Michael W. Larkin S&S Properties r
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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.
Larkin Michael W
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377 -6231 (305) 377 -6222 mlarkin
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
S & S Properties; contact: Avraham Sibony, managing partner
NAME OF PRINCIPAL /CLIENT:
S & S Properties 12501 Coastal Highway Ocean City Maryland 21842
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(410) 250 -8200 (410) 250 -8274
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: Avraham Sibony, managing partner
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Partners: Avraham Sibony (25 %); David Sibony (25 %); Prosper Sibony
(25 %); and Yaron Sibony (25 %).
II. SPECIFIC LOBBY ISSUE:
Development approvals for renovation and partial demolition of, and addition to the 1- and 2 -story buildings on the west side of 919
Collins Avenue for a retail establishment
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 Retation p
Planning Department Staff, HPB, BOA, Planning Board and < t...
City Commission* None c 30i1i
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-rt Fi * Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a pubeari setting. --
t
' in DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER
,
A) LOBBYIST DISCLOSURE: (Required) $ 425.00 per hour.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 425.00 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 ":
0 Yes X No: Are you lobbying on a present or pending 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 ":
[Wes X No: Are you lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation qr 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 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 a not- 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 COMP ATION DURING THE
REPORTING PERIOD.
Signature ► 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.
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Signature of Lobbyist:
,,
Signature of Principal /Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
_. L . o sinini, . Sharona EZaoui r
❑ Produced ID ❑ Produced It' . _ .......••••• . • , • - aY PUBLIC
" - - Form of Identification " e+RY , I - n tifi ter
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1 s - : �"' I I State of Maryland
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N Commission Expires
° N" VII. SIGNATURE AND STAMP OF N March 2011
q z � a OTARY: .
1 W 2 State of Florida, County of Miami -Dade State of Maryland, County of Worcester
S o a -t Sworn to and subscribed before me Sworn and subscribe b fore me,
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L..,i14 _ . Signature of Public Notary"— St of FI�ida Signature of Public —
v; �.. g e o ublic Notary State of Maryland
-;t,• * ." Notarization of Lobbyist's signature Notarization of Principal's signature
FOR CLERK'S USE ONLY
Registration fee: Yes No Amount -- � MCR #
9 [ ] [ ] ount Paid � �
Annual Re D to Paid I ‘?••l 1 r
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Lobbyist Registration Form received and verified by: • . Entered By: a
F: \CLER \$ALL \MARIA -M \Lobbyist \LOBBYIST fORM 05.doc Revised 12/08/04
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office 'CityClerk@miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: AliCtkGIZI iJ Lek //1
understand that no later than February 28th of each year, I must file the following form, pursuant
to Section 2 -485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying
issues.
1) Lobbyist Expenditure and Compensation 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.
i /11 )
Signature: Date: