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Jeffrey Berkowitz/A&R Sobe, LLCCity of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Emalh cityclerkL~d.miami - beach.fi.us LOBBYIST REGZSTRATZON FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) Check Box if an Amendment [}~rknwi ~-~. JeffrP._v [~, 5/8/03 NAME OF LOBBYIST: (Last) (First) (M.D DATE QUAI.J.I-tt:IJ AS LOBBY[ST BUSINESS ADDRESS: (Number ~hd~tr~et) (City) (State) (Zip Code) 305-8~4-2800 TELEPHONE NUMBER: 305-859-8300 FAX NUMBER: j berkowit z ~berkowit zdev. com EMAIL: LOBBYIST RETAtNED BY: A&R Sober LLC NAME OF PRINCIPAL/CLIENT: 1 Casuarina Concourse BUSINESS ADDRESS: (Number and Street) Coral Gables FL 33143 (City) (State) (Zip Code) q~5-R65-q6hh TELEPHONE NUMBER: 305- 667- 5(341 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: · LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORA'I/ON, PARTNERSHIP OR TRUST: 'n'. SPEC/F~C LOBBY ZSSUE: Development of ~he project at the intersection of Fifth Street and Issue to be 10bbied (Describe in detail): A1 ton Road ~'YAGEN~/ZNDIV~DUALSTOBELOBBZED: A)FullName~ndividual/~Ue B)Relationship City of Miami Beach staff N/A City of Miami Beach Commissioners NTA FI_ATP. ATE OR OTHER): A) LOBBYIST DTSCLOSURE: $ 0 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $ 0 1) 2) Pursuant to Ordinance No. 2003-3393 Amendinq Miami Beach City Code Chaoter 2, Article V[L Division 5 Thereof Entitled "Campaiqn Finance Reform" Via The Addition Of Code Section 2-488 Entitted "Prohibited Campaiqn Contributions By Lobbyists On Procurement Issues": Are you Iobbvina on a pr~?nt or pendina bid for (Ioods, e(lui~llteat or services, or on a oresent or pendinq award for qoods, eauiDment or service? Yes /~No~' Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach City Code Chapter 2, Article V]! Division 5 thereof Entitled "Campaiqn Finance Reform", Via The Addition Of Code Se~ion 2-490 Entitled "Prohibited Camoaicln Contributions By Lobbyists On Real Estate Development !ssues': Are vou~f~O~m on a Dendin¢l application for a Develooment Aareeme.,n.t _with th.e Ci.tv. or aE~_~'.~_-~_~b~ for c~anqe of zoninq map de_~q~ation or chanqe to the City $ ~uture Lana u~ Mai)? S/GNA~~ER OATH: ON OCTOBER 1sr OF EACH YEAI~ EACH LOBBY]ST SHALL SUBHI'r TO THE CTW CLERK A S]GNED STATEMENT UNDER OATH, LI:~t-NG LOBBY/NG EXP Beach City Code as amended, and all Produced TD Form of Identification SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: /~ DTI'URES TN THE cTrY OF HZAMI' BEACH FOR 1//1 f~rj/a.r,~ ~rue and~cerrect and that Z have read or am Se Personally"Known~ THE PRECEDTNG CALENDAR YEAR. ! do solemnly swear that all of the foregoing familiar with the provisions contained in reporting requirements. Signature of Lobbyist: Signature of Principal/Client: v[. LOBBY[ST ZDENTZFZCATION: Slg.~ature of,P~blic Notary - State of Flodda ~.. I OFRCU~ NOT~Y ~ I [ Y~M~ S H~UUt~ / Pnnt, ~amp or W~e n~~; ...... 3 I MINION [Xl. NOV. ~ ~ [MX COU ....... ~ State of Florida, County of MiamFDade Sworn to and subscribed before me This c~ day of N ~,~ ,2003. Registration: If rejected, state mason: RegistraUon fee paid: [ ] Yes [ ] No DATA ENTRY DATE: ,5~'/_ ~1~ 2nd Revision 3/18/03 FOR CLERK'S USE ONLY t ] RF_.3ECTED DATE: '~- J ~-- O___~ ,2003 E~RED BY: (/~ / F: ~CLE~%~Lobbyi~l~Uona 03.d~