Michael Larkin - Lincoln 530 LLC MIAMIBEACH X30 0 A ,edd
City of Miami Beach Office of the City Clerrk C E i V E 0
1700 Convention Center Drive, Miami Beach, FL 32M AN , t
Ail 9. 7
LOBBYIST REGISTRATION FORM CITY
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage th passa o d e e
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 & Femandez 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:
Lincoln 530, LLC
NAME OF PRINCIPAL/CLIENT:
1121 Washington Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 538-1999
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: Yaniv Sananes
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Yaniv Sananes
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 530 Lincoln 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 Dept., HPB, BOA, Planning Board, City Commission None
.,r 1/. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required) $ 425.00 per 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 Iobbvina on a present or pending bid for goods. eauipment 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 Iobbvina on a pending application for a Development Aareemept 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 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 a not - for - profit corporation or entity without special compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
V API 28
ON 6e'OBER -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 YEA • A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COM • ENS • DURING THE
REPORTING PERIOD.
Signature of ; : •byist
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.
Signature of Lobbyist:
Signature of Principal /Client: i.._ _
VI. LOBBYIST IDENTIFI: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identifical T c g Form of Identification
Pers q onally known (Lo byist) E_ C� g C P ersonally knowrincipal)
C a
VII. SIGNATURE AND STAMP OF NOT/�tt �
State of Florida, County of Miami-Dade w , State of Florida, County of Miami -Dade
Sworn t• and subscrib =d before o Sw orn and sub before me
Thi day o _ A A ,._l�4 0� � ,,� -� T h is day o I I . / 20 .
��� o3,Ir 40 , E
Signature of Pu •lic Notary - State of Florida x ' Signature of Public No — r e of Florida
Notarization of Lobbyist's signature Notarization of Prin . pal's signature
Registration fee: [ FOR CLERK' USE ONLY
Annual Re o � ' /
g [ ]Yes No Amount Paid "1/ .IX.1�1CR # Date Paid / /1 07421/
Lobbyist Registration Form received and verified by: amt." ,� / Entered By: � LA/ ��[ - .1 f
F: \CLER \$ ALL \MARIA -M \Lobbyist \LOBBYIST fORM 05.doc Revised 12 08/04
MJAMIBEACH
•
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: 14( (,L1
I understand that no later than February 28th of each year, I must file the
following form, 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 and Compensation 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.
/ VAA ./ l . 0((
Signature: *ate:
Revised 09/24/2010 - REP
F:\CLER \LOBBYIST \Expenditure & Disclosure Forrn ltr.doc
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