Monika Entin - Llam Group, LLC /\AIAMI BEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
V�
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.
Entin Monika
NAME OF LOBBYIST: (Last) (First) (M.I)
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 mentin0 brzoninQlaw.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:
I. LOBBYIST RETAINED BY:
Llam Group, LLC
NAME OF PRINCIPAUCLIENT:
Llam Group, LLC 3144 Sheridan Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 716-8300 (305) 716-8302 k.volot @dedienne-aero.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:Karel Volot
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Karel Volot—50%and Frederic Joulin—50%
II.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues,including,but not limited to appearance before the Board of Adjustment for a distance variance to allow
the sale and consumption of alcoholic beverages at a restaurant within 300 feet from a daycare for the property located at 1328-1330 Alton Road,Miami
Beach,FL
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 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
Tanning Department and Building Department Staff None
B, DRB, HPB, BOA, FP City Commission, as None
ecessary* \\
Pursuant to City Code Section 2-482(8) Every registrant shall be required Pursuant to City Code Section 2-482(8) Every re�,str�n .b 'I be
required to state the extent of any business,financial,familial or professional relationship,or other relationship giving r�g P?jan appearan '�
of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied as identified an the t obbyist regi __i
form filed. a J!!
Sec 2-482(g)Any Financial,Familial or Professional Relationship d _
__-
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$310.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $310
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 :'o• Are you lobbying on a present or pending bid for goods,eguopment or serviced=or on,aoresent or pending
award for goods.eguipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes X blow 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 CitVs 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 X No• Are you representing a not-for-profit corporation or entitywithout special r_ompensatign 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 E2iPENDITURF.S. AS WELL AS COMPENSATION--RECEIVED. IN THE CITY OF MIAMI BEACH
EM THE PRECE ING CALENDAR YEAR. A SIATE SITALL BE EILED CA-EbLIE MERE HAVE BEEN NO
EXPENDITURES OR
Signature of Lob yist__
I do solemnly swear that all of the foregoing facts a r"d correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami B ach City Cod d all'repdrting requirements._
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identificatio
�d� NO
Personally known(Lobbyist) Personally known • ;
%A,�
(Principal)VII. Wbiami-Rade c State of Florida SIGNATURE AND STAMP OF os 0 4 o 0
NOTARY: ion EE082284 o 0/2015 State of Florida, C State of Florida,County of Miam i-Dade o E.3 N
Sworn t9pnd subscribed before me Swo nd subscri Mw,me o m
This ✓ da of ,2012 This day of 2012 ;5%0 0
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Sign ture of Public Notary—State of Florida Signatu a of Public Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# A A Da Paid
Lobbyist Registration Form received and verified by.
m /\A I AM I B EAC H
City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139,www.miamibeach1gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Monika Entin
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 Miade-County-_,Commission on Ethics and Public Trust.
Signature: ate:
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