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Mathew Amster/Seth Gadinsky (2)~ 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 prindpai who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or derision of any commissioner; any scion, decision, recommendation of the City Manager or any dty board or committee; or any action, derision or recommendation of any city personnel during the time period of the entire decision-making process on such action, derision or reoommendation that foreseeably will be heard or reviewed by the dty commission, or a dty board or wmmittee. The term spedfically includes the principal as well as any employee engaged in lobbying activities. The term "Labbyists° has spedfk exclusions. Please refer to Ordinance 2004-3435. Amster Matthew NAME OF LOBBYIST: (Last) (First) (M.I) Bercow, Radeil 8', Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) t3~ 377236 (30~1,~77-622 mamsterCalbrzoninalaw com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: Seth Gadinsky NAME OF PRINCIPAL/CLIENT: 1 0 ichigan Avenue Suite 1001 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Tip Code) (786) 276-2387 (305) 475-7759 SethClaGadinskyrealestate.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) FIII out this sed3on 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 596 OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY T5SUE: Development approvals for new Walgreens Store at property located at NE comer of Biarritz Drive and 71 Street. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDMDUAtS TO BE LOBBIED: A) Full Name of individual/Title I B) Any Financial, Familial or Professional Relationship Planning and Zoning Department Staff, DRB, SOA, Planning I None Board, City Commission IY. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSic WHETHER HOURLY, FLI T RATE OR OT!/ERf. A) LOBBYIST DISCLOSURE: (Required) ~ ~$~.00per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 3 (85.00 aer hour The following information moist 6e answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contribuibns By Lobbyists On Procurement Issues": o Yr~ X No: Are you lobbvina on a pre~nt or nandinS,~~ for g~~,eouiDmant or services, or on a ant or Dendiirnr award for goods. ~uiDrrrent or vice? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Devebpment Issues": ~ i '~ ~.~. T ~ W r ~~~~ s °rv . s~` 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 tD any item, shall register with the clerk as required by this section but, shat! 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, 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 I do solemnly swear that all of the foregoing facts a familiar with the provisions contained in Section 2-482 requirements. Signature of Lobbyist: Signature of Principal/C vI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Lobi~ylst) ~~ VII. State of AND STAMP OF NOTARY; Sfgua>:dre of Public idotary =State ~/Flor Notarization of LoW>,ytst's signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ~"~• ~~ ,Personally known (Prindpal) ~'D!~ ~ ~ ~~ State of Florida, County of Miami-Dade ~ Swom and subscribed fore me ~ ~~ This J~_day f 20~ ~ g N S O Signature of Publk tary -State of Fbrida Notarization of Principal's signature Annual Registration fee: (~ ]Yes [ ] No FOR CLEIi:Ii~~LY ~ ~ /l~ 7/ Amount Paid MCR # ~ Date Paid ! ~~ ~ ~ ~ ~~~a ~~,~ ~~1~~~~ re true and correct and that I have read or am of the Miami Beach City Code and al! reporting