Michael Larkin/Len Goldbergm 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.
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 MLarkinCalbrzoningl~w.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Len Goldberg
NAME OF PRINCIPAL/CLIENT:
Neptune Premier Holdings LLC 1632 Meridian Avenue Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 320-7874 (305) 316-4550 milehighcdCalhotmail.com
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:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Variance from Flood Plain Management Board
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
Flood Plain Management Board None
Thomas Mooney None
Jorge Gomez None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required) $375 00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 375 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 as present or pending bid for goods, eauiument or services, or one
psi;; or ~ ; a~°^ °`°"''~ ~'+'' goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
.r r.,_a: ~.... n~„o,lo nt r[+~fnnnt with the City or
^Yes X No Are xou lobbying on as p'.--~W~r' aDo~a.~~~or~ ~~~ a Q~.,~g
~;lip*ion for chance of zoning mag desianatron or change to the r~~'~ F~t~~ Land Use
MaD?
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 snot-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..
^ Yew X No Are you regresentr~a 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 COMPENSATION DURING THE
REPORTING PERIOD.
Sign r of Lobby st
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 o/f~th~e Miami Beach City Code and all reporting
requirements. ~.~Y~ t-~/ \'`-,~`'/ .
~•
Signature of Lobbyist:
Signature of Principal/Client:
a
o VI. LOBBYIST IDENTIFICATION:
~ ~~ ~
a ~ .~ ~ ~ Produced ID
~ $ ~ Form of Identification
2~.iW
Personally known (Lobbyist)
~~~0~ VII.
~s~, a '~
"~' • State ~
Sworn
This
RE AND STAMP OF NOTARY:
County
of
Srg(iature of Public Notary =State owFlor
Notarization of Lobbyist's signature
PR AL IDENTIFICATION:,
Produced ID
Form of Ider
Personally known (Principa
~ O~OTARY~ ,
V1 ~~~ O
.~-
Cato-ado i:~c,~ '9~ PUBS-~~' QQ
4
State of FleriEla, County of ~ F 7 f- C~~O
Sworn and subscribed before me
This 10"'dayof ~a~r , 2001
Signature of P lic o ry -State of Florida Co1o~c.do
Notarization of incipal's signature
F R C E~NLY /l` L
Annual Registration fee: [ Yes [ ] No A unt P id MCR v ~C Date Paid
Lobbyist Registration Form received and verified by Entered By
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