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Michael Larkin Ryder PropertiesSy;. , d v..r~ ~ ~` City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miarni Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, 6y a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolui:ion, action or decision of any commissioner; any action, decision, recommendation of the.. City Manager~or any city board or comirittee; or any action, decision or recommendation of any city personnel during the time period of the.entire decision-making proress on such action, decision or recommendation that foreseeably will be heard or reviewed by the city"commission; or a city board ar 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. tar~kn ~ ~ Michael- W. NAME OF LOBBYIST: (last) (First) (M.I) Bercow, Radell & Fernandez,, P.A. 20O 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: Ryder Properties, LLC NAME OF PRINCIPAL/CLIENT: Ryder Properties, lLC 29-35 9th Avenue New York New York 10014 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (212) 627-9800 ( TELEPHONE NUMBER: FAX NUMBER:"(Optional) EMAIL: (Optional) 'ill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Guy Williams, CFO. . • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR .MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP' OR TRUST: See Exhibit A . ~ II. SPECIFIC LOBBY ISSUE: . Renovation, restoration & redevelopment, including. variances & conditional use permit, of Soho Beach. House at 4385 Collins Ave 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 Department Staff;.HP6, BOA, Planning Board and City Commission* None ... a~A ~,j'.i~ 1 ~'J ~,'9. T.7 A U vr,ic~a ai.i i~~uc is icyiaiauvc ni Howl e, nro, ovrr, ridnC11r1y 6UdfU, af.lU C.0.y l.Ofi1mI55IOf1 m2mD@rS Bfe 110L.IODDteQ OULSIde Or a publlC IleBrlflg S2Ctlflg. .~ ,. >: W~.~ ~ N. DISCLOSURE OF TERMS ANID AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, SLAT RATE OR OTHER A) LOBBYIST DISCLOSURE: (Required;) $ ,425.00 per hour. $) 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" - . o Yes X No: Are you lobbying cm a present or pending bid for cioods, 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": oyes X No Are you lobbying on a pending application for a Development Agreement with the City or application for channge of zoninc~ 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 ~~ection 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.. D_Yes X No:; .Are you representiing anot-for-arofit corlgoration or entity withoutsuecial comuensation 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, Ll[STING 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. ~/ " Signatur of Lobb 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 of the Miami Beach City Code and all reporting requirements. /\q^\\,\\\ / ~ J V Signature of Lobbyist: .Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification R._:~_ ~ ~ Personally known (Lobbyist) ~. a II. SIGNATURE AND STAMP' OF NOTARY: `~~i chi ` ~ tate.of florida, County of .Miami-Dade ~ e `worn to and subscribed before me ~ ;his ~ day of, , 20~~ "' . c~ _ ~ ; ~ ~~ X w ignature li No ary -State of Florida otarization of Lobbyist's signature ..~~yt~y,.,: PRINCIPAL IDENTIFICATION: ~roduced ID ~21y~S L1 C,E~.-C~ Form of Identification ~ r,, ersonally known (Princi al ) . p . Q ~! ~ G 1~C7rtJ4ND ~J N OJ/~ ~t~ii State of , County of ~4ia+a~i-Bade - ~ ~ "~ ~ Sworn and subscribed before me ~~ ~ ~'" Thin 15 day of RP211-- , 20 1l7 ~ ~ (~-~~ ~ Signature of Public Notary -State of Florida Notarization of PrincipaF's signature FOR CLERK'S USE ONLY 0 'Annual Registration fee: [ ]Yes [ ] No Amount Paid D MCR Lobbyist Registration Form received and ~~erified by: - 7 ~ Entered_By: F:\CLER\$ALL`MARIA-M`Lobbyist`LOBBYIST fORM 05.d~oc e Paid ~ `~ ~ Revised 12/08/04 i -,- VJ ~ `~ ~ LLJ, (n ~ ~ Q U 0 ~ ' ~ J . ~.~ ~t ti ~ M ~ ~ O U ~ ,. U N O ~ .~ w Z i` C~ J O ~ 2 'p , ,,0_ .- Exhibit C . . 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