Agreement of Merger has been approved and executed by both limited
liability companies.
FOURTH: The name of the surviving Limited Liability Company is Magic City
Properties X, LLC, a Delaware limited liability company.
FIFTH: The merger shall become effective at 5:00 p.m. EST on. the date the
Certificate of Merger is filed with Delaware Secretary of State.
SIXTH: A copy of the executed Agreement of Merger is on file at the principal place
of business of the surviving Limited Liability Company.
SEVENTH: A copy of the Agreement of Merger will be furnished by the surviving
Limited Liability Company, on request, without cost, to any member of the
constituent entities.
IN WITNESS WHEREOF, said Limited Liability Company has caused this certificate to
be signed by an authorized person this 141h day of December, 2017.
t OF FLOR11DA, C:0U?d'1- L3r DfRUL
•
EBY Cf RTIF % that this ma t, opy of the
d�yd
fled n the s office on ' A ,) 20
Otficrai seal.
{(3I ndCQuAtyCourts
�Y�t— D.C.
MAGIC CITY PROPERTIES X, LLC,
a Delaware limited liability company
111111111111111111111111111111111111111111111
on wn Aw A Awn A A A A V V
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Brpartinrni of tat.r.
C F1-1 2018R0004 123
OR BK 30814 Fs 1329-1330 (2Pss)
RECORDED 01/03/2016 11;:66:1/.t
HARVEY RUVIN CLERK OF COURT
MIAMT-DADE COUNin FLORIDA
I certify the attached is a true and correct copy of the Articles of Merger, filed on
December 21, 2017 as shown by the records of this office.
The document number of the surviving corporation is M14000005721.
CR2E022 (1-11)
Given under my hand and the
Great Seal of the State of Florida
at Tallahassee, the Capital, this the
Twenty-ninth day of December, 2017
OA.
qcgma thnLr
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.___ A• T PAGE
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12-21—' 17 16:35 FROM -
FAX AUDIT NO.: H 17000335053 3
/ T-106 P0002/0002 F-027
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ran �fi�
c-2/
ARTICLES 01r M%12GER!-.'4, 1//y
FOR e.
FLORIDA LIMITED LIABILITY COMPANY Ir
8
•
The following Articles of Merger are submitted to merge the following'Florida limited liability
company into a foreign entity in accordance with Section 605.1025, Florida Statutes.
FIRST: The exact nacre, jurisdiction, and form/entity type of the merging party is as follows:
Name Jurisdiction form/Entity Type
365 NB 6]ST Street, LLC Florida Limited liability company
SECOND: The exact natne, jurisdiction, and form/entity type of the surviving party is as follows:
Name Jurisdiction Form/Entity Type
Magic City Properties X, LLC Delaware limited liability company
The surviving entity is an existing foreign entity that already has a certificate of authority
to transact business in this state.
THIRD: The merger was approved by the foreign surviving entity in accordance with the laws of its
jurisdiction, by the domestic merging limited liability company in accordance with Sections
605.1021-605,1026, F.S., and by each member ofsuch limited liability company who as a result
of the merger will have interest holder liability under Section 605,1023(l)(b), F.S.
FOURTH: This merging Florida entity agrees to pay any members with appraisal rights the amount to
which members are entitled under Sections 605.1006 and 605.1061-605.1072, F.S.
1 Hr The merger shall become effective at 5:00 p.m. BST on the date the Articles of Merger am filed
with Florida Department of State.
SIXT11: The Articles of Merger comply and were executed in accordance with the laws of each party's
applicable jurisdiction.
IN WITNESS WHEREOF, the undersigned have signed their names and affirmed that the
statements herein are true, under penalties of perjury, this loth day of December 2017.
365 NE 61ST Street, LLC,
MAGIC CITY PROPE1RTTI S X, LLC,
a Florida li 1 ited liability company a Delaware limited liability company
By:
Name: thony ns
Title: A •rized Signatory
TE OF FLORIDA, COUNT OF DAD E
• 11. '.E,OY CERTIFY Pat Mi rs aJr0X)PYcrll ilr1
lreg 's rJ9'1 a
i T a'
le4 D.C,
By:
Name: Apthony Bur
Title: Authorized Signatory
FAX. AUDIT NO.: /117000335053 3
THIS INSTRUMENT WAS PREPARED BY:
Michael S. Tobin, Esq.
Rothman & Tobin, P.A.
11900 Biscayne Boulevard. #740
Miami, FL 33181
Folio No.: 01-3218-015-0730
SPECIAL WARRANTY DEED
I 1111111111 31111111111111111111111111111111
CFN 2014ROS7n712
OR Fk 29436 F9s 4293 - 42S7; (5Ps )
RECORDED 12/19/2014 15:11:57
DEED DOC TAX 6,600.00
SURTAX 4,950.00
HARVEY RUVIN, CLERK OF COURT
NIA11I-DARE COUNTYP FLORIDA
THIS INDENTURE, made this 1641 day of December, 2014, between W & G
Investments, a dissolved Florida general partnership by Gioacchino J. Grieco, Jr. as the last
and only surviving general partner ("Grantor"), and 365 NE 61st Street, LLC, a Florida limited
liability company, whose address is 600 Brickell Ave, Ste. 3500 Miami, FL 33131 ("Grantee"),
and whose federal taxpayer identification number is: 59-1838029:
WITNESSETH THAT:
Grantor, for and in consideration of the sum of Ten and No/100 U.S. Dollars ($10.00),
lawful money of the United States of America, to it in hand paid by the Grantee, at or before the
ensealing and delivery of these presents, the receipt of which is hereby acknowledged, has granted,
bargained, sold, alienated, remised, released, conveyed and confirmed and by these presents does
grant, bargain, sell, alien, remise, release, convey and confirm unto the Grantee and its/his/her heirs
or successors and assignees forever, the following parcel of land, situate, lying and being in the
County of Miami -Dade ("County"), State of Florida, and more particularly described as follows:
SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF (the "Land").
SUBJECT, HOWEVER, TO THE FOLLOWING:
Real property taxes and assessments, for the year 2015 and for subsequent years.
Zoning and other regulatory laws and ordinances affecting the Land.
Easements, reservations, restrictions, rights of way, and other matters of record set forth in
EXHIBIT B attached hereto (without thereby re -imposing the same).
TOGETHER with all and singular the tenements, hereditaments and appurtenances
thcreunto belonging or in any way appertaining.
TO HAVE AND TO HOLD the same in fee simple forever.
AND the Grantor hereby covenants with said Grantee that it is lawfully seized of the Land
hereby conveyed in fee simple; that it has good right and lawful authority to sell and convey said
Book29436/Page4293 CFN#20140870712 Page 1 of 5
Land; that it hereby specially warrants the title to said Land and will defend the same against the
lawful claims of any persons claiming by, through or under the said Grantor but against no others.
[TEXT AND SIGNATURES FOLLOW]
Book29436/Page4294 CFN#20140870712 Page 2 of 5
WITNESS my hand and seal this 1017ay of December, 2014.
Signed, sealed and delivered
in the presence ofwitnesses;
Sign:
Print Na
Si
Print Name: ejeavvka
STATE OF FLORIDA
: SS
COUNTY OF MIAMI-DADE )
GRANTOR:
W & G INVESTMENTS,
a dissolved Florida general partnership
By; 1-ccr---cF.G---
Gioacchino J. Grieco, Jr., 1
general partner
only survi
The foregoing instrument was swom to and acknowledged before me this 10/ara.y of December,
2014, by Gioacchino J. Grieco, Jr., as last and only surviving general artner of W & G
Investments, a dissolved Florida general partnership, who is [ sonally known to m or [ ]
has produced as identification and who did not take an oa
NOTARY PUBLIC 3 State Flo a
Print Nan-le:She-4 in- OD121$0e7.—
My Commission Expires:
SOVJOS kniON PePne MIL Palx1011
LIOZ '8 tequierioN :831:11dX3 .(d.
hiSSO dA I NOISSIAINOO AIN *
zanoun TIGHS ,p
Book29436/Page4295 CFN#20140870712 Page 3 of 5
EXHIBIT A
LEGAL DESCRIPTION
Lot 4, Block 18 of SECOND CORRECTED PLAT OF PIERCE'S SUBDIVISION OF LEMON
CITY, according to the Plat thereof as recorded in Plat Book 2, Page 21, of the Public Records of
Miami -Dade County, Florida
AND
LESS the South 2.5 feet and LESS AND EXCEPT that portion of Lot 4, Block 18 of SECOND
CORRECTED PLAT OF PIERCE'S SUBDIVISION OF LEMON CITY, according to the Plat
thereof as recorded in Plat Book 2, Page 21, of the Public Records of Miami -Dade County, Florida,
which lies North of a line that is 25.00 feet South of, as measured at right angles, and parallel with
the center line of N.E. 62. Street, as said center line as shown on the plat of JOYCE PROPERTIES
SUBDIVISION, according to the plat thereof recorded in Plat Book 51, page 38, of the Public
Records of Miami -Dade Cotmty, Florida, pursuant to Order of Taking recorded in Book 10738,
page 1721 together with Final Judgment as to Parcel Nos 42 and 44 recorded in Book 10877, page
2093.
Book29436/Page4296 CFN#20140870712 Page 4 of 5
OR BK 29436 PG 4297
LAST PAGE
EXHIBIT B TO DEED
1. Taxes and assessments for the year 2015 and subsequent years, which are not yet due and payable.
2. Restrictions, covenants, conditions, dedications, easements and other matters as contained on the Plat
of Pierce's Subdivision of Lemon City, recorded in Plat Book B, Page 42, as corrected in Plat Book B,
Page 43, Plat Book B, Page 117 and Plat Book 2, Page 21, of the Public Records of Miami -Dade
County, Florida.
3. Easement(s) in favor of Florida Power and Light set forth in instrument(s) recorded in Official
Records Book 12039, Page 1499.
4. Interest of Lessee(s) together with terms, covenants, conditions, provisions, burdened easements,
rights, duties, obligations and other matters contained in that certain unrecorded Lease with Christian
Kolm d/b/a Christina Kolm Cosmetics, Inc., dated May 1, 2013.
5. The following state of facts as disclosed by survey prepared by John Ibarra & Associates, Inc.,
originally dated June 20, 2013, with the last revision on October 2, 2014, under Job No. 13-002220-2:
a.) Encroachment onto adjoining property of 0.30 foot of 3 foot concrete and brick wall with 6 foot
wood fence on the Northeast comer.
b.) Encroachment of subject property of 0.40 foot of 3 foot concrete and brick wall with 6 foot wood
fence onto sidewalk in the Northwest corner.
c.) Encroachment onto subject property of 0.10 foot of 1 foot concrete and brick wall with 7 foot
wood fence on the upper Southwest corner.
d.) Encroachment onto subject property of 0.10 feet to 0.50 feet of a 7 foot wood fence in the
Southwest corner.
Book29436/Page4297 CFN#20140870712 Page 5 of 5
State of Florida
Department of State
I certify from the records of this office that MAGIC CITY PROPERTIES X,
LLC is a Delaware limited liability company authorized to transact business in
the State of Florida, qualified on August 11, 2014.
The document number of this limited liability company is M14000005721.
I further certify that said limited liability company has paid all fees due this
office through December 31, 2018, that its most recent annual report was filed
on March 7, 2018, and that its status is active.
I further certify that said limited liability company has not filed a Certificate of
Withdrawal.
