Jeffrey Bercow - Eval Weinstein & Gabriela Oliwkowicz Weinstein AAIA/\AI BEACH
City of Miami Beach Office of the City Clerk �.
1700 Convention Center Drive, Miami Beach, FL 33139
2125 LOBBYIST REGISTRATION FORM f ®�" r w k, 9: 15
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to;,eaburage the passage, defeat or
modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendatron o.f 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.
Bercow Jeffrey
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow Radell 86 Fernandez, P.A.200 South Biscayne Boulevard, # 850, Miami FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377-6220 305-377-6222 JBercowa,BRZoningLaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address, phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Eval Weinstein 86 Gabriela Oliwkowicz Weinstein
NAME OF PRINCIPAL/CLIENT:
2900 Prairie Avenue Miami FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 790-9535 eyalweinstein(gmail.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: N/A
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: N/A
II.SPECIFIC LOBBY ISSUE:
Development Approvals 85 Permitting Issues relating to the property located at 2900 Prairie Avenue, Miami Beach, Florida
Issue to be lobbied(Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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 Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning, Building and Public Works staff None. X
PB, DRB, BOA, City Commission, and Land Use None. X
Development Committee, as necessary
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(g)Any Financial,Familial or Professional Relationship
None.
None.
None.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$625.00/hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $625.00/hour
(REQUIRED).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes XNo: Are you lobbying on a present or pending bid for goods.eauipment or services.or on a present or pending
award for goods.equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning map designation or change to the City's Future Land Use Map?,
3) Pursuant to Miami Beach City Code Section 2-482 (h)Any person (except those exempt from the definition of"lobbyist" as set
forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without
special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or
opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration
fees.
_YesXNo; Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST S ' SUBMIT TO T ITY CLERK A SIGNED STATEMENT UNDER
OATH. LISTING LOBBYING EXPENDITURES. AS WEL AS OMPENSA 'ECEIVED. IN THE CITY OF MIAMI BEACI-(
EQ$ THE PRECEDING CALENDAR YEAR. A ST E , , SHAL B FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR •i4 - ► _ •► i ► •7..417 - •■
• aureofL.,bby.'
I do solemnly swear that all of tre f'-regoing f.- :red e and c• -ct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami :ea y ity C-.ems,• - repo •;'equirements.
/
Signature of Lobbyist:
Signature of Principal/Clie/
VI. LOBBYIST ID T '!CATION: PRINCIPAL IDENTIFICATION: -— - -
v
Produced ID ° ;+ ..'.4o;; Produced ID W o '
Form of Identification g'gfk ,�. :e, Form of Identification 1
/Personally known (Lobbyist) n X Personally known (Principal)
m
'-
VII. SIGNATURE AND STAMP OF NOTARY: o � p =4
amKz
State of Florida, County of Miami-Dade o v State of Florida, County of Miami-Dade
Y cn _ Y
Sworn to and subscribed before me .z n� �-" a Sworn and subscribed efo a me
z
This a1ND day of s�'E�,Q,,, 201er 2 ? z > T ZISk day of ,?,A11
.014
Z
f ti
r
Signature of Public Notary tat F da 3 o Signature u lic Notary-
State of Florida ""*
Notarization of Lobbyist's signature co a n Notarization of Principal's,signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ B\_MCR# 4 O% % Date Paid )O-Cr 1c-
Lobbyist
Registration Form receive and verified by:
AAIAi\A!I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granath), City Clerk
CityClerk(q?miamibeachfl.g
ov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Jeffrey Bercow
I understand that no later than February 28 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, or
am no longer lobbying on that issue or for that principal, I am required to
immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or
principal) who fails to timely file a Statement and in addition to any other
penalties which may be imposed as provided in Section 2-485.1, a fine of
$50.00 a day shall be assessed for all Statement(s) filed after the due date.
The City Clerk shall notify the
Miami-Dade County Commission on Ethics and Public Trust of the failure of a
lobbyist (or principal) to file the Statement or pay the assessed fines after
notification.
A. lo,byist, who f. • to file the required Statement by April 30th, 2012,
hall e automa • i. suspended fro lobbying until all fines are paid,
unles- he fine ' • . , -en appealed t• e Miami-Dade County Commission on
1nd Pu• ' =�
/Signa re: Date:
_ i,s,::cellaneou Gash Receipt _ ��xc c = le C _
a 1 `lH a- 6 -4r " t7 3
, --;::','..-,,:.;',.,,-::;::-,:-:-:::':::::- .,::',-,----',.:',.-":11:f-_-',_.". .:.".,„CITY OF MIAMI.BE�►CI�t A r i:. £?S fi.3�} ! »r -.4,--- .J �� 4 ` -,:::::---:...•.;.'''.,',:;--:..,..
. ,
,''..':'',Illikt,:i...q..,;:.,',:.-..-:.'.-,,..s.:,,:!::-±.:.} D Gash D Credit Card Check#. ';
S I
..,,-.1--.:4-7.,::::::3.-;-,-.'''.,,,--,:;,.,-V--;--;..:',;',:_-..,:r..-',',;;,.. ,-..,:-..[,:-;-:.,-.-f?3.-:,-.----::.:;,--.77,-:,.., „,-.•,,,-;':-y.:.,---.Received of x e I 1 4 t A
--."..s,...-,, .. ,..,-,-,,,,,,,-Ad ress- -., - --
r ,' -.r • - r t
F -INFORMATION MUST=BE COMPLETED Office®f Finance Director''•THIS III Of8
.".Y,`.....--J,..-'.:";''''.-,Yia":':-..--=':-;,'- --.'-•L'.- -''.•-"'";,-,..."':-:.'. .7••:-;•-',2'-':_:',..-2:-::......- ...,-..61-! -.r„s � 7 M Z Account Nurabe .govo .,
a= _ Prepare r. _ � :�� �.a. - • ..D pt: .. _ .
'11�. _ - - fy
. cr i•..�r�av-.�- r. .,;- ,r , 7.-,- .. •- ..L_�. Y_x � _}ry M_2 -l.�V f- -ti-"J - ,....r ]r„ -,,
_ `J —
r';.?CN l `�m D •. cD
sal X-3# O rni- 6\3(1),<r-4---"
rf C7 _so
C3-1
CD 01 CO 0N -. � 3
�° CD oo _. sv
a n CO c;o °�' .
3 �-+
fir- n 0` B CD
r- N — r" (7 CIJ
CD CD T
C51 01 oc� + -+ z o
O p . 3
sa
C7 1 W
`c N
n N
CD