Matthew G. Amster - South Beach Tristar, LLC MIAMI BEACH
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.
Amster Matthew G.
NAME OF LOBBYIST: (Last) (First) (M.1)
Bercow Radell &Fernandez, P.A. 200 S. Biscayne Boulevard, Suite 850, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377-6236 305-377-6222 mamster(aD-brzoninglaw.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:
South Beach Tristar, LLC
NAME OF PRINCIPAUCLIENT:
Same 140 N. Federal Highway,2"d Floor, Boca Raton, FL 33432
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
561-241-6336 (William Weisman, Registered Agent)
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: David Edelstein,Managing Member
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: David Edelstein—60%;Jackie Mansfield—20%;Robert Futterman—20%
II.SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for Miami Beach Community Church located at 1,620 Drexel-Avenue
Issue to be lobbied(Describe in detail):
III. CITY AGENCIESIINDIVIDUALS 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
Staff of Planning Department,Building Department,and Public Works Department None. X
B,HPB,BOA,City Commission,as necessary None. X
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 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(8)Any Financial,Familial or Professional Relationship r
None
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISC 4a0 RE:(Required)
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): .
(REQUIRED). 0 hour
The following information must be answered:
1} Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
Yes X No: Are you ladbving on a nrese t or uendino bid for goods a u'nment or ervices or on a Q12LWt or Wending
av:ard far goods.eguiiaMAn or rvice
se ?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes X No• �►re®vau�innny°�+n.,n m npndina an®lication fora®�+�e—lonrtnent Agreement with the itu ors n�IlcatEO�t
change of zoning man designation Or 021392 to the Gitv's Future Land Use MR92
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 No Ate®mr-grawfin g an gt for profit cor,Rnratien or entity without soecial cgMRgnsatian or reimhursem l
V. SIGNATURE UNDER OATH:
ON EEBRLiABy 28 OF9AGH YEAS, 9A0 "'Boy's,EL ALL SUBMIT TO THE 1T CLER A S1GNF.2STATEMENT UNDER
gajH. LISTING-LQHBYING EXE9111121JURES, AS WELL AS- PENAX11012- IN IHE G111 QE MIAMI BE&CH
MR THE P EGEDIWG GALEN AS YEAR A STATEMENT °1A1 i BE FILED EVEN IF THERE HAVE_BEEN NO
FYPENDITURES OR
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Signature of Lob yist
I do solemnly swear that ail of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code nd all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client.
V1. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: o
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—Produced ID _
Produced ID ° o.............-<
Form of Identification Form of Identification 3 z
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Personally known(Lobbyist) m ' ersonally known(Principal) � '
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VII. SIGNATURE AND STAMP OF NOTARY: z
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State of Florida,County of Miami-Dade N m State of Florida,County of Miami-Dade W o a .z
Sworn to and subscribed before me o Z Sworn subscribed before me � C
? Z This ay of ,201; o
This - day of M ,201!- w T ® o
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Signature of Public Notary—S to of oriel
is ° @— S gnature of Publ' Notary—State of*lei�e/l�A_. --;b-4
Notarization of I aabbYid:s signatur °D 0 4 Notarization of Eda2ia=signature
Toe
E COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ )Yes E No Amount Paid MCR# Date Paid
o yist Reg s ration Form received verified y: Revisea
,
F:ICLER\$ALLI aFORMSI LOBBYISTFORMSILobbyistRegistrationForm.doe �S
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
400/hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $400/hour
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 lobbvina on a uresent or aendina bid for aoods.eauioment or services.or on a present or pending
award for goods.equipment 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: Are you lobbying oQending application for a Development Agreement with the City or application for
chanae of zoning map designation or change to the Cities 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 No: Are you representing a not-for-profit corporation or entity without special compensatiorLor 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 THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
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Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
Vl. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: 3 oz
Produced ID Produced ID o o
Form of Identification Form of Identification = Z c
rersonally Personally known(Lobbyist) / known(Principal) ° n
Z r- -N-! z
VII. SIGNATURE AND STAMP OF NOTARY: A
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m, 0 N n'1 �
C W O N
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade o cco z
Sworn to and subscribed before me Sworn r subscribed before me C
This day of , 201_ This
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ay of,*, ,201 ® z .�
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Signature of Public Notary—State of Florida S gnature of Publ' Notary—State of-ReNde
Notarization of Lobbvist's signature Notarization of Principal's,signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ No Amount Paid$ MCR# Date Paid
o yist egistration Form received and verified y: Re—vi se
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City of Miami Bencly 1700 Convention Center Drive,Miami Beach, Florida 33139, www.Miamibeachfl.gov
CITY CLERK dice
Rafael E.Granado,City Clerk CityClerk(a;�miamibeaclAgov
Tcl:305.673.7411,Fax:305.673.7254
LOBBYIST NAME: Matthew G. Amster
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, 2014, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
Signature: Da e:
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