Jeffrey Bercow/Seth Gadinskym MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means ail 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 recommendaton 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 wmmittee. The term speclficaily includes the principal as well as any employee engaged
!n lobbying activities. The term "Lobbyists" has spedtic exclusions. Please refer to Ordinance 2004-3435.
Bercow Jeffrey
NAME OF LOBBYIST: (last) (Rrst) (M.I)
Beroow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Rorida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(,'~0~1377-6220 (3051377-6222 Jbercowna brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
L LOBBYIST RETAINED BY:
Seth Gadinsky
NAME OF PRINCIPAL/CLIENT:
1580 Michioan Avenue Suite 1001 Miami Beach Rorida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 276-2387 (305) 675-7759 SethCa Gadinskyrealestate.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
FIII out this section H prindpal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 596 OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Certificate of Appropriateness/Variance ~ t~/Q ~ ,~ ~ d ~ ~~'~ h
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO 8E LOBBIED:
A) Full Name of Individual/Title I B) Any Financial, Familial or Professional Relationship
Planning and Zoning Department Staff, HPB, BOA, City I None
Commission
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WNETHER NDURL Y,
/~ZAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) _ ! 490.00 cer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).. 4 490.00 oer h~~rr
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 X No: you lobbvina on a oresarrt or oendiina bid fa- @ eauionrarn~ nr ~.,+~-,~ ....... ,
ix~errt or oendina award for aoenOfiorr~ent M 6,ry„~?
2) Pursuant tD Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Devebpment Lssues":
~3
3) Pursuant tp Miami Beach City Code 2-484 (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 anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition bD any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees.,
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISPING LOBBYING EXP DIiURES, LL AS COMPENSATION
RECE3VED, IN THE CITY OF MIAMI BEACH FOR TH CEDING DAR YEAR. A STATEMENT
REPORTING ERIOD N IF THERE HAVE BEEN NO PE DITURES ~NSATION Dt1~RING THE
I do solemnly swear that
familiar with the provision
requirements.
Signature of Lobbyist:
Signature of Principal/Cli~t:
VI. LOBBYIST IDENTIFICATIO
4 iz ^ Produced ID
~ ~ Form of Identification
r,
a
~" ~: '~ Personally known (Lobbyi~)
~~w t
VII. SIGNATURE AND STAMP OF NOTARY:
~. ~ State of Florida, County of Miami-Dade
~~{
Sworn ~nd subscribed fore me
This ~ ay of ~,~;~hf , 201~~
Sign re u is Notary -State of Fbrida
Kota of Lobbyiat's signature
of
ct~ are tr and correct and that I have read or am
2-482 of Miami Beach City Code and all reporting
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
~sonaHy known (PMnCipal)
a.'+~ Marc Halpern
a~~ My Commission DD301014
~q p~ Expires March 29, 2008
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This _.~day of-_, 2p ;~
Signature of Public Nola State of Fbrida
Notarization of Ptfrrd 1's signature
FOR Ct.E~~~q~ILY
Annual Registration fee: ]Yes [ ] No Amount Paid MCR #
Paid v~'