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Home My WebLink AboutTab 36 - Altam Enterprises, LLC (Under Contract to Purchase by Magic City Properties XX, LLC & Magic City Properties XXI, LLC)SPECIAL AREA PLAN APPLICATION DISCLOSURE OF OWNERSHIP Listthe 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) ALTAM ENTERPRISES, LLC 100% Owned by Arbie Axelrod, whose mailing address is 344 NE 61 st Street, Percentage of Ownership Miami, FL 33137 Subject Property Address(es) 340 NE 61 st Street; 371 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. N/A Street Address(es): Legal Description(s): NEISEN O. KASDIN, its Attorney Owner(s) or Attorney Name STATE OF FLORIDA -- COUNTY OF MIAMI-DADE T e regoing ackwlledged�befor rjie thi w by !a i/A �f� �' who is n) individ a Art r/agen o io Owner(s) or Attorney Signature day of --581)(\L)/aVt- a(n) � �'• • n cx individual/partnership/corporation/She is personal! known to me or who has produced agaidefltditaft an. who did o take NOTARY PUBLIC STATE OF FLORIDA Comm# FF233833 Expires 61812019 Signature Rev. 07-2013 7 SPECIAL AREA PLAN APPLICATION DISCLOSURE OF OWNERSHIP 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 XX, LLC Percentage of Ownership See attached corporate ownership chart. Subject Property Address(es) UNDER CONTRACT TO PURCHASE: 340 NE 61st 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 T e,#,oregoing was Cno dged before me this 20 i , by who is (n) individual/partner agent/ • rp at o�o a(n) individual/partnership/corporatio . /She is personally known to me or who has produced as identification an • who ace an oath. tiv v Signature Owner(s) or Atto ney Signature day of 14)ki\UPW\t- (Stamp) Dlana Perez -Gala NOTARY PUBLIC STATE OF FLORIDA Comm* FF233833 Expires 6/8/2019 Rev. 07-2013 7 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 Neil Kadisha 9420 Wilshire Blvd. Ste. 400 Beverly Hills, CA 90212 54.2% 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 MAGIC CITY PROPERTIES XX, LLC OWNERSHIP CHART 1% Guy Laliberte 2200 Rue Stanley Montreal, H3A 1 R6 Canada 99% Lune Rouge Illusion CT Inc., a Delaware corporation 251 Little Falls Dr. Wilmington, DE 19808 35% 25% 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 15% The Anthony Burns Revocable Trust BENEFICIARY: Jessica Lynn Burns 2675 Hunter Ct. Weston FL 33331 George Helmstetter 550 Sabal Palm Rd. Miami, FL 33137 MCD Miami, LLC, a Delaware limited liability company One SE 3rd Ave., Ste. 2110 Miami, FL 33131 100% Magic City Properties XX, LLC, a Delaware limited liability company One SE 3rd Ave., Ste. 2110 Miami, FL 33131 Neil Fairman 180 Palm Ave. Miami, FL 33139 Charles & Valerie Rennert 156 Bal Cross Dr. Bal Harbor, FL 33154 Howard & Amy Vogel 2127 Brickell Ave., Apt. 1002 Miami, FL 33129 31.281% 48.725% 0.428% 0.428% 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 Honda limited liability company One SE 3rd Ave., Ste. 2110 Miami, FL 33131 25% Under Contract to Purchase: 340 NE 61 st St. SPECIAL AREA PLAN APPLICATION DISCLOSURE OF OWNERSHIP 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 XXI, LLC Percentage of Ownership See attached corporate ownership chart. Subject Property Address(es) UNDER CONTRACT TO PURCHASE: 371 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 T Jforegoing wkIdged b 20 , by who is (n) individual/ pa ner/agent/c individual/partnership/corporation. �II She is personally k as identification Perd ez-Gata did (di NOTARY PUBLIC STATE OF FLORIDA Comm# FF233833 Expires 6/8/2019 hi Owner(s) or Attorney Signature (Stamp) ion o no day of —SPhft17 Signature a(n) o has produced Rev. 07-2013 7 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 Neil Kadisha 9420 Wilshire Blvd. Ste. 400 Beverly Hills, CA 90212 54.2% 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 MAGIC CITY PROPERTIES XXI, LLC OWNERSHIP CHART 