Mathrew Amster/Len Goldbergm MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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 teen "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Amster Matthew
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377-6236 (305) 377-6222 MAmsterCalbrzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Len Goldberg
NAME OF PRINCIPAL/CLIENT:
N~Dtune Premier Holdings LLC 1632 Meridian Avenue Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 320-7874 (305) 316-4550 milehighcdCalhotmail.com
TELEPHONE NUMBER: 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:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Variance from Flood Plain Management Board I `O 3e2 /~QfcC)l~4>7 .H'~!'e,
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Flood Plain Management Board None
Thomas Mooney None
Jorge Gomez None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) ~ 185 00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 185.00 per hour
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• Are you lobbying on a {Iresent or pending bid for goods eauiument or services or on a
present or cending award for goods, eauiument or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No• Are you lobbying on a vending avvlication for a Development Agreement with the Citv or
avvlication for change of zoning map designation or change to the City's Future Land Use
Mav?
3) Pursuant to 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 to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
^ Yes X No• Are you rgpresenting anot-for-vrofit corvoration or entity without syecial comvensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ 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
o
o
~,
o °D
~° ~ o0
~ ~ D N
n m~`~M
=og~
z~od
~o~Q
o~~x
Z~~~.,,
~~'''°ja
e °~
ph . ~Olf'
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. ,~jA ~~/~
Signature of Lobbyist:
Signature of Principal/Client:
V!. LOBBYIST IDENTIFICATION:
IDENTIFICATION:
^ Produced ID
Form of Identification
~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of lori a, County f M' '-Dade
Sworn bscrib e
This day of 0
i ure of Public Notary -State Florid
Notarization of Lobbyist's signature
FOR CLE (~ ~',~.lJ$~E ONLY /,
Annual Registration fee: [ es [ ] No Amo P i ~ .V(~ MCR # "Date Paid
Lobbyist Registration Form received and verified b Entered
F:\CLER\$,4LL\MARIA-M\LObbyist\LOBBYIST fORM OS.da Revised 12/08/04
^ Produced ID
Form of
/ e~OTAl~r
Personally known (Principal) ~v~
u7 p
~'~, PUBI.IG 4~
Golo~ado ~ e..,. F
State of Florida, County of ~ ~ aF. C~~O
Sworn and subscribed before me
This i o~' d~ay/~f ~'u.l~ D, 20g~
Signature of Public ota'ry -State of Hariida Colo•-~. b c,
Notarization of rincipal's signature