David A. Napolitan/304-312 Ocean Drive, LLCMIAMIBEACH
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 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.
Napolitan David A.
NAME OF LOBBYIST: (Last) (First) (M.I)
Restaurant Strategies 1688 West Avenue, #1004 Miami Beach, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212) 223-7275 dnapolitan@restaurantstrategies.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
304-312 Ocean Drive, LLC
NAME OF PRINCIPAL/CLIENT:
600 North 3rd Street. 2nd Floor Philadelphia PA 19123
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(215) 625-9722 (215) 625-0167 IouisiorocofskylCaearthlink.net
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: Phillip McFillin, Louis Orocofsky
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Phillip McFillin
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 304-312 Ocean Drive - COA, Variance Approvals, and Conditional Use Permit
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Planning Dept., HPB, BOA, Planning Board, City Commission * None
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* Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied~outsi~ o'Y'a ptibhearing setting.
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I`~ DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FL~i T RATE OR OTHERt
A) LOBBYIST DISCLOSURE: (Required) ~ ,~-~ caper hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $~`JL per hour
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 X No• Are you lobbyina on a present or pendina bid for goods eaui~ment or services, or on a
present or pendina award for aoods eauiament or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No• Are you lobbying on a pendina apalication for a Development Agreement with the City or
aaplication for change of zoning maa designation or chanae to the City's Future Land Use
Mau?
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 X No• Are you representing snot-for-profit corporation or entity without special comaensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC NG CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXP~D,ITU ES OR COMPENSATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist
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I do solemnly swear that alt
familiar with the provisions c
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI
of the foregoing facts are true and correct and that I have read or am
~ntaine~-iq Section 2-482 of the Miami Beach City Code and all reporting
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Produced ID t' L' ,.l ~ ^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII.
SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to~yn~subscribed befyore me r1
This ~~ ~~dav of ~~'Y>~~71 ~ , 207-ItJ
Sigry6t"ure of~'ublic Notary -State of Florida
Notarization of Lobbyist's signature
Form of Identification
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # Date Paid
Lobbyist Registration Form received and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\LObbyist\LOBBYIST fORM OS.doc Revised 12/08/04
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) $ 250 00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 250.00 per hour
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 X 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 X No• 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 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 anot-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 X No: Are you representing anot-for-profit corporation or entity without special compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF 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.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Clien~ o~ --~''---~ '----__~ Manager
LOBBYIST IDENTIFICATION:
~~ Produced ID
PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification Form of Identification
i Personally known (Lobbyist) X Personally knoylilb(~IIrOTC1~al~.TH OF PENNSYLVANIA
NOTARIAL SEAL
HEATHER SCANLON, Notary Public
City of philatlelphliir, phll~. County
PA, C ~~RiP41i1 fires December 11, 2010
rid subscribe before fne
day of ~i',2008 ; '
e of'~ublic Notary- State of Flflric~a j~
ation of Principal's signature
R ~ `b ~~~ Date Paid ~~ ~~
Entered By:
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of
Sworn to and subscribed before me Sworn
This day of , 20_ This ~ ;~'
Signature of Public Notary -State of Florida Signatt+r
Notarization of Lobbyist's signature Notariz
FOR CLERK'S US~ONL
Annual Registration fee: [ ]Yes [ ] No Amount Paid ___~__~ MC
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc
Revised 12/08/04
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
~~ ~~~ ~
L~L~YIST NAME: /~ ~~
CityClerk@miam ibeachfl.gov
I understand that no later than October 1st of each veer, I must file the following
forms, 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 Form
2) Disclosure 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.
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ignature: Date:
I~~:viseia ~12marzoos