1% Guy Laliberte 2200 Rue Stanley Montreal, H3A 1 R6 Canada 99% Lune Rouge Illusion CT Inc., a Delaware corporation 251 Little Falls Dr. Wilmington, DE 19808 35% 25% 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 15% The Anthony Burns Revocable Trust BENEFICIARY: Jessica Lynn Burns 2675 Hunter Ct. Weston, FL 33331 George Helmstetter 550 Sabal Palm Rd. Miami, FL 33137 MCD Miami, LLC, a Delaware limited liability company One SE 3rd Ave., Ste. 2110 Miami, FL 33131 100% Magic City Properties XXI, LLC, a Delaware limited liability company One SE 3rd Ave., Ste. 2110 Miami, FL 33131 Neil Fairman 180 Palm Ave. Miami, FL 33139 Charles & Valerie Rennert 156 Bal Cross Dr. Bal Harbor, FL 33154 31.281% 17.444% 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% Under Contract to Purchase: 371 NE 61st St. WRITTEN CONSENT OF ALTAM ENTERPRISES, LLC The undersigned, being the Sole Member and Manager of Altam Enterprises, LLC, a Florida 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 340 and 371 NE 61 st 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 limited 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"), 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 2C4I'. day of December , 2017. COMPANY: ALTAM ENTERPRISES, LLC By: Cf Cat Name: Arbie Axelrod s, Title: Sole Member and Manager EXHIBIT A Power of Attorney LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that ALTAM ENTERPRISES, LLC, a Florida 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 340 & 371 NE 61st Street in Miami, Florida, giving and granting unto NEISEN O. KASDIN, T. SPENCER CROWLEY III, STEVEN J. WERNICK, and BENJANIIN O. HEDRICK its said attorneys, a limited power of attorney with 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. This limited power of attorney is limited to the grant of authority conferred hereby, and shall not encompass or include any other power or authority other than with respect to the Special Area Plan and Comprehensive Plan Amendment applications for the Magic City Innovation District Special Area Plan as expressly provided herein. IN WITNESS WHEREOF, I have hereunto r? i2017. Signed and delivered in the presence of: Witness Signature Witness Name Witne Signatur /40 f xe/- Witness Name STATE OF cl thk COUNTY OF The forego ) SS: set my/our hand(s) and seal(s) this day of Altam Enterprises, LL By: Name: Arbie Axelrod Title: Sole Member & Sole Manager trument was acknowledged before me this �0'" R day o0e. reirn&c)-{l l 7 by who is personally known to me or who has produced ' a Irv. Qidentification. NOTARY PUBL� � Print Name: 0 )01 47pcsiz, My commission expires: r Nat,_ Notary Public State of Florida T+. Sonia Alonso l My Commission FF 141926 'Pora Expires 07/15/2018 WRITTEN CONSENT OF MAGIC CITY PROPERTIES XX, LLC The undersigned, being the Sole Member and Manager of Magic City Properties XX, 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 properties the Company currently has under contract to purchase at 340 NE 61 st 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, fling 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 30 day ofAjo01144 27( ,2017. COMPANY: MAGIC CITY PROPERTIES XX LLC By: MCD Miami, LLC, its Sole Member and Manager By: A \ Name: George Helmstetter Title: Authorized Representative EXHIBIT A Power of Attorney POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that MAGIC CITY PROPERTIES XX, 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 it has under contract to purchase located at 340 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 24 day of ()ccrrnber , 2017. Signed and delivered in the presence of: WitnessSignature 2 Magic City Properties XX, LLC By: ./`ter „de Name: George Helmstetter r ► 0. ?n IP Z Title: Authorized Representative Witness Name Ctud/cx_a fitness Signature Jo se t n cZ Cca_ Witness Name STATE OF FLORIDA COUNTY OF MIAMI-DADE ) SS: The foregoing in/s ment was acknowledged before me this 20 day of t er tW (�017 by ( idYC e t t 115t t ( who is personally known to me or who has produced a as identification. +0.