Michael J. Marrero - Mathew Johnson . mom
� 5
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139 SEP_7
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passa Q'-,-defeat or
modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation Ilof"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.
Marrero Michael J.
NAME OF LOBBYIST: (Last) (First) (M.1)
Bercow Radell & Fernandez, PA 200 South Biscayne Blvd., Suite 850 Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374-5300 (305) 377-6222 mmarrero(,5-brzoning law.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:
Matthew Johnson
NAME OF PRINCIPAL/CLIENT:
Monty's Restaurant 300 Alton Road Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 861-3500 (305) 861-3555 mjsamba(c_aol.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: .,, 2 4 .
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: R^
ILSPECIFIC LOBBY ISSUE: ` 7,
Development approvals for bar extension at Mont 's Restaurant sip `r
Issue to be lobbied(Describe in detail): ®f�
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
Commission, Planning Staff, Development Boards None X
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
/A
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
-Aft
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$395.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $395.00
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 Ara you lobbying on a present or pending bid for goods,eauinment or services.or on a present or pending
award for goods, eauinment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes � Are you lobbying on a pending application for a Development Agreement with the City or application
f2E 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 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
LQJ3 THE PRECEDING CALENDAR YEAR, A STATEMENT S ALL BE FI ED EVEN -IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATIOU DURING THE REPORTIN
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts ar ue and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City all a �.
Signature of Lobbyist:
Signature of Principal/Client: 1�
VI. LOBBYIST IDENTIFI ION: PRINCIPAL IDENTIFICATION:
/V'"a0 0 i
Produced ID Produced ID
Form of Identification �o*'a, ' Form of Identification '�a•
.��c
m�pz
M �� ivc
Personally known (Lobbyist) o�'� Personally known
as M&
(Principal)VII. A 3,a Q SIGNATURE AND STAMP OF o .a R
056.30 �0 o (n
NOTARY: o m y d N m N
a+m °m S,
State of Florida, County of Miami-Dade N o State of Florida, County of Miami-Dade g a
Sworn t nd subscribed b fppr�� e A Sworn qrjid subscrp edlbef re me
Th day of Cl�l►2V, 2012 °' This day of Y W 2012
awv,( ,
Sig ature 4f Pubic Notary—State of Florida SilAture Ff Public Notary—State of Florida
Notarization of Lobbyi,st's.signature Notarization of Principals signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes No Amount Paid$ `��(/ wMCR# Date Paid 1,97
Lobbyist Registration Form received and verified by:
I
A/\ 1A/\A1BEACJ:-1
Cite of Miami Beach, 1 700 Convention Center Drive. Miami Beach. Florida 33139,wmv.miamibeachll.Qov
CITY CLERK Office CityClerk @)miamibeachA.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Michael J. Marrero
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.
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.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
sad(
Signature: --— ate:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
1 i 1 4 1
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
No.
❑ Cash krCredit Card ❑Check#
-r
20
.7
Received of_ Af J, ',�. .�
Address
For bbvl,e)
(THIS INFORMATION MUST BE COMPLETED)
Office of Finance Director
By
Account Number:
Dept:
Preparers
1
Exhibit B
Monty's Sunset,LLC
1) LIFE OF REILLY CONSULTING LLC 100%
400 ALTON ROAD APT 2604
MIAMI BEACH FL 33139
a. JOHNSON,TRICIA 50%
400 ALTON ROAD APT 2604
MIAMI BEACH FL 33139
b. JOHNSON,MATTHEW 50%
400 ALTON ROAD APT 2604
MIAMI BEACH FL 33139