Monika Entin - Saber 1800 Alton, LLC MIAMIBEACH N,2,4 A-40A i_,Dck,J
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 3 (1p9ji,,, ;7: r-,1.� L: 3
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
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow Radell&Fernandez, PLLC, 200 South Biscayne Boulevard, Suite 850, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377-6237 305-377-6222 MEntin(dBRZoninaLaw.corn
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Michael Klinger
NAME OF PRINCIPAUCLIENT:
Saber 1800 Alton, LLC, 20900 NE 30th Avenue, Suite 812, Aventura FL 33180
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 406-1762 • klingerasaberfund.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.
• IDENTIFY ALL PERSONS HOLDING,DIRE TLY O INDIRE TLY,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, Design Review
Board, Planning Board, Board of Adjustment, Land Use Development Committee, City.Commission, and any City Workshops or
Committees, if necessaru, relatina to the provertu located amt 1824 Alton R_ oad.Miami Beach.Florida)
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
Staff for the Planning Department, Building Department, None. X
Public Works and City administration, PB, HPB, BOA, None. X
City Commission, and Mayor as necessary None. X
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
None.
Nnne_
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)$400.00 per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $400.00 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 XNo: Are you lobbvina on a Present or nendina bid for aoods.eauinment or services.or on a present or pending
award for aoods.ea inment or service?,
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: Are you Iobbvina on a pendina application for a Development Aareement with the City or application for,
chanae of zonina map desianation or chanae 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 No: Are you reoresentina 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
EQR THE PRECEDING CALENDAR YEAR. A STATEMENT S A EVEN IF THERE HAVE BEEN NO,
gXPENDITURESOR • li - . _ • ► i z ■ . : - • : ■ _uAn • •
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Signat. - = L-obbyis
I do solemnly swear that all of the foregoing facts a true and correct and that have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code a . all rep ., • %-quirements.
Signature of Lobbyist: Alb'� _
Signature of Principal/Client: iNgliallk-
VI. LOBBYIST IDENTIFICATION: r 4'. PRINCIPAL IDENTIFICATION:
�• s •.
:i, t•h�ii ,�,UUry
_Produced ID ';x � i.,-; Produced ID �,+�5 . "o;
Form of Identification ,;i 9�•**el'',_ :c . Form of Identification '�`_:
ll "04 w/i I. O-
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..Personally known(Lobbyist)
"c o Personally known(Principal)
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VII. SIGNATURE AND STAMP OF NOTARY: 3. 3 53 m c " LI
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State of Florida, County of Miami-Dade _ • r- ' State of Florida, County of Miami-Dade H T Q
Sworn to and su• crib • before me T H Sworn -.d subscribed before me �. `.. .
This a- • &of �`.At • ,2015 ai o d 7 z This day of 2015 T H d T
‘0"ilk I . �+ � = a Taro m
Signa o c N. cry—State of Florida N d 0 ir 0711
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' Si nature • �•;is f'•ta State of Florida o CD CP N s
Nota zatio. , obbvist's signature w - Not.riza' Principal's signature CO DJ
s—-e'
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY ,7,
Annual Registration fee: [ I Yes[ No Amount Paid$ (050,CO MCR# 1105 b 14-\ Date Paid 0I°as-A Lobbyist Registration Form received and verified by ,_A SOIV %WM-Cal
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M I AM I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerk n m iamibeachfl.gov
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 suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Mi i- ade ounty Commission on Ethics and Public Trust.
/O72 //5T
Signature: / - ►'� Date:
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