David Edelstein - South Beach Tristar, LLCR
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MIAMI BEACH V
City of Miami Beach Office of the City Clerk \0 �Lit
1700 Convention Center Drive, Miami Beach, FL 33139 ` ti
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.
Edelstein David
NAME OF LOBBYIST: (Last) (First) (M.l)
South Beach Tristar, LLC 140 N. Federal Highway, 2nd Floor, Boca Raton, FL 33432
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
561-241-6336 DEdelstein(a-)-tricap.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
1. LOBBYIST RETAINED BY:
South Beach Tristar. LLC
NAME OF PRINCIPAUCLIENT:
Same 140 N. Federal Highway,2nd Floor, Boca Raton,FL 33432
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
561-241-6336 (William Weisman, Registered Agent)
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: David Edelstein,Managing Member
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: David Edelstein—60%;Jackie Mansfield—20%;Robert Futterman—20%
II.SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for Miami Beach Community Church located at 1620 Drexel Avenue
Issue to be lobbied(Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(x)(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,s ing the general nature of the suNect contractual relationshi .
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Staff of Planning Department,Building Department,and Public Works Department None. X
B,BPB,BOA,City Commission,as necessary None. 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,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is
sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2-482(8)Any Financial,Familial or Professional Relationship
None
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