Michael Larkin 1600 Lenox/~a nniQnniRFa~H
l d ~o Gc~~ ox
• .. - City of Miami Beach Office of the City Clerk
1700 Convention ~Center.Drive, Miami Beach, FL 33139
• LOBBYIST REGISTRATION FORIVI
Lobbyist means all persons employed or rE~tained, 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 iricludes the principal as well as any employee engaged
in lgbbying 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 & Fernandes P.A. 200 >: Biscayne Blvd., Suite 850 Miami Florida 33.131
~. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377-6231 ~ (305) 377-6222 mlarkinCa~brzoninglaw.com
TELEPHONE NUMBER: ~ FAX NUMBER: EMAIL:
• I. LOBBYIST ..RETAINED BY:
1.600-Lenox Investors, LLC c/o Greenstreet Partners L:P
NAME .OF PRINCIPAL/CLIENT:
2601 South Bavshore Drive 9th Floor Miami `Florida 33133
BUSINESS NAME AND ADDRESS (IVumber and ,Street) (City) (State) (Zip Code)
(305)858-4225 • (305)858-2334
:..TELEPHONE NUMBER; FAX NUMBER: (Optional) EMAIL: (Optional) "
Fill ~outthis section if .principal is a Coirporation, Partnership. or Trust [Section 2-482 (c)]
e NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Jeffrey Safchik, President
o . IDENTIFY ALL PERSONS HOLDING, DIRECTLYOR'INDI_RECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, .PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY YSSUE:
Rezoning and redevelopment issues concerning-1600-Lenox Avenue
Issue to be lobbied (Describe in detail):
IIL; CYTY AGENCIES/INDIVIDUAILS TO BE LOBBIED: •
A) full .Name of IndivitBual/Title B)'Any Financial, Familial or Professional Relationship
Planning Department Staff, Planning Board,, and City •
Commission * ~ None
~ ~ ~.
* Unless an issue is legislative in nature, Planning Board and City Commission memhers arP not Inhhiari n~itc~r~a of a niihlir haarinn cattinn
`. IV. DISCLOSURE OF"TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HDURL Y,
. ,, FLAT RATE OR ®THERf
A). LOBBYIST .DISCLOSURE: (Required) _- ~ 425.00 der hour
B) ',PRINCIPAL'S DISCLOSURE ~(OF .LOBBYIST COMPENSATION): (Required). $ 425.00 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 Qending awvard 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.uendin4 application for a Development Agreement with the City or "
application for change of zoning map designation o'r change to the City's Future Land Use
Map?
3) Pursuant to Miami Beach Ciiy Code 2-484. (h) Any person (except those exempt from the definition of
"lobbyist" as set. forth_ in Se~~tion 2-481 above) who only appears as a representative of a not-for-profit
corporation or entity without special compensation or reimbursement for he appearance,. whether direct, or
indirect, to express support i~f 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. representinia~ 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 SUBIWIT YO THE: CITY CLERK A SIGNED
STATEMENT UNDER O~-TH,. LIS'TIIVG LOBBYING EXPENDITURES, AS;" WELL AS COP~IPENSATION
',.RECEIVE®, IN THE CITY OF MIAMI BEACH FOR THE. PRECEDING CALENDAR YEAR. A STATEMENT
SH~4LL BE FYLED EVEN TF THERE~IiAVE :BEfN 'NO'EXPEN®ITURE~ OR COMPENSATION' DURING Tlif
REPORTING PERIOD. -
-~ '
" Signatu of Lob yist
I do solemnly swear that all of tlhe foregoing facts are rue and correct and that I have. read or am
familiar with the provisions .contained in .Section 2-482' of the Miami` Beach City Code and all reporting
requirements.
Signature of Lobbyist:.
Signature of Principal/Client:
-\/I. ~ LOBBYIST IDENTIFICATIC PRYNCIPAL IDENTIFICATION:. .
_ / +
o Produced ID ^ .Produced ID
Form of Identification Form of Identification
.' M.
~ ~ ~ Personal) known Lobb ist ~ CAP r ~ . .
Y ~ Y ) e sonally known .(Principal)
~~~
., -
`tiOTARY PL G C-STATE ~F ~ ORIpA
W °.~~ ~ ,,.,,,,,,, Borgia ~~'il iarris
VII'. SIGNATURE AND STAIWP C)F NOTARY:
~ ~: ~ ~ :Commission ~` DD902690
~ ~ ~•,,,,~,,.,~` Expires: AUG. O1, 2013
w ~ State of Florida, County of Miami-Dade State of Florida County of Miami-Dade BoN~~ rxRV A~r~,:L~~ic$o~~LwG co., ixc.
g X ~ ~ Sworn to and subscribed before me Sworn an subscribe before me
~' This ~' day of ~ Zd~~ This ;~ ~ day of C , 20 i~
~,o,,. -
•'~ Si n Lure f blc Nota
• g ry -State of FNorida Signature of ubli' .Notary -State of Florida
~,,,,,~t~• Notarizata of Lobbyist's signatuire~ ~ Notarizatio of Principal's signature
FO LER .U~E ONLN J,~ ^
4nnual Registration fee: , , ]Yes [ ] Nip Amou aid ~~ ~ R #~~ ~ t.ts .Date Paid
_obbyist Registration Form received' and verified by: Entered By:
='\CLER\$ALL\MARIA-M\L bb ' t LOBBYISTf
o yis \ ORM 05.doc Revised 12/08/04.
~,.
~, EXHIBIT B
` ~ ~ Disclosure ~of Interest
.;.. 1600 Lenox. Investors, LLC - .
Florida limited Liability _
,..~
.
Company)
100% Owner:& S ole Member '
. - Greenstreet.SOBE
Investments, LLC (Florida ,
. Limited. Liability Company)
., ,.
.: ~ ~ , : ...~ _ . .
~
1
00% Ovvner &S
ole Member ^
.
~ MG Real Estate Partners,
. -
.. LP (Delaware Limited_ .
: , -: - _
,~ Partnership)
~
._
1 % ~
67.0% ..
32;0%
..,.
General Partner
limited Partner
- ..Limited Partner
Greenstreet Management,.Inc. Knowledge Industries, LLC
(.Delaware Corporation) (California Limited Liability Greenstreet~Capital, LP
. Company).. (rDelaware.Limited
. . ~ ~ Partnership)
. ~ 100.% shareholder
.
. .: ~
o
100 /° shareholder-
` St
J. G
n ~
.
even
ree
`
2601 South Bayshore Drive
Michael R.
Milken
--- .
9th:Floor, Suite.800 ~ ,
1250 Fourth Street, 5th Fioor
~ ~
See page 2
,; , Coconut G "rove, Florida 33133 . ~ Santa Monica, CA 90401
: - - Jeffrey.A. Safchik;
_ _ .
~ ..
... President/Treasurer/Secretary ~ ~ .
. ~ .. Page 1 of 2