Michael Gil/Marcos Kerbel Cuban Hebrew Congregationm 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 prindpal who seeks th enc:ourage the passage, defeat
or modification of any ordinance, resolution, action or deasion of any commissioner; any action, decision, recommendation of the
City Manager or any aty board or committee; or any action, decision or recommendation of any city personnel during the lame
period of the entire decision-making process on such acttior-, deasia~ or recommendation that foreseeably will be heard or reviewed
by the aty commission, or a aty board or committee. The term speafiply includes the prindpal as well ~ any employee engage)
in lobbying activities. The term "Lobbyists" h~ specific eXdusrons. Please f+efer 1D Ordinance 2004-3435.
Gil Midwel A.
NAME OF LOBBYIST: (Last) (First) (M.I)
Bartow, Radell & Fernandez P.A. 200 South Biscayne Blvd., Suite 850 Miami, Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
(305) 377-8690 (305) 377-6222 moil@brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Mans Kerbel
NAME OF PRINCIPAL/CLIENT:
Cuban Hebrew CongrQg~tion of Miami, Inc. 1719 Lenox Avenue Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number aril Street) (dry) (State) (Zip Code)
(305) 604-9101 (305) 6049023
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Marcos Kerbel
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Planning Board Application for properties located at 1700 Michigan Avenue and 1719 Lennox Avenue
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
Planning Dept., HPB,
None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION {DISCLOSE WHETHER fliOf/RLY
FLAT RATEOR OTHER
A) LOBBYIST DISCLOSURE: (Required) ~ 220.00 per hour
6) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). E 220.00 per hour
The following information must be answered:
1) Pursuant to Miami Beads City Code Sedion 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procunament Issues":
^ Yes X No: A_re you lobbying on a uresent or pending bid for 9~,,gguioment or services. or on a
present or pending award for g~gguipmerrt 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 lobbvingon a pending aoMication for a f~onmentAoreement with the City or
application for chance of noning~p~jgnation or change to the City's Future Land Use
MaD?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Sedtion 2481 above) who only appears as a representative of a notfor-profit
corporation or entity wiifiout speaal compensation or reimbursement for the appearance, whether direct, or
indirect, ~ express support of or opposition ib any item, shall register with the derk as required by this
section but, shall not be required to pay any registration fees..
^ Yes X No: Are you representlng anot-for-profit iarnoration or entity soedal 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 CJ~ILENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR OOMPENSJ-TION DURING THE
REPORTING PERIOD. _ _ ~~-
Signature of lobbyist
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 xhe Miami Beach City Code and all reporting
requirements.
Signature of Lobl
Signature of Prim
v=. LoBBYISI
q' Produced
Form of Id
^ Personally known (Lobbyist) ~ ~ o
W `u7i o
VII. SIGNATURE AND STAMP OF
o~~z
State of Florida, County of Miami-Dade ~ ~ W
Swom to and subscri re me
~ ~
a$ ~ o x
This
day of 20 ~ ~ W
Signature of Public Notary -State of Florid k11`,d~
=~ :~
Notarization of hobbyist's signature =~~;
Form of Identification
~~~~~~~~.,~~ STEPHANIE SALTZMAN
•^ Personally known (Pri No18ry pow . Stan of Fbrida
i • • ~f' Conxr~ssion Expires Aup 16, ZOtI
%~,,,~~~~~~,-` Conwntasbn ~ DD 586125
Bonded BY National Note Alan,
Slate of Florida, County
Swom and subsrxibed before me
This i C:V day of 20G~
Signature of iblic-N ry -State of Florida
Notarization~Pnnapal's signature
FOR CLERK'S USE ONLY < 5
Annual Registration fee: [ ]Yes [ ] No Amount Paid ~''~ ` MCR # Date Paid ~6 ~
Lobbyist Registration Form received and verified try: Entered By: h
F:\G1ER\;ALL\MARTA-M\to6byfst\L08BYIST fORM OS.da Revised 12/08/04
Git~r of Miami Beoc6, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachFl.gov
CITY CLERK Office CityClerk@miamibeachFl.gov
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME:
I understand that no later than October 1st of each year, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the Ciiy Clerk's
Office for all active lobbying issues.
1 ~ lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
~r/~ ~~
Signature: Date:
I~ avisatl 0 .?_lDaJ200&
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