Michael Larkin - Felix Cohen DocuSign Envelope ID:233DF6FD-83F2-4638-B10E-A6BBDF730EC2 '-s$40 N , cam/a-4
RECEIVED
M I ANI I BEICH Office of the City Clerk 23 2020
1700 Convention Center Drive
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Miami Beach, FL 33139 Cin'OF MIAMI BEACH
305.673.7411 OFFICE OF THE C;TYCLERK
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid nr 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 terns specifically includes the principal as well as any employee engaged In lobbying
activities. The term"Lobbyists" has specific exclusions_ Please refer to City Code Chapter 2, Article VII, Division 3, entitled"Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City
Clerk. if you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or °n/a" in that section. Any change to any information originally filed, cr any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Larkin Michael
NAME OF LOBBYIST (Last) (First) (Middle Names
Bercow Radell Fernandez Lark-in & Tapancs,PLLC, 200 South Biscayne Boulevard,Suite 850,Miami,FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377 6231 MLarkin@BRZoningLaw.cont
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Cohen Felix
NAME OF PRINCIPAL (Last) (First) (Micdle Name)
5830 NIRR, I.LC 111 I Kane Concourse, Suite 210 Btty Harbor Island FL 33154
PRINCIPAL RLJSINFSS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
8 305-790-0419 r,xy101 6'aoLcurri
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursuant to City Code Section 2-482(h)(1)(a): A principal of any corporation,partnership, or other ertity who appears as a lobbyist on behalf of that
entity,without special compensation or reimbursement for the appearance,whether direct, indirect,or contingent,to express support of or oppos:ion to
an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees.
a
If the principal is a Corporation, Partnership or Trust, the following information MUST, be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,write N/A)!
. NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): See attached
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III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a speck description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development approvals and permitting issues, including, hut not limited to the Historic Preservation Board, Design
Review Board, Planning Board,Board of Adjustment, Land Use and Sustainahility Committee, City Commission,
any City Workshops or Committees, and City Departments, if necessary relating to the property located at
5830 and 5840 North Bay Road, Miami Beach, Florida.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship(If yes,explain) YES NO
Title of Person to be Lobbied
Staff for the Planning Department, Building Department None. X
Public Works, and City Afministration, PB, HPB, BOA None. X
URB, City Couu,,ission, and Mayor 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 City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyist registration form filed.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
None.
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° None.
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S V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$675 per hour
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The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488, entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
_Yes XNo: Are you lobbying on a present or pending bid for moods, equipment or services-or on a present or
pending award for goods,equipment or service?
2) Pursuant to City Code Section 2-490, entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
_Yes XNo: Are you lobbying on a pending application for a Development Aureement with the City or application
for change of zoning map designation or change to the City's Future Land Use Map?
3) Pursuant to City Code Section 2.482(h), any person (except those exempt from the definition of"lobbyist" as set forth in
Section 2-481) 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 city clerk as required by this section,but shall not be required to pay any registration fees.
_Yes XNo: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement?
4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific,technical or other specialized information or testimony in public meetings; any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
Yes XNo: Are you providing only scientific, technical or other specialized information: appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services
within the past election cycle. See Section 2-491 for more information.
_Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the Incumbent member(s)of the City Commission:
_Yes No: If yes. has It been less than 12 months since the elected officials) whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2.482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
_Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the Incumbent member(s)of the City Commission:
b
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_Yes No: if yes, were you promised or did you receive economic consideration In exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes No Amount Paid$ 3 So ' MCR# 4 b l'l` Date Paid 01-13-W
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Lobbyist Registration Form rsoeivedand verified by: �Jlea►.'
i:,CLER`SALLiai—RMS\LOBBYIST FORME\tohhy...l i;egistration Form Revised 09-20-18 REG.doc Revised 09/20/2018
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VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.'
Signature of Lobbyist: Date
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: I Date
Signature of Principal: Date 0 -1 /t)
2 4 2 0
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: County of:
Miami-DadeMiami Dade
Sworn to (or affirmed)and subscribed before me Sworlo (or affirred) and subscribed before me
this day of , 2020 by this D day of iwl , 2020 by
Michael W. Larkin Felix Cohen
NAME OF LOBBYIST NAME OF PRINCIPAL
Produced ID _Produced ID -7 h e zo l WO 6
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
X Personally Known _Personally Known
C624a,fiti
Signature of Notary Public Si.nature of Nota ,�J blic
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printe or Stamped
(NOTARY SEAL) (NOTARY SEAL) ,e,:`.P``;% BARBARAZEEMAN
f� *MY COMMISSION#GG 061186
EXPIRES:February 15,2021
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9l6‘OF F.09- Bonded Thru Budget Notary Services
1 The term"lobbyist"specifically excludes the following persons:
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 6
DocuS i gn Envelope ID:233DF6FD-83F2-4638-B 1 CE-A6BBDF730EC2
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATIONIb4QTHE REPORTING PERIOD.'
