Michael Gil/Thor ACQ, LLCm 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 exclusions. Please refer to Ordinance 2004-3435.
Gil Michael A
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) 377-8690 (305) 377-6222 mgil@brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Thor ACQ, LLC
NAME OF PRINCIPAL/CLIENT:
25 West 39`" Street New York NY 10018
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212)529-7415
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: Joseph J. Sitt
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Joseph J. Sitt
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 910 Lincoln Road
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title ~ B) Any Financial, Familial or Professional Relationship
Planning Dept., HPB, BOA, Planning Board, City Commission ~ None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERJ:
A) LOBBYIST DISCLOSURE: (Required) $ 220 00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 220.00 per hour
The following information must be answered:
1) Pursuant to Miami Beach Ciry Code Section 2-488 Entitled °Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yes X No• Are you lobb~na on a present or pending bid for goods equipment or services or on a
present or pending award for goods eauipment 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 Develoament Agreement with the Citv or
application for change of zoning map designation or change to the City's Future Land Use
Map?
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 1ST 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.
1 `f`.."
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 the Miami Beach City Code and all reporting
requirements. ~~ _ ~ n . ' n
Signature of Lobbyist:
nature of Principal/Client:
4
~ I. LOBBYIST IDENTIFICATION:
'S ao
~; o ~ Produced ID
Y _3 .Q ,;,, Form of Identification
~~'~E=
~ ~ d ~ Personally known (Lobbyist)
Z `" ~ "' VII. SIGNATURE AND STAMP OF NOTARY:
~~'''`'` State of F orida, County of Mia Dade
~"`= Sworn ubscrib efo e~'/~
°" •'`~ This day of f d0 D~
f[Ge of Public Notary ate of~lorida
rization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
.vf~ersonally known (Principal)
STATE
e of nEw Yoarc
~ I~fARY PU8L1C ~
or++ti+•~a~ ~~.
N2W `~OYk- NQyV `I DY~=i ~'. N~utiois ,.
State of Weritla, County of A4ia~-Bede- %, ~i~`'~.. ~ '~~ i
s ~..........•..'' ~o`' ~a
Sworn and subscribed before me '.,,sk~N EXp~{tES``~.•~~
This ~'1G~day of .1G~m.~ , 20~ ~~''~~~~~~~~~~~~"~~
~ ~
Signature of P is Notary -State of F/~}P•W=~Di(k-
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [~No Amount Paid C MCR # a~ Q ~ ate Paidy
/; ~ ~^ ~L Entered B -.<-~7'~.-~-e .~"-rLc~
Lobbyist Registration Form received and verified by:`~l y:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST foRM 08.doc Revised 12J08/04
City of Miami Beach, 1740 Convention Center Drive, Miami Beach, Fbrida 33 T 39, www.miomibeachfi.gov
CiIY CIERK Office CihfClerk@miamibeachfi.gov
Tel: 305.673:741 1 ,Fax: 305.673.7254
LOBBYIST NAME: ~ < < R~.1 y ~
I understand that no later than Qttober ! st of each dear, I must file the following
forms, pursuant to Section 2-4$5 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
i ~ Lobbyist Expenditure Form
2J 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.
Signature: Date: