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Michael W. Larkin - CG TidesM AMt BEA•CH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 20/2 4PR /0 LOBBYIST REGISTRATION FORM C77- 4N /r), 1, f Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, de]eat'br„mq l f etion of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any dity foo'ard. 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 (305) 377-6231 (Number and Street) (City) (State) (Zip Code) (305) 377 -6222 mlarkin @brzoninglaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. I. LOBBYIST RETAINED BY CG Tides, LLC — Meyer Chetrit, Manager NAME OF PRINCIPAL /CLIENT: CG Tides, LLC 2915 Biscavne Blvd., Suite 300 Miami BUSINESS NAME AND ADDRESS (Number and Street) (City) (305) 747 -6408 Florida (State) 33137 (Zip Code) 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: Meyer Chetrit, Manager • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached exhibit. II. SPECIFIC LOBBY ISSUE: Development approvals and permitting issues for properties located at 1220 Ocean Drive & 1201 -1229 Collins Avenue, Miami Beach, FL Issue to be lobbied (Describe in detail): III. 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 title of person to be lobbied Contractual Relationship (Explain) YES NO Staff of Planning Department, Building Department, and Public Works Department None X 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, financ'al, 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 filed. Sec 2- 482(g) Any Financial, Familial or Professional Relationship None. * Unless an issue is legislative in nature, PB, HPB, BOA, & City Commission members are not lobbied outside of a public hearing setting. 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). 445.1 0 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 ": fl Yes X No: Are vou lobbvina on a present or pending bid for aoods, 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 ": DYes X No: Are vou lobbying one pending application for a DevelopmentAureement with the Citv or application for change of zoning map designation or chance to the Citv's Future Land Use Map? 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.. A Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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., 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 Code and all reporting requirements. v l Signature of Lobbyist: Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: 0 Produced ID Form of Identification Personalty known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade Sworn to and subscribed before me This `-t day of. 'O— , 20 j'-- Signet N e of Public Nota -tate Florida ilzation of Lobbyist's sign . ure L IDENTIFICATION: d ID Form of Identification ally known (Principal) MaD4a�a, County of ami:a e nd subscribed before me day of ∎\ , 20t' -- LOIS HUTTER SANCHEZ Notary Public, State of New York No. 01 HU5042516 rauaiif r1 in Queens County omission Expires April 24, 20j. Sig a ure of Public Notary — State of1r Notarization of Principal's signs ur FOR CLERK'S USE ONLY Annual Registration fee: [ J Yes o Amount Paid %Q �D 00 MCt /� #iJr�% Date Paid Lobbyist Registration Form receiv d and verified by: � 5 JOIEntered By: Revised 1/11/2011 N, 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 ": ❑ 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 ": ❑Yes 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.. ❑ Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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. 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 Code and all reporting requirements. Signature of Lobbyist: Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: / PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification ❑ Personally known (Lobbyist) 1ersonally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade Sworn to and subscribed before me This day of , 20_ Signature of Public Notary — State of Florida Notarization of Lobbyist's signature tge4.1 orck Qv eye rit State of l l , County of e Sworn and subscribed before me This 3 day of ∎\ , 20tl— LOTS HUTTER SANCHEZ Notary Public, State of New York No. 01HU5042516 9M nualifieri in Queens County Signature of Public Notary — State ofitedarnmission Expires April 24, 2O1. Notarization of Principal's signature ‘10' FOR CLERK'S USE ONLY Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # Date Paid Lobbyist Registration Form received and verified by: Entered By: Revised 1/11/2011 , City of Miami Beach, 1700 Convention= Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov • CITY CLERK Office Tel: 305.673.7411 , Fax: 305.673.7254 CityClerk@miamibeachfl.gov LOBBYIST NAME: MC1ke( Y J • l_1 -iI- 14 1 tit I understand that no later than February 28th of each year, .( 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. Signature: Date: