Jeff Lehman - Betsy Ross Owner, LLC Y ` f
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, Fp`, ,IP9,0 �:
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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�l)e l4assage, 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.
Lehman Jeff
NAME OF LOBBYIST: (Last) (First) (M.1)
The Betsy Hotel/The Carlton Hotel 1440 Ocean Drive Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER:305-760-6901 FAX NUMBER:305-760-6939 EMAIL:JLehman(cDthebetsyhotel.com
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Betsy Ross Owner, LLC,a Delaware limited liability company
NAME OF PRINCIPAUCLIENT:
Betsy Ross Owner, LLC 1841 Broadway,Suite 800 New York New York 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(917)414-8200 (305)416-6887 ionathanplutzik@gmail.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Ocean Court,LLC,a Florida limited liability company
NAME OF PRINCIPAL/CLIENT:
Ocean Court, LLC 1841 Broadway,Suite 800 New York New York 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(917)414-8200 (305)416-6887 jonathanplutzik @gmail.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)]
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE
All land use,zoning,permitting and code compliance matters relating to properties located at 1440 Ocean Drive and 1433 Collins Avenue
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 eneral 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
All elected and appointed officials of the City of Miami Beach and City None X
employees
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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 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 Any Financial, Familial or Professional Relationship
Not Applicable
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required) A-
d e/ A—
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 pendinq 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 ®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 LOBBYIS HALLS TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES AS WELL AS,,COM E CEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL FILED EVE IF E HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of L `
I do solemnly swear that all oTtw,,foregoing facts are true and correct and that have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach Code and all reporting requirements.
Signature of Lobbyist:
Signature of Pririei
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification
u/Personall known(Lobbyist) M/Personall known(Principal)
)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn tc�'atdsubscribe ore me Sworn�n�isubsc d before me
This JG day of� G H ua 2014 This 56 ay f(11(4q drli, 2014
Signature of Public Not --State-of Florida Signature of Public Notary tate of Florida
Notarization of Lobb Notarizati
ELVIRA RQDRIGUQ
MY COMMISSION;t DD 979250 �:�;Y py�; ELVIRA RODRIGUEZ
*; =*: MY COMMISSION#DD 979250
.,.��� EXPIRES:April 6,2014 �; - EXPIRES:April 6,2014
# 1249409 v 1 Via?•• Bonded Thru Notary Public Underwriters o
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TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: Yes[ ]No Amount Paid MCR# Date Paid
Lobbyist Registration Form received and verified by: it I
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OFF- Ic
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granada,City Cleric CityClerk(a)miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME Jeff Lehman
I understand that no later than February 28 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, or I am no longer
lobbying on that issue or for that principal, 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` bbyist, who fails to file the required Statement by April 30th shall be automatically
suspen d from lobbying until all fines are paid, unless the fine has been appealed to the
Mia '- a County Commission on Ethics and Public Trust.
ture Date
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City of Miami Beach
1700 Convention Center Drive 2014 JAN 3 0 P-M 1: 12
Miami Beach, Florida 33139
www.miamibeachfi.gov Cii'y' ci-C:; K'S OFF ICLE
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Jeff Lehman
Business Name: The Betsy Hotel and Carlton Hotel
Address: 1440 Ocean Drive, Miami Beach, Florida 33139
Office Telephone Number: 305-760-6901
Cellular Telephone Number: 305-760-6939
Email Address: JLehman @thebetsyhotel.com
If more than one lobbyist,please list:
1)
2)
3)
4)
5)
6)
7)
Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
MCR#:
Amount paid: Date paid:
Processed by: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx
Payee: City of Miami Beach GRAY ROBINSON Check#: 11536
Vendor ID: 010982 Check Date: Jan 30/14
Invoice Num Invoice Date Reference Invoice Amount Amount Paid Discount Taken Payment Amt
539028-2/1-30-14-B Jan 30/14 539028-2 850.00 850.00 0.00 850.00
Totals: $850.00 $850.00 $0.00 $850.00
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