`;•"• f.?4,0 MARIAGONZALEZ NOTARY PUBLIC MY COMMISSION # FF 909142 Print Name: 0;,r EXPIRES: October22, 2019 My commission expires: 9fFOF Ft0`� Bonded Thru Budget Notary Services WRITTEN CONSENT OF MAGIC CITY PROPERTIES XXI, LLC The undersigned, being the Sole Member and Manager of Magic City Properties XXI, 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 properties the Company currently has under contract to purchase at 371 NE 61 st 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 �v day of /tiJt titig ,2017. COMPANY: MAGIC CITY PROPERTIES XXI, 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 XXI, 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 it has under contract to purchase located at 371 NE 61 st Street in Miami, Florida, giving and granting unto NEISEN O. KASDIN, T. SPENCER CROWLEY HI, 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 20 day of DeCtm ber , 2017. Signed and delivered in the presence of: Witness Signature fYl rr G e Dr Witness Name (COL4_,tz, fness Signature ae-f Ina (ct- Witness Name STATE OF FLORIDA COUNTY OF MIAMI-DADE ) SS: Magic City Properties XXI, LLC By: Name: George Helmstetter Title: Authorized Representative ri The foregoing instrument was acknowledged before me this 20 day of I ' efl ?r t10i7 by ei-ecY0A i t - l/1St-eVP( who is personally known to me or who has produced a as identification. NOTARY PUBL Print Name: My commission expires: This instrument was prepared by and should be returned to: Amanda Quirke, Esq. 400 Alton Rd Apt 511 Miami Beach, FL 33139 Folio Number. 01-3218-022-0040 111111111111111111111111111111111111111111111 CFN 2009Ro702937 DR Ek 27029 Pas 2669 - 2670► (2a9s' RECORDED 09/29/2009 13:53:48 DEED DDC TAX 0.60 HARVEY RUVIN? CLERK. OF COURT IIIAI1I-DADE COUNTY? FLORIDA This space reserved for recording information QUIT -CLAIM DEED This Quit -Claim Deed, executed this o 4 day of 2009 by Leon A. Axelrod Associates, Inc. whose address is 1021 Ives Dairy Rd. Suit 220 Miami, FL 33179 (the "Grantor"), to Altam Enterprises, LLC, whose address is 344 NE 61 St Miami, FL 33137 (the "Grantee") (wherever used herein the terms "Grantor" and "Grantee" shall include the singular and plural, heirs, legal representatives, and assigns of individuals and the successors and assigns of corporations, wherever the context so admits or requires). WITNESSETH, that said Grantor, for and in consideration ofthe sum of $10.00 in hand paid by the said Grantee, the receipt whereof is hereby acknowledged, does hereby remise, release and quit -claim unto the said Grantee, all the right, title, interest, claim and demand which the said Grantor has in and to the following described lot, piece or parcel of land, situate, lying and being in the County of Miami Dade, State of Florida, to wit: Dullams Unrecorded Plat, Same beginning 204.5 ft South and 918.5 ftEast of NW Corner SW 'A South 100 ft East 100 ft. North 100 ft. West 100 ft. Lot 5 & 6 less 2.5 ft. for St. To have and to hold the same together with all and singular the appurtenances thereunto belonging or in anywise appertaining, and all the estate, right, title, interest, lien, equity and claim whatsoever of the said Grantor, either in law or equity, to the only proper use, benefit and behoove of the said Grantee forever. IN WITNESS WHEREOF, the said Grantor has signed an _sealed the ;.resents the day and year first above written. Signed, sealed and delivered in the'presence of:- / Pr Namei.\ jiCI N f� Print N Arbie Axelrod President, Leon A. Axelrod Associates, Inc. I-Aaxiue\Q (.)Ce.ifo Book27029/Page2669 CFN#20090702937 Page 1 of 2 OR BK 27029 PG 2670 LAST PAGE STATE OF FLORIDA ) ) SS: COUNTY OF MIAMI-DADE ) The foregoing instrument was acknowledged before me this.a14 day of / v j , 2009, by / ,' /,Poo , who is personally known to me or has produced a Florida Driver's License as identification. STATE OF FLORIDA ) SS: COUNTY OF MIAMI—DADE Notary Public NOTARY pu0414SraT6 dF Fwe,o�7 " Marsha H. Errerr'rw c Cbnlil:is�ivu F Type, Print or Stamp Name,; E;DD'35J.iG xpires: DEC. 25, 2011 IIONs DTHIWAT A'TICBONDINGCO,INC. My Commission Expires: The foregoing instrument was acknowledged before me this day of �jembe�, 2009, by MCNV,@ \p—. (AXON(pd , who is personally known to me or has producedda Florida Driver's License as identification. Notary Public Type, Print or Stamp Name My Commission Ex - 2 - Wk. MARIA WOLF Cormniisslon # DD 862043 Expires February 17, 2013 Corded Thu Troy Feet hwmKe20395401B Book27029/Page2670 CFN#20090702937 Page 2 of 2 This instrument was prepared by and should be returned to: Amanda Quirke, Esq. 400 Alton Rd Apt 511 Miami Beach, FL 33139 Folio Number: 01-3218-015-0720 111111111111111111111111111111111111i 1111 1111 CFN 2009R0702933 OR f'k 27029 P9s 2671 - 2673► (3139s) RECORDED 09/29/2009 13:53:.2 DEED DOC TAX 0.60 HARVEY RUVIN CLERK OF COURT MIAPMI-DADE COUt1TYr FLORIDA This space reserved for recording information QUIT -CLAIM DEED This Quit -Claim Deed, executed this.»-( day of ,el usr; , 2009 by Arbie and Manuela Axelrod whose address is 344 NE 61 Street Miami, FV 33137 (the "Grantor"), to Altam Enterprises, LLC, whose address is 344 NE 61 St Miami, FL 33137 (the "Grantee") (wherever used herein the terms "Grantor" and "Grantee" shall include the singular and plural, heirs, legal representatives, and assigns of individuals and the successors and assigns of corporations, wherever the context so admits or requires). WITNESSETH, that said Grantor, for and in consideration of the sum of$10.00 in hand paid by the said Grantee, the receipt whereof is hereby acknowledged, does hereby remise, release and quit -claim unto the said Grantee, all the right, title, interest, claim and demand which the said Grantor has in and to the following described lot, piece or parcel of land, situate, lying and being in the County of Miami Dade, State of Florida, to wit: See Exhibit A for Legal Description To have and to hold the same together with all and singular the appurtenances thereunto belonging or in anywise appertaining, and all the estate, right, title, interest, lien, equity and claim whatsoever of the said Grantor, either in law or equity, to the only proper use, benefit and behoove of the said Grantee forever. IN WITNESS WHEREOF, the said Grantor signed ealed thes . is the day and year first above written. Signed, sealed and delivered in the presence of: irt Pri Name I/ L,4/=/r!// PrintN. •e bie Axelrod Manuela Axelrod Book27O29/Page2671 CFN#20090702938 Page 1 of 3 STATE OF FLORIDA ) SS: COUNTY OF MIAMI-DADE ) The foregoing instrument was acknowledged before me this o? 1 day of ,at,/ ,,, f 2009, by %,n• gic 4xe/K,o.0 T �iou � A lQ. n , who is personally known to e or has produced a Florida Driver's License as identification. /7) 44-4-Zr-, /1- A---) Notary Public Type, Print or Stamp Name My Commission Expires: `c �i:_ Mar 13 H. Comxiss:on '/ Freeman, BcJ pip ;Ff2C A1'LAh-t7C B0,\ p:G CO RC —2— Book27029/Page2672 CFN#20090702938 Page 2 of 3 OR BK 27029 PG 2673 LAST PAGE LEGAL DESCRIPTION LOT 3. LESS THE EAST 1.00 FOOT THEREOF, AND LESS THE NORTH 7.50 FEET AND THE SOUTH 2.50 FEET THEREOF FOR ROAD RIGHT—OF—WAY. IN BLOCK T8 OF 'SECOND CORRECTED PLAT OF PIERCE'S SUBDIVISION. LEMON CITY." ACCORDING TO THE PLAT THEREOF. AS RECORDED IN PLAT BOOK 2, PAGE 21. OF THE PUBLIC RECORDS OF DADE COUNTY. FLORIDA T Lot 3, in Block 18, of SECOND CORRECTED PLAT OF PIERCE'S SUBDIVISION, LEMON CITY, according to the plat thereof. recorded in Plat