Neisen Kasdin - Mark Becker • Ovt14oortPiL`Sf`✓1�
MIA •
MI BEACH
i Office of the City Clerk p
1700 Convention Center Drive APP i 1 • 3 l
Miami Beach, FL 33139 ;;;,,
305.673.7411 (;:,: ::'. "I f ii, l'P"1
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:
Kasdin Neisen • O.
NAME OF LOBBYIST (Last) (First) _ (Middle Name)
Akerman LLP 98 SE 7th Street, Suite 1100 . Miami FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-982-5629. neisen.kasdin@akerman.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Becker Mark
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Becker Boards Miami, LLC 2200 NE 33rd Avenue, Unit 6D Fort Lauderdale FL 33305
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
602-740-9145 mbecker@beckerboards.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Purr sriannt to Gity®170e Section 2.1'4`82(h)'(11)(E: A prin'eipal of Eyo,corporation, partnership (p other entity w o appears®6 lobbyist®iU behalf of that
entity.dacmit special compensation Cy reimbursement for(ft)appearance,waglkayaRg.indirect CG'contingent SO( i(o e o o aCR oo position t
an item shall register with the®Ierk as required by this subsection but shall not be required to pay any regist:a ion fees
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): See attached.
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): See attached.
Page 1 of 5
,iii
•
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.
Outdoor advertising legislation and zoning issues.
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
City Commission None
City Administration None
Planning Board None
Historic Preservation Board None
•
Board Members None
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):
$855.00 per hour
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":
_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 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 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 bythis section, but shall not be required to pay any registration fees.
Yes XNo: 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.
Yes XNo: 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.
_Yes XNo: 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 XNo: if yes, has it been less than 12 months since the elected official(si whom yo, provided campaign
consulting services _as sworn
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.
Yes XNo: 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 XNo: If yes were you promised or o d you receive economic consideration in exchanq• fo ca ,paiq
ons: Itinq se.rvices�:
TO BE COMPLETED.BY CITY CLERK'S STAFF ONLY3)0
i
Annual Registration fee: [ ]Yes[t;]No Amount Paid$ °O MCR# {_ 1 CI _� Date Paid O —2 5 !e
Lobbyist Registration Form received and verified by: `'/v "
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS'\Lobbyist,Registration Form Revised 09-20-18 REG.doe, Revised 09/20/2018
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 PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAG r1 I. LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENS v •3 ()URING THE REPORTING PERIOD?
Signature of Lobbyist: /„i Date 2
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 fa 11' r i i the provisions contained in Chapter 2,Art.VII, Division 3, entitled"Lobbyists” of
the Miami Beach City Code an•1 rt rting requirements.
Signature of Lobbyist: V Date
Signature of Principal: i`v ` Date -/— 2 J t
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of .. ciOYOciIA. . . State of ttrl Zo V1.0.
County of: i 11 1 —. IL, County of: A(i ncopa
Sword (or affirmed nA U scribed before m Sworn to(or affirm d)and subscribed before me
this Z.,1 day of I%1�CIJf I I ,20 by this cz3Niay of PcIf,rit ,2014,by
L1u1 0 . �1Q9i1/� Mar ecKe
ME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
`Personally Known- V Perso ally Known
of NotaryPablid
le. (1
Signature of Notary Public Signature '
Diana Perez-Gate ow—Ter
r
Name of Nota _ f_ NOTA�RY,PUBLIC
ry'• '�� '_ 1TE`OFe�iIDA Name of Notary,Typ d, Printed or Stamped
o�'•-30' Comrn#FF233833
(NOTARY SEAL) Expires 6/8/2019 (NOTARY SEAL) posy Terry
••! Notary Public-Arizona
Q.-5 Maricopa County
( ' My Commission Expires
brr.o: BAa 14 2019
1 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
•
•
M1AMBEACH . • •
City of Miami Beach, 1.7(.10 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
Office of the City Clerk •
Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.7411,Fax:305.673.7254
•
NAME OF LOBBYIST: Nelsen Kasdin
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 off$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
commenci g Oc ber 1 of each year, and the fee for such annual registration shall be
•
$500.00 p t Section 2-482:of the Miami Beach City Code.
• •
\-2
Ukit\ `Q
Signature of Lobbyist Date
•
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc
Page 5 of 5 •
Becker Boards Miami, LLC
Mark D. Becker
Joseph N. White
Garren Development, LLC
(50%) White Media Group, LLC
(50%)
MBF
City Hall
1700 Convention Center Dr.
Miami Beach , EL �3l39 `� -~ ��
305-673-7420
Welcome
003444-0007 Esther G 04/25/2019 01 :37PM
Description: MCR OPEN
69. , e'. Ss , IR E
(NCR)
Reference 1 : 423195
` MCR OPEN (MCR)
2019 Item: HCR
1 � 70O.O0 ' ��
NCR OPEN (NCR) 700.00
` `700.00 - 0.
czi
Subtotal 400.00
Total � 700.00 `^/ - � V �
CHECK 350.00
Check Nu|8b8[38024417
CHECK 350.00
Check NVNb8r30024418 �� /~� ~ ~ w �
._ - _-__ _- \
Change due 0'00 '
Paid by: AKERNAN LLP ' 0U� �� - ' � ~ z �:-.~
1|||U@U@l||N|/U|{8il|l0|�|l|OUU/N|U� |0U|/
]���/|0�|N|���!|(ii�N�����j��������||!U��|� |i�(U|
nutuwAnbam
!
li
_________
Thank you for your payment -
CUSTOMER COPY ^
,