Abraham Werjuka/Savoy Hotel City 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 pdndpal 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 recommendaUon of any' dty personnel defined in any
manner in this section, 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 dry commission, or a dty board or committee. The term specifically includes the
principal as well as any employee engaged/n lobbying activities. The term "Lobbyists" has specific exclusions, Please refer
to Ordinance 2004-343S.
· ROSEN . HAROLD
NAME OF LOBBed: (~st) (First)
ROSEN SWITKES CABRERA & ENTIN, P.L. 407 LINCOLN ROAD, PHSE
(M.I)
BUSINESS NAME AND ADDRESS
(305) 534-4757
(Number and Street) (City)
(305) 538-5504
:MIA~e~EACH, FL~>IC~)
TELEPHONE NUMBER:
X.. LOBBYXST RETAXNED BY:
ABRAHAM WERJUKA
FAX NUMBER: EMAIL:
NAME OF PRINCIPAL/CLIENT:
SAVOY HOTEL MANGEMENT LLC. 400-420 COLLINS. AVENUE, MIAMI BEACH, FL
BUSINESS NAME AND ADDRESS (Number and Street)- (Qty) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership er Trust [Section 2-482 (c)] '
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
ABRAHAM WERJUKA
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
IX. SPECXFXC LOBBY XSSUE:
APPEAR BEFORE THE HISTORIC PRESERVATION BOARD
Issue to be lobbied (De~.,ibe in detail):
XXX. CXTY AGENCXES/XNDXVZDUALS TO BE LOBBXED:
A) Full Name of Xndividual/Tifle B) Any Financial, Fariflilalor'professronal R. elaUott~,ip
HISTORIC PRESERVATION BOARD
IV. DTSCLOSURE OF TERNS AND AMOUNTS OF LOBBYTST COMPENSATION (DI'SCLOSEdlH.~I-I£R ~-IOUl~i Y~
FLAT RATE OR OTHER.):.
A) LOBBYIST DISCLOSURE: (Required) $ 4 5 0.0 0 an hour
B) PR[NCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSAT[ON): (Required). $ 4 50.0 0 an hour
D Yes ~:No: Are You representinq a not-for-orofit coruoratJon or entity without special compensation · reimbursement. Pursuant to Ordinance No. 2004-3435.
1) .Pursuant to Ordinance No. 2003-3393 Amendinq Miami Beach City code Chapter 2, Article VII, Division 5
Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibite, I
Campaiqn Contributions Bv Lobbyists On Procurement Issues":
[] Yes ~o: Are you Iobbyinq on a present or oendina bid for Qoods. equipment or services, or on a oresen
or oendinq award for aoods, eauioment or service?
2) .Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach City Code Chapter 2, Article VI! Division
thereof Entitled "Campaign Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibite, I
Campaian Contributions By Lobbyists On Real Estate Development Issues":
DYes .~ No: Are you Iobbvina on a pendinQ aoulication for a Development Aareement with the City
aoolication for chanqe of zoninu mao desiqnation or chanqe to the City's Future Land Use Map?
V. SIGNATURE UNDER OATH:
Signature of Principal/Client: ~
VL LOBBYZST, D E NTZ F~CATTO N .'~/~_///
[] Produced ID
FoFm of Identification
~f'/'PPersonally known (LobbyiSt)
ON OCTOBER IsT OF EACH YEAR, EACH LOBBYZST SHALL SUBMZT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LTSTZNG LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAM! BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTLNG PER~OD.
Signature of Lobbyist
]: do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am
familiar with the provisions containedJ, Pr-~ction 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
l~'Produced ID 7C/-~ ~;;~L
Form of Identification
[] Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to.and subscribed before me ·
This __~a~___day of ~ 20~)~
Signature of Public Notary - State of Florida
L...;';'::':; ....... ~,..,~.......o.~ ...,~..;; .,..,c.. i
State of Florida, County of Miami-Dade
Sworn and subscribed 'before me __
This 1~~, 20 O~
Signature of Public Notary - State of Florida
Notarization of Principal's signature
~,~'~ Notary Public State of Florida
-'~:~ Craig M Dome
My Commission DP432417
Expires 05/22/2009
FOR CLERI(JS USE ONLY ;
Annual Registration fee:. ~:~] Yes ( ] No Amount Paid ~75 ~ MCR # ~----~"'~-~"~ b Date aid .--~-~~
Lobbyist Registration Form received and verified by: .~::::~~,
Revised 02/10/04 F: L'~--ER~.LL\MARIA-M\LOBBYIST\LOBBYIST FORM 04