Signature of Lobbyist: Date 7/10/2020
`-3'JHMA:1US31-6d,r
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all -e11'firrEtti irements.
Signature of Lobbyist: 4_C-_//\ • Date
Signature of Principal: f WI Date i D 2-d a 0
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: Miami-010c County of: Miami Dade
Sworn to(or affirmed)and subscribed before me Swor o(or affirrfled) and subscribed before me
this day of_07/10.12020 ,202Q by this a day of i ..e_- 2020, by
Michael W. Larkin Felix Cohen
NAME OF LOBBYIST NAME OF PRINCIPAL ! n c,�,,
Produced ID _Produced ID I1 It t' e-s o e�4 6- J ' t IP'6
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
X Personally Known Personally Know
8 ,614RALA 1 Chi•Cihaf,(/
Signature of Nota i=utiric°' Signature of Nota blic
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N Betty Llerena 14 stiviz A Of,�. y
'B Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Print or Stamped
1 Betty Llerena 1
(N� Commission #GG 175999
Notary Public State ofFlaida (NOTARY SEAL) =o�hr':P�i,�, BARBARAZEE.IAN
M / My Commission Expires Mar 05,2022 * *MYCOMMISSION#GG 061186
/ v, o� EXPIRES:February'b,au1
14or e04. Bonded Thu Budget Notary Services
0 1 The term"lobbyist"specifically excludes the following persons:
V
E-, Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who
0 only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
f the appearance.
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DocuSign Envelope ID:233DF6FD-83F24638-B10E-A6BBDF730EC2
MIAMIBEACH
City of Miami Beach, 1730 Conveltion Center Drive,,Miami Beach, Florida 33139,www.rniamibeachfl.gov
Office of the City Clerk
Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.7411. Fax:305.673.7254
NAME OF LOBBYIST: Michael W. Larkin
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 of each year, 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
8
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
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--DoeuSigned by:
�!✓�_' 7/10/2020
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Signature of Lobbyist Date
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French North Bay Road,LLC
Name and Address % of Ownership
Felix Cohen Revocable Trust 100%
1927 NE 118 Road
North Miami, FL 33181
Felix Cohen Revocable Trust
Name and Address % of Ownership
Shayne Cohen 16.6%
1927 NE 118 Road
North Miami, FL 33181
Romain Cohen 16.6%
1927 NE 118 Road
North Miami,FL 33181
lacques Cohen 16.6%
1927 NE 118 Road
North Miami, FL 33181
Iulian Cohen 16.6%
1927 NE 118 Road
North Miami, FL 33181
Stephane Cohen 16.6%
1927 NE 118 Road
North Miami,FL 33181
Marlon Cohen 16.6%
1927 NE 118 Road
North Miami,FL 33181
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5830 NBR,LLC
Name and Address % of Ownership
French North Bay Road, LLC 50%
1927 NE 118 Road
North Miami, FL 33181
Aguacero, LLC 25%
1111 Kane Concourse,Suite 210
Bay I Iarbor, FL 33154
Diluvio, LLC 12.5%
1111 Kane Concourse,Suite 210
Bay Harbor,FL 33154
Tormenta, LLC 12.5%
1111 Kane Concourse,Suite 210
Bay Harbor, FL 33154
Aguacero, LLC
Name and Address % of Ownership
Moris Tabacinic 100%
1111 Kane Concourse,Suite 210
Bay Harbor, FT. 33154
Diluvio, LLC
Name and Address % of Ownership
Michael Tabacinic 100%
1111 Kane Concourse,Suite 210
Bay Harbor,FL 33154
8
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Tormenta, LLC
Name and Address % of Ownership
Eli Tabacinic 100%
1111 Kane Concourse,Suite 210
Bay Harbor,H. 33154
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Lobbyist Registration Form - MWL
DocVerify ID: CA5918F9-D9CD-4031-8C D0-CC7868038DC 1
Created: July 10, 2020 12:59:25 -8:00
Pages: 7
Electronic Notary: Yes/ State: FL
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E-Signature Summary
E-Signature Notary:Betty Llerena(BII)
July 10,2020 13:00:27-8:00[3DCA74D69911][38.86.132.251]
bl lerena@brzoninglaw.com
I .1111
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Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
No. 426694
❑ Cash 0 Credit Card 0 Check# $
20
Rocived of
Miscellaneous- MCR-2020
Mc .4 A... r. f
Fd CR OPEN(MCR)
Payment Amount: 350.00
476694
(THIS INFORMATION MUST BE COMPLETED) Office of Finance Director
By
Account Number:
Preparer: Dept: EXT: