Mathew Amster/North Beach Flats, 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.
Amster Matthew
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow & Radell, P.A. 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:
North Beach Flats, LLC
NAME OF PRINCIPAL/CLIENT:
North Beach Flats. LLC 321-33 84`" Street Miami Beach Florida 33141
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)828-4070 (305)828-9875
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Oscar Delgado, Director of Delgado Brothers Real Estate
Development, Inc., which is the Managing Member of North Beach Flats, LLC
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: See attached Exhibit A
II. SPECIFIC LOBBY ISSUE:
Extension of Time for Design Review Board File No. 20083 for property located at 321-33 84`" Street Miami Beach, Florida
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
DRB
None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) $230 00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $230.00
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 Wending bid for goods eguipment 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 lobbving on a pending application for a Development Agreement with the Citv or
application for change of zoning map designation or change to the Citv's Future Land Use
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
REPORTING PERIOD. /Ji/~a..~.!~ -
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. ~~, ~,
Signature of Lobbyist: / °"
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Produced ID
Form of Identification
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Personally known (Lobbyist)
'~ VII. SIGNATURE AND STAMP OF NOTARY:
~, State of F a, County f Mi mi- de
Sworn rib e r e
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PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Principal) ~
~~ °~ Notary Public State of Floric
Isel L Delgado
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lion of Lobbyist's signature Notarization of cipal's signature
FOR CLER ' US O Y (~~ ~^,
Annual Registration fee: ]Yes [ ] No Amount ~d R # OC=-~~~V Date Paid
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Lobbyist Registration Form received and verified by: C" Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04
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City of Meami Beach, 3 iDt} Convention Center Drive, Miami Beach. Florida 33139, www.miarr?rbeochfl.gflv
CIaY GIERK Office Cit•~Clerk~m+amibeachfl.gov
Tel: 305.b73.T41 1 , FQx: 3DS.bT3.?254
Lfl8BY151' NAME: l V ~~`~` ,~ YVI~l'
I understand that no later than fltttober 1 s# of each xear, I must file the following
farms, pursuant to Section ~ ~$.~ of the Miami Beach City Cade, with the City Clerk's
C}ffice far all active lobbying issues.
l ~ Lobbyist Expenditure Form
2j Disclosure Form
failure to file these forms on a timely basis will result in my name being #ransmtted to the
Miami-Dude County Commission an Ethics and far code viola#ion 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.
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Signature: ate:
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Miscellaneous Cash Receipt ;_,.-~;.,~.,_t~_~.~,~„~,._
CITY OF MIAMI BEACH
D Cash
Received of
(THIS INFORMATION MUST BE COMPLETED)
No. 295330
Director
Account Num r:
Preparer•< Dept: EXT•
Credit Card `®Check # ~ ~ ~ ~ $ 5~ ~ ~'