Michael Larkin - 983 Washington Avenue MIAMIBEACH
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, PA 200 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:
Please notify this office if your contact information changes:address,phone,or a-mail address.
I. LOBBYIST RETAINED BY:
The Club Investment Group,LLC—Eugenio Marrapodi,Manager
NAME OF PRINCIPAL/CLIENT:
The Club Investment Group,LLC 1680 Michigan Avenue,Suite 1022 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)606-0185 e.miami @email.it
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: Eugenio Marrapodi,Manager
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Development approvals and permitting issues for property located at 983 Washington Avenue,Miami Beach, FL
Issue to be lobbied(Describe in detail):
CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4)include the commissioner of personnel sought to be lobbied,and whether the lobbyist
has entered into contractual relationship(paid or unpaid)with said city commissioner or personnel from 12 months preceding
such person's commencement of service with the city to the present date,stating the general nature of the subject contractual
relationship.
Sec 2482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Department and Building Department None X
Staff
PB,HPB,BOA,City Commission,as necessary* None X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or
professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner
or city personnel who is sought to be lobbied as identified on the lobbyist registration form file&J1.J A n
Sec 2-482 Any Financial Familial or Professional Relationship
None. 9S W 112 /
*Unless an issue is legislative in nature,PB,HPB,BOA,&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
OTHER):
A) LOBBYIST DISCLOSURE: (Required)_ $445.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). ___$445.00
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":
n Yes X No: Are you lobbying on a present or pending bid for goods,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":
nYes 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 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..
n Yes X No: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28"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.
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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 Miami Beach City Cod and all reportin requirements.
Signature of Lobbyist: J
Signature of Principal/Client: �`��" ���•�
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
SSA( Rv S I c�K ,�R o t��, �►
0 Produced ID N Produced ID 2
Form of Identificatio g N Form of Identification d _ o
Q;to 0
Personally known (Lobbyist) ° 0 Personally known (Principal) In
VII. SIGNATURE AND STAMP OF NOT ° V' o E
State of Florida, County of Miami-Dade 9 State of Florida, County of Miami-Dade N Z s
Sworn to and subscribed before me Sworn and subscribed before me Ll ,i 6'
This 1 P-A-e—day of`�`�^�R 20 a- L= This day of . 20_ ty
Signature of Public Nota -St of FI icla Signature of Public Notary� � -State of Florida �
Notarization of Lobbyist's signature Notarization of Principal's signature
FOR ERK'S USE ONLY / 2
Annual Registration fee: [ ]Yes[ ]No Amount Paid MCR# —' -Date aid 7 7�
Lobbyist Registration Form received and verified by: Entered By: i
Revised 1/11/2011
C 'orm.doc Revised 1/11/2011
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office CityClerk @miomibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: -CAgel 141, L�r�Cn
I understand that no later than February 28th of each yeas', 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.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who fails to
timely file a Statement and in addition to any other penalties which may be imposed as
provided in Section 2-485. 1 , a fine of $50.00 a day shall be assessed for all Statement(s)
filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on
Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the
assessed fines after notification.
Any lobbyist, who fails to file -the required -Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all =fines are. paid, unless the fine has been
appealed to the Miami-Dade County Commission on-Ethics and Public Trust.
3 /a �a/?
-Signature: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form"doc