Hook 2, at Page 21, of the Public Records of Dade County, Florida; less however, the East one foot thereof, for street widening; and lase the following described portion thereof: Begin 2.5 feet North of the Southwest corner of said Lot 3; thence go Easterly 2.5 feet North of and parallel with the South line of said Lot 3, for 93.60 feat. to a paint; thence go Northerly. one foot West of and parallel with the East line of said Lot 3. for 93.60 feet to a point; thence go Westerly forming a 90 degree angle. for 69.95 feet, to a point on the West line of said Lot 3; thence go Southerly along the West line of said Lot 3. for 96.01 feat, to the Point of Beginning, and lase the following described portion thereof; Begin 7.5 feet South and one foot Nest of the Northeast corner of said Lot 3, thence go Southerly. one foot west of and parallel with the East line of said Lot 3. for 98.00 feet, to a point; thence go Westerly, forming a 90 degree angle, for 69.95 feet, to a point on the West line of said Lot 3. thence -go Northerly. along the West line of said Lot 3, for 99.31 feet. to a point; thence go Easterly, 7.5 feet South of and parallel with the Nosth sine of said Lot 3, for 69.91 feet, to the Point of Beginning, all lying and being in Dade County, Florida. RECORDERS NOTE The legibility of writing, typing or pri,,.i ,.g unsatisfactory in this document when recerrsd Book27029/Page2673 CFN#20090702938 Page 3 of 3 State of Florida Department of State I certify from the records of this office that ALTAM ENTERPRISES LLC is a limited liability company organized under the laws of the State of Florida, filed on August 6, 2009. The document number of this limited liability company is L09000076011. 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 January 11, 2018, and that its status is active. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Fifth day of June, 2018 OA% 0440%, Secretary of State Tracking Number: CU3208752452 To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateofStatus/CertificateAuthentication State of Florida Department of State I certify from the records of this office that MAGIC CITY PROPERTIES XX, LLC is a Delaware limited liability company authorized to transact business in the State of Florida, qualified on June 19, 2017. The document number of this limited liability company is M17000005195. 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: CU8810019355 To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateofStatus/CertificateAuthentication State of Florida Department of State I certify from the records of this office that MAGIC CITY PROPERTIES XXI, LLC is a Delaware limited liability company authorized to transact business in the State of Florida, qualified on June 19, 2017. The document number of this limited liability company is M17000005199. 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: CU6264396519 To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateofStatus/CertificateAuthentication Lo Qwo 7boIf (Requestor's Name) (Address) (Address) (City/State/Zip/Phone #) El PICK-UP ❑ WAIT MAIL (Business Entity Name) • Certified Copies (Document Number) Certificates of Status Special Instructions to Filing Officer: Office Use Only 11 A i 111 11 300159215933 Io, ;CIS;/i_ig--i i10111--022 +:*12S. 00 N. Osflitai AUG - 7 2089 TO: Registration Section Division of Corporations SUBJECT: • COVER LETTER AL-rA LLC, Name of Limited Liability Company The enclosed Articles of Organization and fee(s) are submitted for filing. Please return all correspondence concerning this matter to the following: A-rlo e p v\v\ Antvock Name of Person 3114 NtQI St w�tac�; r-, 33137 Firm/Company Address City/State and Zip Code uSCkxe,roe o&. QOWI I mail reAs : (to be used for future annual report notification) For further information concerning this matter, please call: 1 1'► yet 4-Q,ko &1 at ( 3 o6 ) l J & f _7 `I3 S Name of Person Area Code & Daytime Telephone Number Enclosed is a check for the following amount: $125.00 Filing Fee D$I30.00 Filing Fee & 0$155.00 Filing Fee & 0$160.00 Filing Fee, Certificate of Status Certified Copy Certificate of Status & (additional copy is enclosed) Certified Copy (additional copy is enclosed) Mailing Address Registration Section Division of Corporations P.O. Box 6327 Tallahassee, FL 32314 Street/Courier Address Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 ARTICLES OF ORGANIZATION FOR FLORIDA LIMITED LIABILITY COMPANY ARTICLE I - Name: The name of the Limited Liability Company is: �Cl-rArv� C-NtEV-Mtsc'S LLC. (Must end with the words "Limited Liability Company," "L.L.0 ," or "LLC.") ARTICLE II - Address: The mailing address and street address of the principal office of the Limited Liability Company is: Principal Office Address: Mailing Address: 3 LI tW6oI St sum e, WAt (L.- ; 3 i'3/ ARTICLE III - Registered Agent, Registered Office, & Registered Agent's Signature: (The Limited Liability Company cannot serve as its own Registered Agent. You must designate an individual or another business entity with an active Florida registration.) The name and the Florida street address of the registered agent are: v e VIAavion 1 ei roc1 Name 3 1 1 1 J ty 1 Florida street address (P.O. Box NOT acceptable) FL 3 City, State, and Zip 3137 Din r—rn r-• rn �.7 rrt rn u) - .e r.rl ZZ :Zf Nd 9— Onv 6C Having been named as registered agent and to accept service of process for the above stated limited liability company al the place designated in this certificate, 1 hereby accept the appointment as registered agent and agree to act in this capacity. 1 further agree to comply with the provisions of all statutes relating to the proper and complete performance my duties, and 1 am familiar with and accept the obligations of my position as registered agent provided for in Chapter 608, F.S.. Registered Agent's Signature (REQUIRED) (CONTINUED) Page lof2 ARTICLE IV- Manager(s) or Managing Member(s): The name and address of each Manager or Managing Member is as follows: Title: "MGR" = Manager "MGRM" = Managing Member (Use attachment if necessary) Name and Address: A-� b`e AX€ trot 31111 NE- GI St m agit 'c FL 33(3r7 ARTICLE V: Effective date, if other than the date of filing: . (OPTIONAL) (If an effective date is listed, the date must be specific and cannot be more than five business days prior to or 90 days after the date of filing.) REQUIRED SIGNORE: Signature of a member or an authorized representative of a member. (In accordance with section 608.408(3), Florida Statutes, the execution of this document constitutes an affirmation under the penalties of perjury that the facts stated herein are true.) } ,-b;e f xel'COC( Typed or printed name of signee ncn r- 'c • c M r 1 c D t -ry-11 S II Filing Fees; o r.) $125.00 Filing Fee for Articles of Organization and Designation a N of Registered Agent $ 30.00 Certified Copy (Optional) $ 5.00 Certificate of Status (Optional) Page 2 of 2 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 XX, LLC", FILED IN THIS OFFICE ON THE NINTH DAY OF JUNE, A.D. 2017, AT 4:27 O'CLOCK P.M. 6439621 8100 5R# 20177213435 You may verify this certificate online at corp.delaware.gov/authver.shtml Page 1 Authentication: 203635990 Date: 12-13-17 State of Delaware Secretary of State Division of Corporations Delivered 04:27 PM 06/09/2017 FILED 04:27 P106/09/2017 SR 20174683152 - File Number 6439621 CERTIFICATE OF FORMATION OF MAGIC CITY PROPERTIES XX, LLC 1. The name of the limited liability company (hereinafter called the "LLC") is Magic City Properties XX, LLC. 2. The registered office of the LLC is to be located at 1013 Centre Road, Suite 403S, Wilmington, DE 19805. The name of the registered agent located at