Monika Entin - Harding Hotel, LLC '�31G Nara.-SAur
MIAMI BEACH = Mra 3,
City of Miami Beach Office of the City Clerk „ • r-
1700 Convention Center Drive, Miami Beach, FL 3-319
LOBBYIST REGISTRATION FORM i i ! �_I:.I-. i, 1 I l•I_
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 MEntinal3RZoninaLaw.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:
Alan Lieberman. President of PCCO. Inc.. the Manaaina Member of Hardina Hotel. LLC
NAME OF PRINCIPAL/CLIENT:
Harding Hotel, LLC 7310 Harding Avenue, Miami Beach FL 33141
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-531-5831 c/o Chris.Rollinsnsouthbeacharouv.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,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, Design Review
Board, Planning Board, Board of Adjustment, Land Use Development Committee, City Commission, and any City Workshops or
committee , if necessaru, relatina to the vronertu located at 7310 Hardina Avenue. Miami Beach, Florida.
Issue to be lobbied(Describe in detail):
lll. 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
DRB, 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
None
None
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$425.00 per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $425.00 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 Iobbvina on a present or nendina bid for aoods.eauioment or services.or on a present or pending
award for aoods.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 JCNo: Are you Iobbvina on a pendina application for a Development Aareement with the City or application for
chance of zonina map desianation or chanae to the City's Fut re 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 X No: Are you reoresentina . 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 BEACt{
EQ@ THE PRECEDING CALENDAR YEAR. A STATEMENT SHAT.L:BE—FILED EVEN IF THERE HAVE BEEN NO,
g)CPENDITURES OR COMPENSATION DURING THE REPORTING P r 0D,
'4
Signature of Lobbyist
I do solemnly swear that all of the foregoing fac : are true ans irrect and'that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Cod- and all repot g r-quirements.
Signature of Lobbyist: -,
Signature of Principal/Client: •,
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: -
_Produced ID '00. **;A:7 ) _Produced ID•
Form of Identification ........... Form of Identification ()
c
m O
-
& Personally known(Lobbyist) i` a 3 Personally known(Principal) g m O
VII. SIGNATURE AND STAMP OF NOTARY: Q ; ; y=
1 o 6 O m
State of Florida, County of Miami-Dade E T H d m p State of Florida,Co my of Miami-Dade(; r m
Sworn to and subscrib before me , m Swor •n' subscr ed b ore me 0 -n O
�1� ° > This i •ay of _ " ,2016 r-
This �. -y of -Y ,2016 m ;, �'
V)
AP/�� /]�/ d N N O N
'•��,I /Cdr lam. •
Sig atu �' '.lic Notary-State of Florida ' .nature of Public Notary-State of Florida
Notariza of Lobbyist's signature Notarization of princioal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY c+� /
Annual Registration fee: [ ]Yes,LX]No Amount Paid$ S0. MCR# YI/4(/,c Date Paid 7/I1/b
Lobbyist Registration Form received and verified by n
•
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibcacht.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CitvClerlarniamibeachil.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 t - ''iami-Dade - ounty Commission on Ethics and Public Trust.
41-- .-- (e.2
Signatur-: Date:
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Formrevised 5-30-2012.doc
7
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION. PARTNERSHIP, OR LIMITED LIABILITY COMPANY
If the property that is the subject of the application is owned or leased by a corporation, partnership, or limited
liability company, list ALL of the owners, shareholders, partners, managers, and/or members, and the percentage
of ownership held by each. If the owners consist of one or more corporations, partnerships, trusts, partnerships,
or other corporate entities, the applicant shall further disclose the identity of the individual(s) (natural persons)
having the ultimate ownership interest in the entity.'
Harding Hotel,LLC- 7310 Harding Ave.,Miami Beach, Florida 33141
NAME OF CORPORATE ENTITY
NAME AND ADDRESS %OF OWNERSHIP
PCCO, Inc. 100%
8101 Harding Avenue
Miami Beach, Florida 33141
PCCO, Inc. 8101 Harding Avenue,Miami Beach, Florida 33141
NAME OF CORPORATE ENTITY
NAME AND ADDRESS %OF OWNERSHIP
Alan Lieberman, President 50%
19955 NE 38th Court, Unit 2904
Aventura, FL 33180
Nathan Lieberman, Vice President 50%
1680 Meridian Ave, Unit 102
Miami Beach, FL 33139
IF THERE ARE ADDITIONAL CORPORATE OWNERS, LIST ALL SUCH OWNERS, INCLUNG CORPORATE NAMES
AND THE NAME,ADDRESS,AND PERCENTAGE OF OWNERSHIP OF EACH ADDITIONAL OWNER, ON A SEPARATE
PAGE.
NOTE:Notarized signature required on page 9
FILE NO.
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