Monika Entin - Santa Barbara 230, LLC It"
CD MIAMIBEACH BEAcH -z--/-) 20 ,A• f
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139J5 NL 12 pH- 14: 9
LOBBYIST REGISTRATION FORM CITY 1117.i; -;:.‘-:. OFF
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
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow Radell&Fernandez,PA 200 South Biscayne Blvd., Suite 850 Florida 33131
BUSINESS NAME AND ADDRESS . _ (Number and Street) (City) (State) (Zip Code)
(305)374-5300 (305)377-6222 mentina.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:
Santa Barbara 230, LLC
NAME OF PRINCIPAUCLIENT:
Santa Barbara 230, LLC c/o Trans Inns Management 150 Davie Blvd., Suite 401, Ft. Lauderdale, FL 33316
BUSINESS NAME AND ADDRESS _(Number and Street) (City) (State) (Zip Code)
(561)287-5400 james.vosota@voshospitality.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:See Attached disclosure
• • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:!
Development Approvals and Permitting Issues, including, but not limited to the Historic Preservation Board, Planning Board,
Board of Adjustment,Land Use Development Committee, and City Commission, if necessary, relating to the property located at
230 20th Street, Miami Beach, FL.
Issue to be lobbied(Describe in detail):
Ill.;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
Planning Department and Building Department Staff None
PB,-HPB, BOA, City Commission, as necessary* None
c. .: 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(g)Any Financial,Familial or Professional Relationship
•
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc n
• , •
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$400.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). $400.00.
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 Iobbvina on a present or pendina bid for aoods.eauioment or services.or on a present or pending
award for aoods.eauipment or service?
. • 2) ..: Pursuant to:Miami Beach_City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_W, .-❑.,Ye&X No:---Are you lobbvina on a pendina application fora Development Aareement with the City or application for
chanae of zonina map desianation or chanae to the City's Future Land Use Mao?
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
.1- : :.- 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 reoresentina a not-for-profit corporation or entity without special compensation or reimbursement
V. SIGNATURE UNDER OATH:
�
. . ON FEBRUARY.28th 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
,.;E.QB,THE'=PRECEDING CALENDAR.,YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO,
gXPENDITURES OR a 1 i - ► .- • k . ►: • _ : '0 : ► : •i
. Signature of Lobby'
.1.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 an. _ -porting requ. - -nts.
∎4,-c
_ Signature of Lobbyist:
Signature of Principal/Client: a-- —
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
a;
❑ Produced ID ;".••:° . ❑ Produced ID
Form of Identification ►� i�•,0c Form of Identification
Personally known(Lobbyist) ❑ Personally known
c) .°.
(Principal)VII. ..: a 3 .SIGNATURE AND ST - 1 MffCHELL GARRET?
7,
`"
NOTARY: 3 ` r' =' -
- MY COMMISSION#EE86066c
EXPIRES December 26,201,
State of Florida,County of Miami-Dade 4 y N T State of Florida,Count 41 � M Wade Fia+dallota service can
Sworn to d subscribed before me T T Sworn and subscribed a ore me l�
This day_of ,20� °N a F. This .i ,ay of A •-14,-, ,20
iat
;' �'!iii,��,/ -_&-_ •. NG A A .
S'ignatur_t •li Notary–S ate of Florida .. " `•nature of P i lic Not. ?' '.-te of Florida
Nbtarizati•-- of j,.obbvist's signature Notarization of Principal's,signature
:: TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ No Amount Paid$ C)U- _ MCR# - Date Paid (5.4gE:
Lobbyist Registration Form receiv and verified by: ('rt�e�
1 ,i w
•
erA MIAMI ' EACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Monika Entin
-1 understand that_no.later than February 28th 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, 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
Aimely 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 ►A'_ - - County Commission on Ethics and Public Trust.
dggifir 16es(
Signature: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
CITY OF MIA-I BEACH
!'EVELOPMIENT REVIEW t i,,2\R±Ir.
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of the application is owned or leased by a CORPORATION, list the principal
stockholders and the percentage of stock owned by each. Where the principal officers or stockholders consist of
another corporation(s), trustee(s), partnership(s) or other similar entity, further disclosure shall be required which
discloses the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity).*
Santa Barbara 230, LW
C/O Trans Inss Management, Inc.
150 Davie Blvd. Ste 401., Fort Lauderdale, FL 33316
NAME, ADDRESS,AND OFFICE %OF STOCK
SB 230 Hospitality, LLC Member 50%
Spectrum Building I
4 901 NW 17th Way, Suite 503
Fort Lauderdale, FL 33309
BBM3II, LLC, Managing Member 50%
2900 McKinnon St., Apt#1101
Dallas, TX 75201
SB 230 Hospitality, LLC
4901 NW 17th Watt, Suite 503, Fort Lauderdale, FL 33309
NAME,ADDRESS, AND OFFICE %OF STOCK
James D. Vosotas, Managing Member 50%
Spectrum Building I
4901 NW 17th Wat,'. Suite 503
Fort Lauderdale, FL 33309
Dart Vosotas, Member 50%
Spectrum Building I
4 901 NW 17Th Wata, Suite 503
Fort Lauderdale, FL 33309
BBM3 II, LLC
2900 McKinnon Si.,Apt#1101, Dallas, TX 75201 •
CORPORATION NAME and ADDRESS
NAME,ADDRESS, AND OFFICE %OF STOCK
Branden Muhl, Managing Member 33.3%
235 West 48th Street.,Apt. 37C
New York, NY 100036
Blaine B. Muhl, Member 33.3%
2402 West 114111 Street
Leawood, KS 66211
Britain B. Muhl, Member • 33.3%
2402 West 114th Street
Leawood, KS 66211
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S)AND EACH INDIVIDUAL'S
NAME,ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
NOTE:Notarized signature required on page 8
6
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Address
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(THIS INFORMATION MUST BE COMPLETED) • Office of Finance Director •
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