Corey J. Lafferty - Prince Michael Assn., Inc. ,- L\ ce,Lt'usNA1 I BEACH
4
RECEIVED
Office of the City Clerk 2018 FEB 12 PM 2. 42
1700 Convention Center Drive
Miami Beach, FL 33139 CITY OF MIAMI BEACH
305.673.7411 27FICE t'F THE CITY CLER'r
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 City Code Chapter 2,Article VII, Division 3, entitled"Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Lafferty Corey J.
NAME OF LOBBYIST (Last) (First) (Middle Name)
Bercow Radell Fernandez & Larkin, PLLC 200 S. Biscayne Blvd, Suite 850, Miami, FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)456-6759 corey@precisionartdesign.Com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Prince Michael Condominium Association, Inc.
NAME OF PRINCIPAL (Last) (First) (Middle Name)
20314 NE 34th Court, Miami Beach, FL 33140
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
elidadon@bellsouth.net
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): Eli Dadon, President
• NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
3 CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A): c& ," / ``-f/ 0
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development approvals and permitting issues for property located at 2618 Collins Avenue.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship (If yes, explain) YES NO
Title of Person to be Lobbied
Planning Staff, City Development Boards, None X
Land Use Development Committee None X
and Commission 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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
None.
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
-cet.
Page 2 of 5
The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
_YesXNo:• 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 City Code Section 2-490, entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
—YesX_No: 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 City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in
Section 2-481)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 city 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?
4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
YesXNo: Are you providing only scientific, technical or other specialized information: appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services
within the past election cycle.See Section 2-491 for more information.
_YesXNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
_Yes_No: If yes, has it been less than 12 months since the elected official(s)whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
—YesX_No: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
_Yes_No: If yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETEDET .BY CITY CLERK'S STAFF ON(L'YY
Annual Registration fee: [f]Yes[ ]No Amount Paid$ Or 0 & MCR# 1 q" r Date Paid O
Lobbyist Registration Form received and verified by: --. 14.50SC7 't-i (1- .
F:\CLER\$ALL\aFORMS\,LOBBYIST FORMS 1Lobbyist Registration Form Revised 01.-OI.-iR REG.doc Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDI CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED LOBB . A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATI D b -I THE REPORTING PERIOD.1 /
Signature of Lobbyist: Date Z-/9! $
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar i the pro 'sions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all r•po '. r, irements.
Signature of Lobbyist: ,a, AIL Date
Signature of Principal:
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of I—C.orI Q(o. State of
County of: ►V1 I p.m -1713P-F County of:
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me
this 9 day of Misr b v A c, , 201$, by this_day of , 20_, by
Crzek
NAME OF LOBE IST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
Personally Known _Personally Known
Signature of Notary Public Signature of Notary Public
JAgilh-)iw AV/Di/Lid
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
Notary Public Stals Of Florida
(NOTAR if) • f ro$ An (NOTARY SEAL)
My Commission FF 929919
11► Expires 1W22/2019
The term"lobbyist"specifically excludes the following persons:
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.'Signature of Lobbyist: Cee RC V\UU S l�� Date
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: SC' ' A( P(,{2 Date
Signature of Principal: Date dt q /17E)
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of State of L 1 0 ei ()/
County of: County of: H A 4 I - I) -1
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed and subscribfore,i e
this day of 20_, by this 09 day of tedb'? ' I , 20'3, by
� i
1:),h b0 L.)
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known Pe.
Signature of Notary Public Signature of Notary Public
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
(NOTARY SEAL) (N EAC? IVANNA FONT
r' Commission#GG 45237
.,;, . • My Commission Expires
' „„^' November 06, 2020
1 The term"lobbyisr specifically excludes the following persons:
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E. Granado,City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.741 1, Fax: 305.673.7254
NAME OF LOBBYIST: Corey J. Lafferty
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 of each year, 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing Octo, •er 1 of each year, and the fee for such annual registration shall be
$500.0 pursua'Ito Section 2-482 of the Miami Beach City Code.
/t
Signature f Lobbyist ` Date
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 01-01-18 REG.doc
Page 5 of 5
11/20/2017 Detail by Entity Name
DIVISION OF CORPORATIONS
EXHIBIT B
_DP/IJIUi I rlf*
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Deoartrnent of State / Division of Corporations / Search Records / petail 8y Document Number/
Detail by Entity Name
Florida Not For Profit Corporation
PRINCE MICHAEL CONDOMINIUM ASSOCIATION,INC.
Filing Information
Document Number N96000003882
FEI/EIN Number 65-0752141
Date Filed 07/24/1996
State FL
Status ACTIVE
Last Event REINSTATEMENT
Event Date Filed 10/04/2017
Principal Address
2618 COLLINS AVENUE
MIAMI BEACH,FL 33140
Mailing Address
20314 ne 34 ct
First Floor
AVENTURA,FL 33180
•
Changed:05/14/2015
Registered Agent Name&Address
Vaknin,SMadar
20314 ne 34 ct
AVENTURA,FL 33180
Name Changed:05/14/2015
Address Changed:05/14/2015
Officer/Director Detail
Name&Address
Title P
Dadon,Eli
1124 KANE CONCOURSE
Bay Harbor Islands, FL 33154
Title T
http://searchsunbiz.org/Inquiry/corporationsearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&SearchNemeOrder=PRINCEMIC... 1/2
11/20/2017 Detail by Entity Name
Saul,Ratovich
17070 Collins Ave
ste 256
Sunny isles,FL 33160
Title S
vaknin,Smadar
20314 ne 34 ct
AVENTURA,FL 33180
Annual Reports
Report Year Filed Date
2015 01/23/2015
2016 03/15/2016
2017 10/04/2017
pocument Images
10/042017—REINSTATEMENT View Image In PDF format
03/152016—ANNUAL REPORT View image In PDF format
05/142015—AMENDED ANNUAL REPORT View image In PDF format
012312015—ANNUAL REPORT View image in PDF formal
03212014—ANNUAL REPORT View Image in PDF format
08/212013—Rea.Anent Chanae View image in PDF format
01/23/2013—ANNUAL REPORT Mew image In PDF format
021162012—ANNUAL REPORT View image in PDF format
04/072011—ANNUAL REPORT View image in PDF format
02/092010—ANNUAL REPORT View image In PDF format
02/112009—ANNUAL REPORT View image In PDF format
03242008—ANNUAL REPORT View image In PDF format
09/06/2007—ANNUAL REPORT View image In PDF format
07/092007—REINSTATEMENT View Image In PDF format
08/20/1999—ANNUAL REPORT View image In PDF format
07/13/1998—ANNUAL REPORT View image In PDF format
06/24/1997—ANNUAL REPORT View Image in PDF format
07/24/1996—DOCUMENTS PRIOR TO 1997 View Image In PDF format
Honda 0=p1trrent o'State,OP.Gmn of Coiporatasns
hlip://search.sunbiz.org/Inquiry/corporationsearch/Search ResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder—PRINCEM IC... 2/2
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Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
No. 419809
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(THIS INFORMATION MUST BE COMPLETED)
Office of Finance Director
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Preparer: ----Ili',01\J ....'x't ' :1 ,' '1 * i Dept:
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