Matthew Amster/Carlo Gambino (3)m 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 term "Lobbyists" has specific exdusions. Please refer to Ordinance 2004-3435.
Amster Matthew
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow, Radell & Fernandez, P.A. 200 South Biscayne Blvd., Suite 850 Miami, Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377-6236 (305) 377-6222 mamster@brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Carlo Gambino
NAME OF PRINCIPAL/CLIENT:
Carlo Gambino 5600 La Gorce Drive Miami Beach Florida 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 576-5776 (305) 576-5787 Carlo@getcarson.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this sedaon if 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 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Revocable permit application for 5600 La Gorce Drive
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
Ci Commissioners None
Jorge Gonzalez, City Manager and Staff
None
Fred Beckman, Director of Public Works and Staff None
Jorge Gomez, Director of Planning and Staff None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATEOR
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 present or cending bid for goods equipment or services or on a present or
fending award for goods equipment 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 pending application for a Development Agreement with the City or application
sir ~h~~~p of zoning map designation or change to the City's Future Land U~ Mau?
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 representing anot-for-profit corporation or entity without special compensation 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 REPOJ+]rTIIyG PERIOD.
Signature of Lobbyi
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 th mi ach C' Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF
This
of Public Notary -State
lion of Lobbyists sigr
Annual Registration fee: [ ]Yes [ ] No
Lobbyist Registration Form received and verified by:
F:\CLER\~1LL\MARIA-M\Labbyist\LOBBYIST FORM OS.doc
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
n~ Personally known (Principal) WIUJAMCARSON
~, // . ~:
.=~a`~'r'~a
o ~ ~ ._ .: MY COMMISSION # DD 589~5~? ; _•
~, ~; ~~f EXPIRES:Odober 10, 201U
rix _-~.a ~i~~ BondedThruNotaryPubYCUndenvrdes i,
=" :~- State of Florida, County of Miami-Dade
~ ~~ ~.: w
~ ~ ~ Swom and subscribed before me
'`~ ~- This ~da of K~ 20 D•7
z° sn ~ w
b ~
,~'~• ~~ Signature of Public Notary State of Florida
~}~ Notarization of Principal's signature
'S USE ON
t Pai ~ MCR # Date Paid ~ ~~
Entered By:
Revised 12/08/04