Given under my hand and the
Great Seal of the State of Florida
at Tallahassee, the Capital, this
the Fifth day of June, 2018
i&-s%
Secretary of State
Tracking Number: CU5105810084
To authenticate this certificate,visit the following site,enter this number, and then
follow the instructions displayed.
https://services.sunbiz.org/Filings/CertificateofStatus/CertificateAuthentication
Delaware
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF THE CERTIFICATE OF FORMATION OF "MAGIC CITY PROPERTIES
X, LLC", FILED IN THIS OFFICE ON THE EIGHTH DAY OF AUGUST, A.D.
2014, AT 2:41 O'CLOCK P.M.
5583564 8100
SR# 20177815322
You may verify this certificate online at corp.delaware.gov/authver.shtml
Page 1
Authentication: 203845373
Date: 12-28-17
State of Delaware
Secretary of State
Division of Corporations
Delivered 02:47 PM 08/08/2014
FILED 02:41 PM 08/08/2014
SRV 141052316 - 5583564 FILE
STATE of DELAWARE
LIMITED LIABILITY COMPANY
CERTIFICATE of FORMATION
• First: The name of the limited. liability company is
Magic City Properties X, LLC
• Second: The address of its registered office in the State of Delaware is
Corporation Trust Center, 1209 Orange Street in the City of Wilmington, . 1.9 8 01 . The
name of its Registered agent at such address is .The Corporation Trust Company
• Third: (Use this paragraph only if the company is to have a specific effective date of
dissolution: "The latest date on Which .the limited liability company is to dissolve.is
▪ Fourth: (Insert any other matters the members determine to include herein.)
In W►tness Whereof., the undersigned 0 executed this Certificate of Formation. this
8 day of AUGUST
roks3. wpm CT Sy.tmn that kit:
By:
Authorized Person(s)
Name:. Deck Lofuts
Typed or Printed
CITY OFMIAMI
DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO
SUPPORT OR WITHHOLD OBJECTION
The City of Miami requires any person or entity requesting approval relief or other action from the City Commission or any of its
boards, authorities, agencies, councils or committees, to disclose at the commencement (or continuance) of the hearing(s) on the
issue, any consideration provided or committed, directly or on its behalf, to any entity or person for an agreement to support or
withhold objection to the requested approval, relief or action. "Consideration" includes any gift, payment, contribution, donation, fee,
commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or
implied, or any promise or agreement to provide any of the foregoing in the future.
Individuals retained or employed by a principal as a lobbyist as defined in Sec. 2-653, and appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners'
legal representative are not required to fill out this form.
NAME: Neisen 0. Kasdin
(First Name)
(Middle) (Last Name)
HOME ADDRESS: c/o Akerman LLP, 98 SE 7th Street, Suite 1100
(Address Line 1)
(Address Line 2)
CITY: Miami STATE: Florida ZIP: 33131
HOME PHONE: (3 0 5) 9 8 2- 5 6 29 CELL PHONE: FAX:
EMAIL: neisen.kasdin@akerman.com
BUSSINESS or APPLICANT or ENTITY NAME
BUSINESS ADDRESS:
Magic City Properties X, LLC
One SE 3rd Avenue, Suite 2110
(Address Line 1)
Miami, FL 33131
(Address Line 2)
1. Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board,
authority, agency, council, or committee.
Approval of Comprehensive Plan Amendment (PLUM) required for the Magic City Innovation
District Special Area Plan (SAP).
2. Has any consideration been provided or committed, directly or on your behalf, to any entity or person for an agreement to
support or withhold objection to the requested approval, relief or action?
YES LINO
If your answer to Question 2 is No, do not answer questions 3, 4 & 5 proceed to read and execute the Acknowledgment. If
your answer to Question 2 is Yes, please answer questions 3, 4 & 5 and read and execute the Acknowledgement.
Doc. No.:86543
3. Please provide the name, address and phone number of the person(s) or entities to whom consideration has been provided
or committed.
Name Address Phone#
a. n/a
b.
c.
* Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
n/a
5. Describe what is being requested in exchange for the consideration.
n/ a
ACKNOWLEDGEMENT OF COMPLIANCE
I hereby acknowledge that it is unlawful to employ any device, scheme or artifice to circumvent the disclosure requirements of
Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; and that in addition to the criminal
or civil penalties that may be imposed under the City Code, upon determination by the City Commission that the foregoing
disclosure requirement was not fully and timely satisfied the following may occur:
1. the application or order, as applicable, shall be deemed void without further force or
effect; and
2. no application from any person or entity for the same issue shall be reviewed or
considered by the applicable board(s) until expiration of a period of one year after the
nullification of the application or order.
PERSON SUBMITTING DISCLOSURE:
Signature
Neisen O. Kasdin
Print Name
Sworn to and subscribed before me this day of , 201
. The foregoing
instrument was acknowledged before e by r � ��Q /� � � iA ,
who has produced
not take an oath.
as identification n ; or s persona . , know to me and who did/did
f a
ST 1' OF Idi> l +ez-Gala
;,',4-' : ta' ' . I4RY PUBLIC
� >d,OF FLORIDA Notry (-_-•())c\_\,1
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t' Expires 6/8/2019 Print game
Enclosure(s)
Doc. No.:86543 Page 2
Corrected
Paid By 365 NE 61st Street LLC
Miami -Dade County, Florida
Paid 12/11/2017
plicate public user 06/04/2018
Receipt# ECHECK-18-089926 $17,918.43
2017 Real Estate Property Taxes
Notice of Ad Valorem Tax and Non -Ad Valorem Assessments
SEE REVERSE SIDE FOR IMPORTANT INFORMATION
FOLIO NUMBER
MUNICIPALITY
MILL CODE
01-3218-015-0730
MIAMI
0100
365 NE 61 ST ST LLC
1 SE 3 AVE 2110
MIAMI, FL 33131
Property Address
365 NE 61 ST
Exemptions:
AD VALOREM TAXES
Miami -Dade School Board
School Board Operating
School Board Debt Service
State and Other
Florida Inland Navigation Dist
South Florida Water Mgmt Dist
Okeechobee Basin
Everglades Construction Proj
Childrens Trust Authority
Miami -Dade County
County Wide Operating
County Wide Debt Service
Library District
Municipal Governing Board
Miami Operating
Miami Debt Service
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
6.77400
0.22000
0.03200
0.12750
0.13840
0.04410
0.46730
4.66690
0.40000
0.28400
811,158 7.43650
811,158 0.59350
NON -AD VALOREM ASSESSMENTS
RA
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
811,158
5,494.78
178.45
25.96
103.42
112.26
35.77
379.05
3,785.59
324.46
230.37
6,032.18
481.42
Save Time. Pay Online. www.miamidade.gov
t RETAIN FOR YOUR RECORDS t
(Combined taxes and assessments
$17,183.71
i
2017 Real Estate Property .. DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 4-
Taxes
FOLIO NUMBER
01-3218-015-0730
PROPERTY ADDRESS
365 NE 61 ST
LEGAL DESCRIPTION
18 53 42 PB B-43 & PIERCES DIV LEMON CITY PB 2-21 &
LOT 4 LESS S2.5FT & LESS
365 NE 61 ST ST LLC
1 SE 3 AVE 2110
MIAMI, FL 33131
11111111111 II 11111111 II
0 1 3 2 1 8 0 1 5 0 7 3 0+
Make checks payable o:
Miami -Dade Tax Collector
(in U.S. funds drawn on U.S. banks)
Amount due May be Subject to Change Without Notice
Mail payments to:
200 NW 2nd Avenue, Miami, FL 33128
Du.licate .ublic user 06/04/2018
PAY ONLY ONE AMOUNT
If Paid By Please Pay
Mar 31, 2018 $0.00
1000000000000000000132180150730201700000000000000000000002