Jonathan Plutzik - Betsy Ross Owner, LLC � t s
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FW18JAIR S ;
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.
Plutzik Jonathan
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:jonathanplutzik�gmail.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 PRINCIPAL/CLIENT:
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 jonathanplutzikggmail.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Ocean Court,LLC,a Florida limited liability company
NAME OF PRINCIPAUCLIENT:
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:
N
--- C=
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] ..c-
c_._
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY
r� ,r
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CQ5PORATION,
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 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
All elected and appointed officials of the City of Miami Beach and City None X
employees
# 1249412 v 1 -
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,FT RA�k OR 6THER):
A) LOBBYIST DISCLOSURE:(Required) OVA e l WA '
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required)
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On�Pfocurgnent"�
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 ®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 SHA BMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES AS WELL AS C INSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL LE VEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
i
Signature of L b is -
I do solemnly swear that all of the ec at have read or am familiar with the provisions contained
in Section 2-482 o i eac Cit de and orting requireme
Signature o
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) WPersonally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to an subscribed before me Sworn and subscribed_ before me
This day of u4 ,2014 This Ada f Hui 014
Signature of Public Notary ate of Florida Signature of Public Not —State of Florida
Notarization of Lobbyist's signatll ELVIRA RODRIGUi:Z Notarization of Principal's signs
VIRA RDflaIGUEZ
�'"'• '•- EL 979250
= MY COMMISSION#DD 979250
EXPIRES:April 6,2014 :'•os ,, MY COMMISSION#DD
# 1249412 v 1 nded Thru Notary underwriters -*: ;*: EXPIREg;April 6'2Odery ers
Public
' Pf`�`'' Bo = " Thru Notary Fubli
''"" Bonded
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TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ es[ ]No Amount Pai $ 5W n 0 MCR# 3 2-1 1.61 Date Paid
Lobbyist Registration Form received and verified by:
1 ;
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granada,City Clerk CityClerkC�miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME Jonathan Plutzik
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
i
assessed fines after notification.
A lobbyist, 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
Miami-Da ounty Commission on Ethics and Public Trust.
nature Date
# 1249412 v 1
.W '20 J.-4 001 116-
Miscellaneous Cash Receipt f=�: : _ . �f4 1:: }a.. 0 _
CITY OF MIAMI BEACH
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(THIS INFORMATION MUST BE COMPLETED) ®ffic9 of Finance DIrect®r:
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Account Number:
Preparersa f : _
Dept: