Monika H. Entin - Hans Bhojwani B:EACH� i
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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 H..
NAME OF LOBBYIST: (Last) (First) (M.1)
Bercow Radell&Fernandez, P.A., 200 S. Biscayne Blvd., # 850, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377-6237 305-377-6222 MEntin(a)BRZoninaLaw.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:
Hans Bhojwani
NAME OF PRINCIPAUCLIENT:
Manhattan House, Inc., 1655 Washington Avenue, Miami Beach FL 33139
BUSINESS NAME AND ADDRESS(Number and Street) (City) (State) (Zip Code)
786-216-2161 3b S�-S'301-1113 ha.nsbhoiwani�2rna.il.77.
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: Hans Bhojwani
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See the attached.
II.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues, including, but not limited to Historic Preservation Review Board, Planning
Board, Board of Adjustment, Land Use Development Committee, and City Commission, if necessary, relating to the property
located at 1651 Washinaton Avenue, Miami Beach, Florida.
Issue to be lobbied(Describe in detail):
nl. CITY AGENCIESANDIVIDUALS 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
Planning Department and Building Department Staff None
B, HPB, BOA, City Commission, and Land Use None
Development Committee, as necessary
Pursuant to City Code Section 2-482(8)Every registrant shall be required to state the extent of any business,financial,familial or professional
relationship,or other
to be lobbied as identified on the lobbyist registration on form filed.propriety,with ar�y u_jrent�ty com i!sioner�r city personnel who is
9 9
Sec 2-482 Any Financial, Familial or Professional Relationship :01
,- �,
None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required): $ • yo or hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): � •V V �Il� I�A�
(REQUIRED).
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 No: Are you lobbying on a present or Bending bid for goods,eauioment or se rvices.or on a present or
ggpdnljg award for goods.eauioment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Ar.p ygu lobbying on a pending application for a Development Aareement with the City or application
=change of zoning map desianation or change to the City's Future Land Use Map2
3) Pursuant to.Miami Beach City Code Section 2-482(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 Xo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 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
EM TIJE ERECE12ING CALENDAR YEAR, A STATEMEbij SHALLJM -`LED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR
Signat re o Lobbyist
I do solemnly swear that all of the foregoing facts are true and corr E and that I have ead or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code an II reportin equirements.
G
Signature of Lobbyist:
Signature of Principal/Client:
A
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: o �°+
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Aga � S <ao
Produced ID N Produced ID W
Form of Identification Form of Identification
Personally known(Lobbyist) H Personally known(Principal) m
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VII. SIGNATURE AND STAMP OF NOTARY: LU d E
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of E �a0 lot,,
State of Florida, County of Miami-Dade �' State of Florida, County of Miami-Dade ' ;,
Sworn and subscribed before me Sworn nd subscnb before me
This 057 f Liaj 2014 c ""' Thi of Wsignature 12014 �s;�• ��;•'
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Signatur of P aliotW-State of Florida Signature of ;u lic — orida
Notariz tion o signature NotarizatiorVof
TO BE COMPLETED BY ITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
istration Form.doc Revised 04/27/2012
A r% IN
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City of Miami Beach, 1700 Convention Center Drive-, Miami Beach, Florida 331-'19,[W'",W.Mi-,Lnlibeachfl.gov
CITY CLERK Office
Rafael 17. Granado, City Clerk City Clerk Arn i am i beac=
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Monika H. Entin
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 lobbyist, who fails to file the required Statement by April 30th, 20129 shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami- ade-County Commission on Ethics and Public Trust.
Signature Date
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