such address is Registered Agents Legal Services, LLC. IN WITNESS WHEREOF, the undersigned Member has executed this Certificate of Formation of Magic City Properties XX, LLC this 9t' day of June, 2017. George Helmstetter, Authorized Representative of Member 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 XXI, LLC", FILED IN THIS OFFICE ON THE NINTH DAY OF JUNE, A.D. 2017, AT 4:29 O'CLOCK P.M. 6439623 8100 SR# 20177213435 You may verify this certificate online at corp.delaware.gov/authver.shtml Page 1 Authentication: 203753692 Date: 12-13-17 CERTIFICATE OF FORMATION OF MAGIC CITY PROPERTIES XXI, LLC ..... . State of Delaware Secretary of State Division of Corporations Delivered 04:29 PM 06/09/2017 FILED 04:29 PM 06109..2017 SR 20174683227 - File Number 6439623 1. The name of the limited liability company (hereinafter called the "LLC") is Magic City Properties XXI, LLC. 2. The registered office of the LLC is to be located at 1013 Centre Road, Suite 403S, Wilmington, DE 19805. The name of the registered agent located at such address is Registered Agents Legal Services, LLC. IN WITNESS WHEREOF, the undersigned Member has executed this Certificate of Formation of Magic City Properties XXI, LLC this 9th day of June, 2017. George Helmstetter, Authorized Representative of Member 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 O. 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 2 9 CELL PHONE: FAX: EMAIL: neisen.kasdin@akerman.com BUSSINESS or APPLICANT or ENTITY NAME Altam Enterprises, LLC BUSINESS ADDRESS: 344 NE 61st Street (Address Line 1) Miami, FL 33137 (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 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 Q NO 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 fonn. 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 eriod of one year after the nullification of the application or order. PERSON SUBMITTING DISCLOSURE: ignature Neisen O. Kasdin Print Name (� Sworn to and subscribed before me this day of . 200 I v . The foregoing instrument was acknowledged before me by , who has produced as identification an .: r is pe sona ly ow a o me and who did/did not take an oath. , / I STATE OF FLORIDA CI P MI$ Perez -Gala ..,,,, A +w• OF BLIC T, N. FLORIDA ;�` `��-' ��- STATE OF FLOR .,�'5' � A �. 6f\-)A- Com FF233833 1 .,t-•-'� r .....- -. Print Name Enc '' ' -'' Expires 6/8/2019rs Page 2 Doc. No.:86543 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 O. 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 2 9 CELL PHONE: FAX: EMAIL: neisen.kasdin@akerman.com BUSSINESS or APPLICANT or ENTITY NAME Magic City Properties XX, LLC BUSINESSADDRESS: 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 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? 111 YES J NO 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 Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; or civil penalties that may be imposed under the City Code, upon determination by disclosure requirement was not fully and timely satisfied the following may occur: 1. the application or order, as applicable, shall be deemed void without effect; and 2. no application from any person or entity for the same issue considered by the applicable board(s) until expiration of a eriod nullification of the application or order. PERSON SUBMITTING DISCLOSURE: the disclosure requirements of and that in addition to the criminal the City Commission that the foregoing further force or shall be reviewed or of one year after the ignature Neisen O. Kasdin Print Name 1 , 200 1 The foregoing U Sworn to and subscribed before me this instrument was acknowledged before me by as identification day f , who has produced an for is personally kn wll o Inc nd who did/did not take an oath. STAT ;,, , ? FLOW9 -Gaffe CI `°-'-�,� VARY PUBUC rs" '''; 'tTyNrE FLORIDA r �I OF ra EP.,�`A /� X ••��' � ar'.' Commit FF233833 TO%� 1—'6 "" •. ' Exp ref O g/812019 �Y J� Print Name Enclosure(s) Page 2 Doc. No.:86543 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 2 9 CELL PHONE: FAX: EMAIL: neisen.kasdin@akerman.com BOSSINESS or APPLICANT or ENTITY NAME Magic City Properties XXI, LLC BUSINESSADDRESS: 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 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 ❑X NO 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 iss shall be reviewed or considered by the applicable board(s) until expiration of a p of one year after the nullification of the application or order. PERSON SUBMITTING DISCLOSURE: Sig re Neisen O. Kasdin Print Name Sworn to and subscribed before me this day of 200 . The foregoing instrument was acknowledged before me by 0 Iwlio has produced as identification an ; or as ersonally known to me ana vho did/did not take an oath. STATE OF FLORIDA CITY OF NIIAMI MY COA1IvS( t ty r. '.,, P'.IBUO )\OPK ARY W.._ q ' STATE OF FLORIDA Print Name c;.r ' 4-•• rn# "+�,,�.�. FF233833 •"• V 61812019 Doc. No.:.'�'�� s�'• EXpI�®S Page 2 Paid By Miami -Dade County, Florida Effective Date 11/30/2017 plicate public_user 06/04/2018 Paid 12/18/2017 Receipt # Acct01-18-000564 $9,577.88 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 01-3218-022-0040 MIAMI 0100 ALTAM ENTERP LLC 344 NE 61 ST MIAMI, FL 33137 Property Address 340 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 578,008 578,008 418,203 418,203 418,203 418,203 418,203 418,203 418,203 418,203 418,203 6.77400 0.22000 0.03200 0.12750 0.13840 0.04410 0.46730 4.66690 0.40000 0.28400 578,008 578,008 418,203 418,203 418,203 418,203 418,203 418,203 418,203 418,203 7.43650 418,203 418,203 0.59350 NON -AD VALOREM ASSESSMENTS RA 418,203 3,915.42 127.16 13.38 53.32 57.88 18.44 195.43 1,951.71 167.28 118.77 3,109.97 248.20 Save Time. Pay Online. www.miamidade.gov t RETAIN FOR YOUR RECORDS t (Combined taxes and assessments $9,976.96 i 2017 Real Estate Property .. DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 4- Du.licate .ublic user 06/04/2018 Taxes FOLIO NUMBER 01-3218-022-0040 PROPERTY ADDRESS 340 NE 61 ST LEGAL DESCRIPTION 18 53 42 DULLAMS UNRECORDED PLAT SAME BEG 204.5FTS & 918.5FTE OF NW COR SW1/4 S100FT E100F ALTAM ENTERP LLC 344 NE 61 ST MIAMI, FL 33137 0 1 3 2 1 8 0 2 2 0 0 4 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 PAY ONLY ONE AMOUNT If Paid By Please Pay Dec 13, 2017 $0.00 1000000000000000000132180220040201700000000000000000000004 Paid By Miami -Dade County, Florida Effective Date 11/30/2017 plicate public_user 06/04/2018 Paid 12/18/2017 Receipt# Acct01-18-000563 $14,153.60 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 01-3218-015-0720 MIAMI 0100 ALTAM ENTERPRISES LLC 344 NE 61 ST MIAMI, FL 33137 Property Address 371 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 843,106 843,106 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 6.77400 0.22000 0.03200 0.12750 0.13840 0.04410 0.46730 4.66690 0.40000 0.28400 7.43650 0.59350 NON -AD VALOREM ASSESSMENTS RA 843,106 843,106 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 623,434 5,711.20 185.48 19.95 79.49 86.28 27.49 291.33 2,909.50 249.37 177.06 4,636.17 370.01 Save Time. Pay Online. www.miamidade.gov t RETAIN FOR YOUR RECORDS t (Combined taxes and assessments $14,743.33 i 2017 Real Estate Property .. DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 4- Taxes FOLIO NUMBER 01-3218-015-0720 PROPERTY ADDRESS 371 NE 61 ST LEGAL DESCRIPTION PIERCES DIV LEMON CITY PB B-43 LOT 3 BLK 18 LESS PB 2-21 S2.5FT & LESS N8FT M/L FOR R/W LO ALTAM ENTERPRISES LLC 344 NE 61 ST MIAMI, FL 33137 11111111111 II 111111 II 0 1 3 2 1 8 0 1 5 0 7 2 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 Dec 13, 2017 $0.00 1000000000000000000132180150720201700000000000000000000001