Michael W. Larkin~ D ~(-~~" a ~ ToN /~o/~-D
~~~~ ~~~~
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@brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Seth Gadinsky
NAME OF PRINCIPAL/CLIENT:
1680 Michigan Avenue Suite 1001 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 276-2387 (305) 675-7759 Seth@Gadinskyrealestate.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust
• 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:
Extension of Time for development approvals for 1011-15 Alton Road
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
Planning and Zoning Department Staff, HPB, BOA, City
Commission * None
an isSUe is lenlslatlve in nature. HPR. R(1A. Planninn Rnard_ and City Cnmmicdnn memherc are not Inhhiad nutcide of a nuhlir hearlnn cettlnn_
1~
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) $ 385.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 385.00 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 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":
^Yes X No: Are you lobbving on a pending application for a Development Agreement with the Ciri or
application for chance of zoning map designs ion or change to the ~itv's Future Land Use
Man?
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..
^ Yes X No: Are you representing snot-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.
Sigfiature of LofSbyist
I do solemnly swear that a
familiar with the provisions
requirements.
Signature of Lobbyist:
of Principal/C
~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
'~
^ Produced ID ^ Produced ID ~~~~`~°~NNE C, p ~~~6i,,
Form of Identification Form of Identification \\~,~~ ~pP`,Missio ~qp~,'r
~ ~ Personally known (Lobbyist) .personally known (Principal) * : ~'` ~~°e 18'?0,~ :. "~~~.:
I. S ATURE AND STAMP OF NOTARY: o,=~ #DD •s : *'
/ 696572 a.:
~~~c tate of I ids Coun f mi-Dade State of Florida Coun of Miami-Dade '~9A~:'~a ~~~'' cQ
far. ~ wor ubscribe for me Sworn aid subscribed before me /`r~/~fQ`i~ arpTE,r°F~~~
hi day 20~~ Thisa~ day of? ~ ,,' , 20 O ~- t
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nature of Public Notary -State of Florida Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
FOR CLERK'S E ONLY .~/ o
Annual Registration fee: [ ]Yes [ ] No Amount Paid MCR # to Paid
Lobbyist Registration Form received and verified by: Entered By: ~'
F:\CLER\$ALL\MARIA-M\Lobbylst\LOBBYIST fORM OS.da Revised 12/08/04
II of the foregoing facts are true and correct and that I have read or am
contained in Section 2-482 of the Miami Beach City Code and all reporting
a,. ~. ,
City of Miar»i Beach, 17rJC3 Cor:vention Center Chive, Miami $each. Fioric~a 33134, www.miamibeachfl.~v
ClT`f CLERK C~~face CityClerk~miamibeflchfl.gov
Tel: 345.673,743 1 , l:ax: 345.b73.7254
LC>BBY15T NAME: ! " ~ ~,C/~-~t'~ ( ~~ ~~ M~
! understand that no later than t3ttober '1st of each year, !must file the fallowing
forms, pursuant to Section 2-485 of the Miami $each City Code, with the City Clerk`s
C.}ffice for all active lobbying issues.
1 ~ Lobbyist Expenditure Form
2~ Disclosure Farm
Failure to file these farms an a timely basis will result in my name being transmitted to the
Miami-Dade County Commission an Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby an 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: