Mark Turkel - Mark Lyn San i�/I Cry I
MIAMI E
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.
Turkel Mark
NAME OF LOBBYIST: (Last) (First) (M.1)
Leroy Street Studios 113 Hester Street, New York NY 10002
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
121,21431-6780 (212)431-6781
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Mark L!n
NAME OF PRINCIPAUCLIENT:
West San Marino, LLC 555 Bryant Street, Suite 347, Palo Alto CA 94301
(NUM Der and Street) i y (State) (Zip Code)
917-532-7432 marklundc(a-)amail.com
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: Mark Lyn 100% ,t.,
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH WRPORATION,
PARTNERSHIP O ==
II.SPECIFIC LOBBY ISSUE: == -
Development Approvals and Permitting Issues, including, but not limited to Historic Preservation Board, Planning and.Board
Qf,6diugtMr,nL agg2rovajg foc t j2rapeLdeg Iggategi gt 121 Last i2an Ugrino Drive,Miami Reach. FL.
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
arson's commencement of service with the city to the present date,stating the general nature of the subject contractual relationshi .
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO
title of person to be lobbied
Planning Department and Building Department Staff None.
PB, DRB, HPB, BOA, FP, City Commission, LUDC, and None.
Commission Committees, as necessary None.
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 Any Financial,Familial or Professional Relationship
None-
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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).
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: AM you lobbvina on a present or pending bid for goods.eauiament or services.or on a rlresent or nendina
award for goods,pguipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes)No: ArQyou IobbYLa on a ep nding application for a Development AgEUement with the City or application for
change of zonina map designation or change to the Cit)es 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)No_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 THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
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: hA V'
9=9F 1 F868ME0...
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) JKPersonally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sw n and subscribe
This day of , 2014 d y R ;2,014JENNIFER WEBBER
*: Commission#FF 125104
MV Commission Expires
Signature of Public Notary–State of Florida Signat re blic Notary–S MaY 20, 2018
Notarization of Lobbyist's s'4 nature Nota za 'on of Principal's signature
TO BE COMPLET E CITY CLERK'S STAFF COLY _-7 K-) /I
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Dat aid
Lobbyist Registration Form received and verified by:
' • 1 7
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$200 1Hr
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 Procurement
Issues":
_Yes XNo: Are you lobbvina on a oresent or aendina bid for goods,eauioment or services.or on a uresent or pending
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)CNo: Are you lobbvina on a pending aoolication for a Develooment Agreement with the City or aoolication for
change of zoning map designation or change to the Citd's Future Land Use Mao?
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)No: Are you representing a not-for-orofit corporation or entity without special compensation or reimbursement.
I
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 E!REQEDlbjQ CALENDAR XEAR. A STATEMENT SHALL BE FILED EVEN JE IHERE HAVE BEgN bIQ
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing jacts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami d all reporting requirements.
Signature of Lobbyist:
i
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
V/,
ersonally known(Lobbyist) Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dad MICHAEL B CHEN State of Florida, County of Miami-Dade
Sworn to and subscribed before me Notary Public -State of New York Sworn and subscribed before me
This day of A H 201 This day of 2014
' N0. 01CH6233973 '
qualified in Kings Con _.,
Signature u is o a — of FI ommission Expires of Public Notary—State of Florida
Notarization of Lobb®signature' Notarization of Prince signature
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,
I
/\AIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, w%vw.miami beach il.gov
CITY CLERK Office
Rafael E. Granado, City Clerk City Clerk a miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: Mark Turkel
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 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.
7 t e 1 *V�6 �u ( '
Signature: ate :
MICHAEL B CHEN
Notary Public - State of New York
N0. OICH6233973
Qualified in Kings Co u y
My Commission Expires
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