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Matthew Amster - SML 350 Lincoln, Inc. 0 MIAMIBEA ► Pl� - , , °, P 3S City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach,; FL 3313 ) 1 LOBBYIST REGISTRATIONiFORM Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to ena v t le passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decisic ni 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 foreseeabl p will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term 'Lobbyists" has specific exdusions. Please refer to Ordinance 2004 -3435. Amster Matthew NAME OF LOBBYIST: (Last) (First) (M.I) Bercow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131 _ BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 377 -6236 (305) 377 -6222 mamster(ci tirzoninalaw.com TELEPHONE NUMBER: FAX NUMBER: EM AI : 1 I. LOBBYIST RETAINED BY: 1 SML 350 Lincoln, Inc. (Meir Levy, Vice President) NAME OF PRINCIPAL/CLIENT: 1 SML 350 Lincoln. Inc. 666 Broadway. 2n Floor New York City New York 10012 BUSINESS NAME AND ADDRESS (Number and Street) (City) i (State) (Zip Code) (212) 481-7943 (212) 481-7945 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) i Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Shaul Levy, President; Meir Levy, Via P resident • IDENTIFY ALL PERSONS HOLDING DIRECTLY OR INDIV.CTLY, A 5° OR QRE OWNERSHIP INTE N SUCU CORPORATION, PARTNERSHIP OR TRUST: 7 c e4 n AL.( Levy /t i. II. SPECIFIC LOBBY ISSUE: Development approvals and variances, including beer & wine distance separation n variances for renovatiun of ground floor of 350 Lincoln Road Issue to be lobbied (Describe in detail): I 1, III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual /Title B) Any Fina Icial, Familial or Professional Relationship Planning Department Staff, HPB, BOA, Planning Board and City Commission* None * Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied out side of a public hearing setting. 1 I 9,/,.- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $ 310.00 per hour ! B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 310.00 per hour The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2 -488 Entitled "Prohibited Campaign Coiitributions By Lobbyists On Procurement Issues ": , ❑ Yes X No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited :ampaign Contributiors By Lobbyists On Real Estate Development Issues ": I i ❑Yes X No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation for change to the City's Future Land Use Map? I' 3) Pursuant to Miami Beach City Code 2-484 (h) Any person 1 (except those exempt from the definition o "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not - for - profs: corporation or entity without special compensation or reimbursement for the appear ance, whether direct, o • indirect, to express support of or opposition to any item, shall register with the clerk as' required by this section but, shall not be required to pay any registration fees.] ❑ Yes X No: Are you representing a not - for -profit corporation or entity without special compensation or reimbursement. I V. SIGNATURE UNDER OATH: ' ON OCTOBER 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CIry CLERK A SIGNET[ STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATIOI RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. iA STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPEN URES 0 OMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or ani familiar with the provisions contained in Section 2 -482 of the Miami Beach City Code and all reporting requirements. ' i Signature of Lobbyist: �/' ��- Signature of Principal /Client: ' VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ii Produced ID ' ' Form of Identification Form of Ide tification /Personally Personally known (Lobbyist) APersonall known (Princip 1) i VII. SIGNATURE AND STAM __ • iiIli , s CRISTINA D. GONZALEZ State of Florida, County of Miami-D._ ,,,, *= MY • C OMMISSION q D D . : o' Jew York, County of New York Sworn to and subscribed before me EXPIRES: March 23, p Bo nded Thru Notary Public ,, : • d day o ri bed m 2 0 t 1 A714.-. TA714.-. th-i day of - 5\51---.1 = _� _- . _ Signature of Public Notary Stat of Fl ida Signature of Public Notary — Spate of New York Notarization of Lobbyi s signature Notarisation of Principal's signature 7---A ?-1 / FOR CLERK'S . SE ONLY �/ 2:5'V . !- ' , ' r Annual Registration fee: [ ] Yes [ ] No Amount Paid / MCR ee ai Q KR? TOOK warmly L COUNTY obbyist Registration Form received and verified by •# i Entered By: 4 t o m F• \CLER \$ALL\MARIA -M \Lobbyist \LOBBYIST fORM 05.doc I i Rev sed 1 0 /04 . I ' bbl AM �- C 1. .,..; ..,.� City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www,miamibeochil.gov , CITY CLERK Office CityClerkigimiamibeachfl.gov Tel:105.673.7411 , Fax 305.679.7254 ' I LOBBYIST NAME: MATTHRW AMSTRR 1 understand that no later than February 28th of each year, I must file the following form, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1 ) Lobbyist Expenditure and Compensation Form Failure to file these forms an a timely basis will result in my Name being transmit'ed to the Miami -Dade County Commission on Ethics and for .code violation evaluation. in addifion, once an issue I have registered to lobby or has been resolved, 1. am required ro immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Signature: Da :