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Monika H. Entin - Cueto Miami, LLC ^ «- Ci ty of Miami Beach Cffi0a of the City Clerk \ / � 1700 Convention Center Drive, Miami B88oh, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by o principal who seeks to encourage the peaoogo, defeat or modification of any ondinenco, eoo|ution, action or decision of any commissioner-, any eodon, deoioion, recommendation of the City Manager or any city board or committee-, or any acuon, decision or recommendation of any city personnel during the time period of the entire decision-making process on such acu|un, decision or recommendation that h,naoeeau|v will be heard or nsv|evw»u by the city commission, or city board or committee. The momn specifically includes the principal as well as any employee engaged in lobbying activities. The term^LobbNmto^has specific exclusions. Please refer to Ordinance 2U04'343m. NAME OF LOBBYIST: (Last) (First) (M.1) Bercow Radell&Fernandez, P.A., 200 S. Biscayne Blml BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-377-6237 305-377-6222 MEntinaBRZonin!gLaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. 1. LOBBYIST msnwmsoBY: � � � NAME", ,"=.P"^`^.=.`. Cueto Miami, LLC 10773 NW 581h Street, Unit 683 Dorad Florida 33 BUSINESS NAME AND ADDRESS(Number and Street) (City) (State) (Zip Code) 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: Vidal Bada Vazquez-55%and Alejandra Bada Vazquez 45% IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached x.SPECUFUC LOBBY ISSUE: Development Approvals and Permitting Issues, including, but not limited to Design Review Board, Planning Board, Board of AdjUstment and Citu Commission, if necessaru, relating to the yrovertu located at 1759 Bau Road, Miami Beach, FL Issue to be lobbied(Describe in detail): iii. CITY AG ENCKES/UN DUVUDUALS 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 I Planning Department and Building Department Staff None X PB, DRB, HPB, BOA, City Commission, and Land Use None X Development Committee, as necessary None X Pursuant mo City Code Section x-400(g)Every registrant shall uw required to state the extent m any business,financial,familial ovprofessional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought mue lobbied ao identified on the lobbyist registration form filed. Sec 2-482(g)Any Financial,Familial or Professional Relationship ;1 -i-7i 19 --il Mone ti IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required): $330.00 per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $330.00 per hour (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: ALP you lobbying on a present or pending bid for good s.eauipment or services.or on a present or pending award for goods,eauipment 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: ArQyou lobbying on a pending application for a Develooment Agreement with the City or application for change of zoning map desianation or change to the City's Future Land Use Map? 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 X o: 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 JHg PREQEQIbIQ CALEN12AR YEAR, A STAIE I_S+hktt7-�� FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR Signature of Lo yi I do solemnly swear that all of the foregoing facts ar a and correct a at I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code a all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: LOBBYIST IDENTIFICATION: P INCIPAL IDENTIFICATION: CO Produced ID Produced ID ° J Form of Identification Form of Identification � s v rn g Personally known(Lobbyist) Personally known(Principal) w SIGNATURE AND-STAMP OF NOTARY: of Florida,County of Miami-Dade State of Florida, County of Miami-Dade ° rn d subscribed before me Sworn and subscribed before me !Thi ay of 2013 This\'9 day of bet 2013 ure lic tary—State of Florida Signature of Public No ry—State of Florida No arizatio Lob®signature Notarization of signature F-Anniial RPO-Oratman fee- Yes E—V-/,-, TO BE COMPLETE CITY CLERK'S STA.FFF 2 b MCR Lobbyist Registration Form received and verified by: (/ , J Revised 04/27/20 C ih-(11,111aIIIi Beach, 1700 Convention Center Drive. N41-aml Beach, Florida 33139, CITY CIAAK 011"Ice, Rajliel L Granado. Clerk A Tel: 305.673.7411 . Fax: 305.673.7254 LOBBYIST NAME: Monika 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, 2012, shall be automatically SUM- from lobbying until all fines are paid, unless the fine has been appealed to e Miami-Da"eunty Commission on Ethics and Public Trust. V Date Signatur e