Michael W. Larkin - Steve Roadruck~ s~'AMIBEACH
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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 commissiiin, or a city board or committee. The term specifically inchudes the principal. as well as-any employee engaged
• in obbying 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
y . TELEPHONE NUMBER: FAX NUMBER: EMAIL:-
I. LOBBYIST RETAINED BY: `
Steve Roadruck ...
. NAME'OF PRINCIPAL/CLIENT: ' ..
• ~ Miami Beach Rod & Reel Club, Inc.. 208 S.' Hibiscus Drive Miami`Beach Florida 33139
-BUSINESS NAME AND ADDRESS (Numberand Street). {City) - • (State) (Zip Code)
`.(305): 531-1233.
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: Steve Rdadruck
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN-SUCH
' ~ CORPORATION, PARTNERSHIP OR TRUST; .
IL SPECIFIC LOBBY ISSUE:
Potential Designation. of the Property Located at-208 S. 'Hibiscus Drive as a Local 'Historic Site
;'Issue to beaobbied (Describe in detail):
IIL, • CITY AGENCIES/INDMDUALS TO BE LOBBIED: ~ •
A) Full Name of Individual`/Title B) Any Financial.Familial or Professional Relationship .
Planning Dept.; PB; BOA, HPB, Planning. Board; City Norie • '
Commission
• * Unless an issue is legislative in nature, HFB,"BOA; Planning Board, and City Commission members are not lobbied outside of a public hearing setting.
~~
I~
" ""'°IV: DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE. WHETHER HOURLY,
. FLAT RATE OR OTHERf
'-'~ A) ,LOBBYIST DISCLOSURE: (Required) $ 425.00 per hour " "
. B) PRLNCIPAt'S DISCLOSt1RE (OF LOBBYIST COMPENSATION): (Required).- $ 425.00 per hour
The following information must be answered:..
2) Pursuant to Miami Beach City Code Section 2-488 Erititled "Prohibited Campaign Contributions.By Lobbyists
On Procurement Issues":
' ^-Yes X No: Are you lobbvina on a present or aendina bid for goods, eaui~ment or services, or on a
present or pending award for aoods, equiament or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
C;",
"' ^Yes. X Na Are you lobbying on a pending application for a Development Agreement with the City or
aiaalication for change of zoning map designation or change to the City's Future Land Use
M-~
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) wFio 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 representing snot-for-profit coraoration 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.
. RECENED, 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 .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 Mi i Beach City Code and all reporting
requirements.
,Signature of Lobbyist:
" .
Signature of Principal/Client:. ,.~ ~. -
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: .
^ Produced ID ~ ^ Produced ID "
Form of Identification
m~
~ j/~ersonally known (Lobbyist)
g ~ VII. SIGNATURE AND STAMP OF NOTARY:
~.~'~ ~ "
~ ~~' .State of Florida, County of Miami-Dade
~~ Sworn to rid subscribe before me '
. ~ .This ~ day of ~~ 200
• ~Z~~ Signature" Public Notary -State of Florida
,~ ~-~~ Notarization of Lobbyists signature
Form; of Identification
°Personally known (Princi'~PV ~~ DA
A
LSr~a: AiA Y 24 2C` l 2
State of Florida, County ofMiami-t~a~e~`'An*rtcxc;,mu~an;, p,~.
Sworn subscrib re me
.` . ,iThis ~` d f CI 1
v
Signature of Public Notary = Stat .of Florida
.Notarization. of Principal's signature
' FOR CLERK'S USE ONLY
Annual Registration fee: [ ]Yes;[ ]' No Amount Paid ~ MCR # ~ ~ ~ .Date Paid '~ /~~
Lobbyist Registration Form received and verified by: Entered By: -~
F:\CLER\$ALL\MARIA-M\LObbyist\LOBBYIST fORM OS.doc Revised 12/08/04