Michael Gil/Yaakov and Roza HalmovCity 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, wheti~er Paid or not, by a prirx~pai who seeks tp erage tine
passage, defeat or modification of any ordir-arK:e, resolution, anion or derision of any aommissiorier any aeon, derision,
recomrr~end~on of the Cdy Manager or any aty board or oon~niltee; or any action, derision or recommendation of any
aty persoru~el during the time period of the entire deasan-making process on such action, decision or recommendation
that foreseeably will be heard or rcwiewed by the city oarrNssion, or a city board or aornmitbee. The berm specifiraily
irxiudes the prirxipal as well as any employee e~x,~apedin lobbying actihties. The berm `lrobbYisis" has spadHc
exdusfons. Please refer bo Ordinance 2004-3435.
Gil Mid'iael
A
NAME OF IABBYIST: (Last) (First)
(M.I)
Bernow, Bedell B Fernandez P.A.
33131
BUSINESS NAME AND ADDRESS
(~P ~)
(305)377-8690
TELEPHONE NUMBER:
200 South BLscayne BNd., Suitie 850
(Number and Street) (City)
(305) 377-6222
FAX NUMBER:
Miami, Florida
(~~)
rrgil~ilbrzoninglaw.oom
EMAIL:
I. LOBBYIST RETAINED BY:
Yaakov and Roza Haimov
NAME OF PRINCIPAL/CLIENT:
X757 Prairie. Avenue Miami Beach Florida,
33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
(gyp ~)
(305)216-6457
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
~ out this sectlon if prinaipai is a corporation, Partnersi>~- or Ttust [SeWon 2-482 (c)]
•1 NAME OF CHIEF OFFICER, PARTNER, OR BENEFICURY:
•2 IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
C~tPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Design Review Approval from the Design Review Boats ~ 31 J ~ ~(~,~,~ ~42--
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Fall Name of Ir~nridual/Title B) Arh f Rnandal. Fa~fal or Prefesdoml p ',
Planning ~. ~, ~Y ~ None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
ter, fur~rEO,~or~~:
A) LOBBYIST DISCLOSURE: (Required) ~ 165.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). S 165.00 per hour
The following information must be answered:
1) Pursuant to Miami Beach qty Code Section 2-488 Entitled "Prohibited Campaign Contributions By
Lobbyists C+n Procurement Issues":
QYes X No• Are you ilobbvi~,g on a orpsent or ~,g bid for goods, epuipment or services. or
on a present or Wending award torg~,~yjwnent or service?
2) Pursuant to Miami Beach qty Code 2-490 F_ntitled "Prohibited Campaign Contributions By Lobbyists
On Real Estate Development Issues":
DYes X do: Are ~g on a pending apdication for a Development Aare~ernent wilt! the
City or application for change of zor~ina map desjgnatjon or change to the CiiLv's
Future Land Use Map?
3) Pursuant to Miami Beach Gty Code 2-484 (h) Any person (except those exempt from the definition
of "bbbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-for-
proiitcorporation or entity without special compensation or r~eimbursernent for the appearance,
whether direct, or indirect, to express support of or opposition do arty iberrr, shall register with the
dark as required by this sed3on but, shall not be required to pay any registration fees..
D Yes X No: Are you representlng snot-for-proRt corporation or entiLr witl~out special
V. SIGNATURE UNDER OATH:
ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CiiY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS
t~OMPENSATION RECEIVED, IN THE CITY ~ MIAMI BEACH FOR THE PRECEDING CALENDAR
YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
'i
Si of Lobbyist
I do soletnniy swear that all of the foregoing facts are tnie and correct and that I have read or
am familiar with the provisions contained in Section 2-482 of the Miami Beach qty Code and all
reporting requirements.
Signature of
S~nature of Principal/Client:
vI. LossYlsT
D Produced ID
Form of Identification
D Personally known (LobbyLst)
VII. SIGNATURE AND STAMP OF NOTARY:
~q i /Yl0
PRINCIPAL IDENTIFICATION:
D Produced ID
Form of Identification
naly known (Principal)
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State of ,County Miami-Dade State of Florida, County of Miami-Dade
S subscri
This day of 20~
. Swom an~lsubsai before
Thist,~~ y of 20~~Pu
a~ ~ •••.B~% UICIAJ. MORAGA
* * MY COMMISSION q DD 526512
~ Florida
lion of Lofbbyislvs sig re EXPIRES: March 8, 2010
Nj ~!
~ ~ ~ Nota ~~ Bonded Thru Budget Notary Services
riZation Of iPrincipal's signature
~ ~ i~ ~~~ ~~~ ~
Ann fee: [ Yes [ ] No Amount Paid M(R # ~ Date Paid
Lobbyist R Fam received and verified by: Entered By:
F:\CLER\Sw.\MARU-M\LohbY~s~1L086Y15T FORM QS.doc
ReMeed 12/08J04