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Peter A. Zalewski - Palau Sunset Harbor, LLCCity of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel during the time period of the entire decision - making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004 -3435. Zalewski Peter A. NAME OF LOBBYIST: (Last) (First) (M.I) Condo Vultures, LLC, 1005 Kane Concourse, Suite 205, Bal Harbour, FL 33154 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 -865 -5629 1- 305 - 832 -0311 (e -fax) peter @condovultures.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. LOBBYIST RETAINED BY: Palau Sunset Harbor, LLC NAME OF PRINCIPAL/CLIENT: Meir Srebernik, c/o Mathew Cicero, South Florida Condominium Management, Inc., 3100 NW 72 Avenue, Suite 113, Miami, FL 33122 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 - 637 -3699 305 - 634 -7607 mcicerosflamat.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2 -482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Meir Srebernik, President, Palau Sunset Harbor, L • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached Exhibit "A" LC ILSPECIFIC LOBBY ISSUE: Develop property with a mixed -use residential and commercial structure (requiring conditional use permit: Issue to be lobbied (Describe in detail): gey fa/c2s° itiVh ��i� :2,9 s' `6i` ,' 41,1 j/ ,P; /v s3/3� Ill. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: o°(i ' ` ��^' Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date, stating the general nature of the subject contractual relationship. Sec 2- 482(a)(4) Full Name of Individual and title of person to be lobbied Contractual Relationship (Explain) YES NO Planning Board, Design Review Board X Richard Lorber, Acting Planning & Zoning Director X City Planners - Mercy Lamazares, Michael Belush, Katia Hirsh X Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional relationship, to be or other as identified on giving g rise to an re appearance eo of anlimproprieti AiihIeytggrenk.city commissioner or city personnel who is 9 Y 9 SIB Sec 2- 482(g) Any Financial, Familial or Professional Relationship ce .f, , None IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) � Hourly - $ �� '9° B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ' (Required). Hourly - $ ,�cv. The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2 -488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues ": ❑ Yes El 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 Campaign Contributions By Lobbyists On Real Estate Development Issues ": ❑ Yes g No: Are you Iobbyinq on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code 2 -484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2 -481 above) who only appears as a representative of a not- for - profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees. ❑ Yes I No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL •ME- NSATION REQ.E.B/E-D, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMEN HALL B 1/LED EVE THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERI• I do solemnly swear that all in Section 2 -482 of th-. ' iami Beac Signature of Lobbyis Signature of Principal /Clie Sign- - of Lobb -t rego facts are true an correct and that I have read or am familiar with the provisions contained C: ode and all r rting requirements. VI. LOBBYIST IDENTIFICATION: ❑ Produced ID Form of Identification 1 Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade Sworn tAana subscribed fore e This G eay s 7 , 2OlX 2012 ignature(of Public Notary — State of Florida Notarization of Lobbyist'spignature PRINCIPAL IDENTIFICATION: Produced ID , D ( (7 1- Form of Identification ❑ Personally known (Principal) State of Florida, County of Miami -Dade Sworn and subscribed 'efore This d . r 201X 2012 ature of Public Notary - tate ' Florida Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S TAFF •NL Annual Registration fee: [ ] Yes [ ] No Amount Paid $ 'g5) . MCR # Lobbyist Registration Form received and verified by: LOMYIST :°..'.isMeALr:'r`;byist Annual FiegLt-.at €o:? Date Paid .41: • X -< - C) p 52 a. u) Ku�v is- o P+ ca as c m ?t N R Revised 1/11/2011 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.7411 , Fax: 305.673.7254 CityClerk @miamibeachfl.gov LOBBYIST NAME: Peter A. Zalewski I 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 on a timely basis will result in my name being transmitted to the Miami -Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Signa ure: VC/4 Z4 Date: PATHMAN LEWIS, LLP ATTORNEYS AT LAW WAYNE M. PATHMAN, P.A. HAROLD L. LEWIS, P.A. DAVID E. SACKS LOUIS P. ARCHAMBAULT JOHN A. MOORE* DAVID JOVE BRUCE L. BENNETT"* SARA WALTERS ANTHONY VICTOR DE YURRE JONATHAN C. BROWN PETER L. MELTZER * also admitted to practice in Texas Member Washington, D.C. Bar Ms. Silvia Prieto City of Miami Beach City Clerk's Office 1700 Convention Center Drive Miami Beach, FL 33139 RE: PALAU Dear Silvia, March 26, 2012 ONE BISCAYNE TOWER • SUITE 2400 2 SOUTH BISCAYNE BOULEVARD MIAMI, FLORIDA 33131 -1803 TELEPHONE (305) 379 -2425 FACSIMILE (305) 379 -2420 www.pathmanlewis.com DAVID E. SACKS dsacks@pathmanlewis.com Please see enclosed Lobbyist Registration Form for Mr. Peter A. Zalewski. My assistant Sandy paid for the Annual Lobbyist Registration Form and attached Lobbyist Registration Form on Friday. Very truly yours, PATHMAN LEWIS, LLP David E. Sacks DES /sls Enclosures r: \palau sunset harbour \palau sunset harbour - zoning and use \Itrs \silvia prieto enc peter zalewski lobbyist registration form.docx li S JId313 )d13 C? :C kid n ll0Z a City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk' Office Tel: 305/673 — 7411 Fax: 305/673 - 7254 ANNUAL LOBBYIST REGISTRATION FORM Name: Peter A. Zalewski Business Name: Condo Vultures, LLC Address: 1005 Kane Concourse, Suite 205, Bal Harbour, FL 33154 Phone: 305 - 865 -5629 Email: peter @condovultures.com If more than on Lobbyist, please list: 1) 2) 3) MCR #: Amount paid: Date paid: Processed by: Date: Send this form with a check for $500 payable to the City of Miami Beach for each lobbyist FABLER \$ALL \aFORMS \LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM.docx THE FACE'CF THIS DOCUMENT HAS A COLORED 6ACKGRO�ND ON WHITE PAPER THAT IS SENSITIVE TO _O� EMICAL ALTERATION FOR SECURITY, THIS DOCUMENT CONTAINS A TRUE WATERMARK ON LACK HOLD TO LIGHT TO VIEW 63 1462/670 Book..i NO , { { ;CO�al Gables FL, 33134 '' i i !;I '6 I� I• • I I i� I I i u' �,, CHECK NO CHECK DATE VENDOR PALAU SUNSET HARBOR LLC 3100 NW 7.. 2ND AVENUE 000065 03/15/12 CITYOF NT I /,� f I �t I I' I I I I I I V; IAMI FL' 3;3122; , ,�'� CHECKAMOU7 I � I II * * * * * * *3 750 00 THREE�THOUSAND SEVEN HUNDRED':FIFT• AND 00 �100�DOLLARS I „ , !n II• I i, +� I ��' I i., � , -. ., � ;I �i% /.l �!I .✓ �, L' � I P 1 I i i -4 � , TO THE Y D OF MIAMI BEACH " � ORER ®F' �/AuI�E�z js (� c r;P?�' I 1 CIT • �dA G • I -, , �A 10RIZEDSIGNATURE �� • u� 0 rrl ti 0 0 ru 1 ti ti 0 D- LO 0 000006 511'