Clifford A. Schulman - Mitchell Scott Investment ' A
MIAMI BEACH
City of Miami Beach Office of the City Clerk P -1 AM 9: 50
1700 Convention Center Drive, Miami Beach, 171_391W 171_391W �
LOBBYIST REGISTRATION FORM 1 T Y C� , 9'i, G i r I("I.
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.
Schulman Clifford A.
NAME OF LOBBYIST: (Last) (First) (M.1)
Weiss Serota Helfman, et al. , 2525 Ponce De Leon Blvd Ste 700, Coral Gables, FL 33134
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-854-0800 305-854-2323 cschulman @wsh-law.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LQBBYIST RETAINED BY:
Mitchell Scott Investment Group, Inc. a Florida Corporation /Sherbrooke Apts. Inc. a Florida
Chapter 719 Cooperative
NAME OF PRINCIPAUCLIENT:
901 Collins Avenue, Miami Beach, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 532-0958
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:
Mitch Novick, President (of both Mitchell Scott Investment Group, Inc and Sherbrooke
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• I� OTI)Y ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
Legal representation Mitchell Scott Investment Group, Inc. a Florida Corporation and Sherbrooke Apts. Inc. a Florida
Chapter 719 Cooperative concerning land use at 919, 909 and 901 Collins Ave.
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to ba lo:,bied,and whether the lobby;st has ertarad
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
u
Planning Board None X
Land Use Board None X
City Commission None X
Planning Department one X
City Manager's Office one 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
City Agencies Individuals to be Lobbied continued:
City Attorney's Office None X
Mayor and commissioners None
No financial, tamiiiai or protessional relationship X
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) 5 5 0.O OSC}eper (hourd)
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $550 . 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 ®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 ® 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 N 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 eVENJF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signa a of Lo byist
I do solemnly swear that all of the foregoi g facts are tr a and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Mia i Beach City ode)C all orting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
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❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification o Cj
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Personally known(Lobbyist) Wpersonally known(Principal) 3 H
VII. SIGNATURE AND STAMP OF 14 , ` F' ! c �
WMQ11E SAWAFF-N.gvE't i;=
W ComMMMON 0 EE @�2i
State of Florida, County of Miami-Dade . ;ter= EX"ES:Nawtriiifer 21,2f►1a State of Florida, County of Miami-Dade $ s
Sworn to an subscribed fore me "' a.,•' � ' 'Nr' '�''�'�"�""''`�"
c�„ �, -,;, �p w r sub c i ed before me o N � a
This 31 S day of , 201 ='= -�-- °°'*`' '- 'T is ay' , 20
Signature of to of Florida SignatLffe of P c ota '-state of Florida
(
Notai o. i 's gnature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
gi [ ] [ MCR# Date Paid
Annual Registration fee: Yes No Amount P id$'
Lobbyist Registration Form received brnd verified by:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist AnnuaI Reg istrati'. Form.doc Revised 1/11/2011
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City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel:305.673.741 1 ,Fax:305.673.7254
LOBBYIST NAME: LiF-- caeD SC q1 a
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.
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Signature: Date: