Michael Larkin/John Kunkel` m MIAM!BEACH
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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 South 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:
John Kunkel
NAME OF PRINCIPAL/CLIENT:
1398 Bav Drive Miami Beach FL 33141
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)586-3148
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
out this section if principal is a Corporation, Partnership or Trust [Section 2-482
• 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:
DRB Approval for 1398 Bay Drive
Issue to be lobbied (Describe in detail):
III. CM AGENCIES/INDMDUALS TO BE LOBBIED:
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A Full Name of Individual Title
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B) Any Financial, Familial or Professional R~latioa~9hip ~-I
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Planning Department, DRB, City Commission * None , ~
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* Unless an issue is legislative in nature, HPB, BOA, Planning Board, and 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 OTHERr
A) LOBBYIST DISCLOSURE: (Required) $ 385.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 385.00 Der hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions 8y Lobbyists
On Procurement Issues":
^ Yes X No: Are you lobbying on a present or pending bid for goods eguipment or services or on ~
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 lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation or 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 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 anot-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. ~ /
Signature of Lobbyist
I do solemnly swear that
familiar with the provision
requirements.
Signature of Lobbyist:
all of the foregoing facts are true and correct and that I have
s contained in Section 2-482 of the Miami Beach City Code and
Signature of Principal/Clie~
VI. LOBBYIST IDENTIFICA
^ Produced ID
. Form of Identification
Personally known (Lobbyist)
S
g ~ I. SIGNATURE AND STAMP OF NOTARY:
to of o ida, Coun f iami-Dade
r or subscri a me
' day o 0~
na ure of Public Notary - St to of Florida
~• ~ otarization of Lobbyist's signature
~.
Annual Registration fee: [ J ]Yes [ ] No
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\LOtibyist\LOBBYISr fORM OS.doc
read or am
all reporting
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identificati ~~~
ray Commisston #oD645953
i~i•sonally known (Principal) Frq~fres 03/30/20) )
State of Florida, Co o / ~~r~Z's45953
Sworn and subscr gr Ex~ _~il
This day o ~/ _
Signature of Public tary~tate of Florida
Notarization of P incip 's signature
FOR CLERK'S USE ONLY v
Amount Paid ~_ MCR # ~ Date Paid
Entered By:
~~
Revised 12/08/04
City of Midmi BeoCh, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.7411 ,Fax: 305.673.7254
C ityClerk@m iam ibeachfl. gov
LOBBYIST NAME: ~'~I (..~ ~a~ ~ ~--~-~ ~C t n
I understand that no later than October 1st of each year, I must file the following
forms, 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 Form
2) Disclosure 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.
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Signature:
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Date:
~:tCi_Ei2tLQi3BYtSTl~obbyist Registration Form 32708.cioc