Benton Launerts - Palau Sunset Harbor, LLCCity of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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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.
Launerts Benton
NAME OF LOBBYIST: (Last) (First) (M.I)
Parksman Parking, LLC, 18851 NE 29 Avenue, Suite 1011, Aventura, FL 33180
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
888 - 982 -7275
305 - 466 -6606 ben @parksmanparking.com
TELEPHONE NUMBER:
FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
LOBBYIST RETAINED BY:
Palau Sunset Harbor, LLC
NAME OF PRINCIPAL /CLIENT: Meir Srebernik, c/o Mathew Cicero,
South Florida Condominium Management, Inc., 3100 NW 72 Avenue, Suite 113, Miami, FL 33122
BUSINESS NAME AND ADDRESS (Number and Street) (City)
305 - 637 -3699
305 - 634 -7607
(State) (Zip Code)
mcicero an.sflamgt.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: Meir Srebernik, President, Palau Sunset Harbor, L
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Attached Exhibit "A"
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u.SPECIFIC LOBBY ISSUE:
Develop property with a mixed -use residential and commercial structure requirin�g conditional use permit
Issue to be lobbied (Describe in detail): 47— `�0/4a ,2s 4237 „201-Y it/42W $ei1 `.c/, /'� 3 '/
nl. 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
title of person to be lobbied
Contractual Relationship (Explain)
YES
NO
Planning Board, Design Review Board
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Richard Lorber, Acting Planning & Zoning Director
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City Planners - Mercy Lamazares, Michael Belush, Katia Hirsh
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Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial crprof€ sional=
relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city peonn�twho
dentified on the lobbyist registration form filed. G1 —
Sec 2- 482(g) Any Financial, Familial or Professional Relationship
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None
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE: (Required)
No Compensation
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).
No Compensation
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
2)
❑ Yes
n 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?
Pursuant to Miami Beach City Code 2 -490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues ":
g 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 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 I No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th 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 Bea • y Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal /Cliei .
VI. LOBBYIST IDENTIFICATION:
❑ Produced ID
Form of Identification
1 Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami -Dade
Sworn and;tsubscribe be re me
This l/`�UU da of 2oot 2012
naiure oT<Ptiblic o ary — State of Florida
Notarization of Lobbyist's si ature
PRINCIPAL IDENTIFICATION:
❑ Produced ID
Form of Identification
a Personally known (Principal)
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State of Florida, County of Miami -Dade 4• _,c•4
Sworn and subscrib be •re me
This d y max 201) "titre
gnature of Public Notary — State . bride
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ Yes [ ] No Amount Paid $ ,'S O MCR # 3 /$ L Date Paid
Lobbyist Registration Form received and verified by:
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Revised 1/11/2011
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 , Fax: 305.673.7254
CityClerk @miamibeachfl.gov
LOBBYIST NAME: Benton Launerts
I understand that no later than February 28th 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, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
Signature:
g/21//
Date:
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City of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida 33139 www.miamibeachfl.gov
City Clerk' Office
Tel: 305/673 — 7411
Fax: 305/673 - 7254
ANNUAL LOBBYIST REGISTRATION FORM
Name: Benton Launerts
Business Name: Parksman Parking, LLC
Address: 18851 NE 29 Avenue, Suite 1011, Aventura, FL 33180
Phone:
888 - 982 -7275
Email: ben @parksmanparking.com
If more than on Lobbyist, please list:
1)
2)
3)
MCR #:
Amount paid: Date paid:
Processed by: Date:
Send this form with a check for $500 payable to
the City of Miami Beach for each lobbyist
F: \CLER \$ALL \aFORMS \LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM.docx