Menachem Korf - Breackenridge Equity, LLC 300 3 1/Attu Cret
MIAMI
City of Miami Beach Office of the City Clerk [006 s ° Psi ' :
1700 Convention Center Drive, Miami Beach, FL 33139
CITY i_• -
LOBBYIST REGISTRATION FORM t t .j `� '
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.
Korf Menachem
NAME OF LOBBYIST: (Last) (First) (M.I)
Century Builders&Restoration 1257 Alton Road, Ste. 2 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-604-9003 305-992-9003 mendy(@,,centurvb-r.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:
Breckenridge Equity, LLC
NAME OF PRINCIPAUCLIENT:
150 Airport Road, Suite 900 Lakewood NJ 08701
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
732-370-4030
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)]
Mark Tress
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Stephen Werdiger and Mark Tress
ll.SPECIFIC LOBBY ISSUE:
3003Ihdian Creek Redevelopment and Sea Walt Issues-s
15s6-6-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
Board of Adjustment,Dept of Public Works,Historic Preservation Board X
City of Miami Beach Commissioners, City Manager, City Attorney X
Planning Board, Design Review Board, Building Dept., Planning Dept. 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
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY.FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
gaup*. *260.0°
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':
MOO Yes XNo: .:13.... ,1: .. : • :sent • :: ►. ►. • • • •nods =. ,►►e •r=:r v cos • •► : :rose t or •0,. n
award for goods.equloment 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: Am you lobbying on a aendlno application for a Development Agreement with the City or application for
change of zonIng map designation or change 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.
YesXNo• _ c =•ma ,, ►: odor • •l • :orationo e► % wih.u_s!.u,lel o k_- •norre a:arse :.►.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR.EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH.!(STING LOBBYING EXPENDITURES.AS WE L AS COMPENSATI N RECEIVED.IN THE CITY OF MIAMi BEACH FOR
THE PRECEDiN-G CALENDAR YEAR. A STATEMENT SHALL B ILED = EN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION URING THE REPORTING PERIOD, Agri,
�/ Si :cure• 'et S
i do solemnly swear that all of the'rore•.• • facts are true and ct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Ma LB6a••/r∎ Code and all reporting requirements.
Signature of Lobbyist: �f/�/ab._
Signature of Principal/Cli I
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
.,F.?:. .\;
17 �!` ;cv Produced ID
Produced ID l if ∎ 1
/// Form of Identification `o, .j°/ Form of Identification
✓Personally known(Lobbyist) —Personally known(Principal)
s 33 0
V11. SIGNATURE AND STAMP OF NOTARY: d roli 3 —
z m K E
P.State of Florida.County of Miami-Dade Q y2 rn State of Florida,County of Miami-Dade
Sworn to end subscribed before� E- g, 2 z It Sworn and subscribed before me
This X day of �$ �1 1 3. .2 4t -fl This day of ,201_
///. $ oo - r
Signature of Public Notary-State of Florida 3 ° 0 0 Signature of Public Notary-State of Florida
Notarization of J..obbviat'e signature co Notarization of Principal's signature
TO BE COMPLETED BY CiTY CLERK'S S AFF ONLY
Annual Registration fee: t`t J Yes( ]No Amount Paid$ .oio CRS 0 431 Date Paid l' t I;)-I C
Lobbyist Registration Fenn received and verified by
F:tCLER‘SALLtaFORMS%LOBBYIST FORMSItobbyist Annual Registration Form.doc Revised 01/22/2014
F:ICLERISALLIaFORMSILOBBYIST FORMStLobbyist Registration Forrn.dac
MIAMI BEACH
City of Miami Beach, 1700 Comontion Contot Drivo,Miami Beach,Florida 33134,www.miomibeachfl.gov
CITY CLERK Office
Rafael E.Gronodo,City Clerk CilyClerk @miamibeachfi.gov
Tel:305.673.7411 ,Fon:305.673.7254
LOBBYIST NAME: Menachem Korf
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$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist,who falls to file the required Statement by April 30th of each year,shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed the .mi-Dade County Commission on Ethics and Public Trust.
/ 1 lei. 0(1.013. 2.Q I ID
na r=: Date:
F:ICLERI$ALL1aFORMSILOBBYIST FORMSILobbyist Registration Form.doc
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 XNo: Are you lobbying on a present or pending bid for goods.equipment 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 XNo: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning map designation or change 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-profs 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.
YesX 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 FOR
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
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: .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
_Produced ID _Produced ID itoRD
ftkiAl
Form of Identification Form of Identification iv �L4N
g��°�Y P+ibllc
®Personally known(Lobbyist) V Personally known(Princip !CO �of Jemmy
nre8 O7ii ei
VII. SIGNATURE AND STAMP OF NOTARY: N4� .-r.o +
y pc►HO
State of Florida,County of Miami-Dade State of FtOPlU'a,County of hlieatr&ade L D 2 Y
Sworn to and subscribed before me Sworn a1 d subscribed before me
This day of ,201_ *44-This at day of i'(?i3"b: ,201a
Signature of Public Notary—State of Florida Signature ublic Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: ( J Yes( )No Amount Paid$ MCR# Date Pald
Lobbyist Registration Form received and verified by: Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc
F:\CLER\$ALLIaFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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