Matthew Amster/Rita & Steven Starr & Kelapa Investments, Inc.~ 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 Ordnance 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:
I. LOBBYIST RETAINED BY:
Rita and Steven Starr & Kelapa Investments, Inc. (Rita Starr, President)
NAME OF PRINCIPAL/CLIENT:
1810 Michioan Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)525-5535
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: Rita Starr
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 604-08 Collins Avenue and 215 6 Street
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title I 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,
.- ~LATRATEOROTHERf
A) LOBBYIST DISCLOSURE: (Required) $ 230.00 oer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 230.00 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 uendina bid for goods, equipment or services, or on a
present or pending 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 Develoument Agreement with the City or
application for change of zoning map designation or change to the City's Future Land Use
Ma°?
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 a not 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-urofit coruoration or entity without suecial 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 EXPENDITt~~~O/R1OMPF,fISATION DURING THE
REPORTING PERIOD. ~~~~ ..~~_
ignature of Lobbyist
I do solemnly swear that all of the foregoing
familiar with the provisions contained in Sectio
requirements.
Signature of Lobbyist:
Signature of Principal/C
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
ersonally known (Lobbyist)
I. SI ATURE AND STAMP OF NOTARY:
=fate of FI ri a, County f is i-Da
•~ wor s s i
g w his y of
~•~e i re of Public Nota fate of Florida
~'av.,,~, tarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
~/~-"rsonally known (Pri ~• UYNEHARRIS
~,,. „~; MY COMMISSION ~ DD 534759
~~ EXPIRES: March 30
' ; ~ Baided ThN PlObry PuDlk
rzf,;t~•
State of Florida, County of Miami-Dade
Sworn and subscribed before me /
This day of M 20C~ a
igna u of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLE 'S USE NLY
Annual Registration fee: [ ]Yes ~o Amount P 'd ~ MCR # a /7 ~/ / Date Paid ~ D
Lobbyist Registration Form received and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYISr fORM OS.doc Revised 12/06/04
facts are true and correct and that I have read or am
n 2-482 of the Miami Beach City Code and all reporting
1~~~
City of Miami Seacfi, 1700 Convention Center Dr'rve, /Miami Beoch, fbrida 33139, www.miamibeachfl.gav
CtTY CLERK Office
Tel: 305.673.7411 ,fax; 303.673:7?3d
C i tyC le rk~m i o m i bea ch f i. g ov
LOBBYIST NAME: ~''!~~~~~`~-~
I understand that no later than nt~ber 1st of each near, t must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk`s
Office for afl active lobbying issues.
1 } lobbyist Expenditure Form
2} Disclosure Form
Failure to file these forms an a timely basis will result in my Home being transmitted to the
Miami-Dade County Commission an Ethics and for code violotion evaluation.
In addition, once an issue 1 have registered to lobby on has been resolved, 1 am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
-__ ~ ~ ~~
Signature: Date:
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