Michael W. Larkin - CG Sunny Isles, LLC /\AIAMIBEACH -
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.1)
Bercow Radell & Fernandez, PA 200 S. Biscayne Blvd, Suite 850, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377-6231 (305) 377-6222 mlarkin(d)brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
CG Sunny Isles, LLC, CG Sunny Isles I. LLC. & CG Sunny Isles II. LLC—Joseph Chetrit& Meyer Chetrit, Managers
NAME OF PRINCIPAUCLIENT:
Same 2915 Biscayne Blvd, Suite 300, Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)747-6408
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 Chetrit and Meyer Chetrit,Managers and Authorized Signatories
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached.
ii.SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for one hotel project located at 2000 & 2030 Park Ave, 2035 Washington
Ave. 425 &435 20t Street, and 430 21St Street -
Issue to be lobbied(Describe in detail):
Ill. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4) include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such
person's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship.
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Staff of Planning Department, Building Department,and Public Works None X
Department
PB, HPB, BOA,City Commission,as necessary* None X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional
relationship,or other relationship giving rise to an appearance of an impropriety,with any current clt cq i sinner or city personnel who is
sought to be lobbied as identified on the lobbyist registration form filed. �I .1 } �1 13 A 1 I J
Sec 2-482(g)Any Financial, Familial or Professional Relationship
-4: 1 4>4
*Unless an Issue is legislative in nature,PB,HPB,BOA,&City Commission members are not lobbied outside of a public hearing setting.
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$445/hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED).$445/hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes X No: Are you lobby'na on a present or Dendina bid for aoods.eauioment or services,or on a present or oendina
award for aoods.eauioment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbvina on a Dendina application for a Development Aareement with the City or application for
chanae of zonina map desianation or chanae to the Citv's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2-482(h)Any person (except those exempt from the definition of"lobbyist"as set
forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without
special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or
opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration
fees.
Yes X No: Are you reoresentina a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH
Eft$ THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION 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 the Miami Beach City Code and all reporting requirements.
��
Signature of Lobbyist:
AU
IN4nature of Principal/Client:
VI. LOBBYIST IDENTIFIC PRINCIPAL IDENTIFICATION:
_Produced ID ;. � CRISTINAD.GONZALEZ Produced ID
Form of Identicati " My comlASSION#DD 96m
f
e
EXPIRES'March 23,2014 Form of Identification
Zersonally Bonded Thru Nolery Public Underortiters
known(Lobbyist) _Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOT Y:
,`ioly 1'e'• JEANINE RODRIGUEZ
State of Florida, County of Miami-Dade ;,•roe ��;; Stat of Florida, County of Miami-Dade
Sworn to and subscribed before me Notary Public-State of 1`1(84% d subscribed before me
This ;L1 i day f 7 - 2012 N, ate;My Comm.Expires Jan 14,
y P � day of 3Uy�d�2012
(�_ '•,;o�„g,. Commission#DD 8517
Signature of Public ota St Me of F rida Signature of Public Notary—State of FI �
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED�Y CITY CLERK'S TAF/F� YQ i f v
[�Annuyal Registration fee: [ ]Yes[ ]No Amount Paid$ S D — MCR# 6 J Date Paid
b fst Registration Form received and verified y:
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F:\CLE istration Form.doc Revised 04/27/2012
/\AIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerkomiamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Michael W. Larkin
I understand that no later than February 28 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, or I am no longer
lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's
Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who
fails to timely file a Statement and in addition to any other penalties which may be
imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
blocibq a
Signature: Date:
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EXHIBIT B
DISCLOSURE OF INTEREST
NAME OF INTEREST BOLDER % INTEREST
1. CG Sunny Isles,LLC,a Florida Limited Liability Corporation 51%
3200 Stirling Rd
Hollywood,FL 33021
Judah Chetrit,Manager 100%
3200 Stirling Rd
Hollywood,FL 33021
2. CG Sunny Isles I,LLC,a Florida Limited Liability Corporation 20%
3200 Stirling Rd
Hollywood,FL 33021
Joseph Chetrit,Manager 100%
3200 Stirling Rd
Hollywood,FL 33021
3. CG Sunny Isles II,LLC,a Florida Limited Liability Corporation 29%
3200 Stirling Rd
Hollywood,FL 33021
Meyer Chetrit,Manager 100%
3200 Stirling Rd
Hollywood,FL 33021
TOTAL for Applicant 100%
0