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Michael Larkin - Pierre ElmalehC ' ' - City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 ?0<� (�� A -� f�: �A LOBBYIST REG|STRATCJNFORK8 �°' ' ="`^ �" m. .� °� Lobbyist means all persons employed or retained, whether paid or not, by principal who seeks to encourage thepassage defeat or modification of any ondinanoe, noao|uUon, action or decision of any commissioner; any action, decision'I reubmr�e�d��xz�drtna'�my | 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 f0000eeab|y 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 "Lobbyimto" has specific exclusions. Please refer bx Ordinance 2OO4'3435. Larkin Michael W. NAME OF LOBBYIST: (Last) (First) (M.1) Bercow R d ll & Fernandez, PA2OO South Biscayne B|vd Suite 850 Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 (305) 377-6222 m1arkinabrzoninglaw.com TELEPHONE NUMBER� FAX NUMBER: EMAIL: Please notify this office/f your contact information changes: address, phone, or e-mail address. |. LOBBYIST RETAINED BY: Pierre Elmaleh NAME OF PRINCIPAL/CLIENT: 8421 Crea i LLC 407 Lincoln Rd Ste 9D Miami Beach FL 33139 TUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: ,°^.`"=B=": ("v"""°v 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: See Attached IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached x.SPECIFIC LOBBY ISSUE: Develument Board Aipiprovals for 8421 Cresipi Boulevard, Miami Beach 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 or personnel sought moue lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said unv commissioner or personnel from 12 months peoouinu such stating person's commencement of service with the city to the present date, the |nature of the Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied PlanningDepartment and BUilding Department Staff None X PB. JJPB. BOA. City Commission. as necessary* None X Pursuant u,City Code Section o-4ou(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 muo lobbied an identified on the lobbyist registration form filed. Sec 2-482(g)Any Financial, Familial or Professional Relationship � C-VUners\cle/hadVAppData\LooaNMiomooftYWindowo\Temponory Internet FllenXConUenLOuUooN83LGODOHU-obbyistRegistration Formreviued5'3O'2012doc - U � � _r IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A LOBBYIST DISCLOSURE:(Required)) ( q ) $500.00 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $500.00 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 bending bid for goods.eauinment or se rvices. or on a present or 8endjng award for goods,eauinment or service? 2) Pursuant to Miami Beach City Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes X No: Are you lobbyina on a gendingaRplication for a Development Agreement with the City or application fQE change of zoning man designation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2-482 (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 Now Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 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 EM 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 requireme s. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID r.2 Form of Identification =: �= Form of Identification W ° Personally known (Lobbyist) 4 Personally known (Principal)VII. SIGNATURE AND STAMP OF NOTARY: W a V State of Florida, County of Miami-Dade State`-of Florida, County of Miami-Dade 4 IV* Sworn to nd subscribep before a 5lp Swo a ubscri d before , e w I<,,iS This da f.... 2693 c��l� This f ti , 201 ,J � Signat re of Publ' o ry—S ate of Florida Si r u otary— at of Florida Notarization of signature arization of Princil2al's signature TO BE COMPLETED-BY CITY CLERK'S TAF LY Annual Registration fee: [ ]Yes[ o Amount Paid$ MCR# �o Date Paid I/.V// Lobbyist Registration Form receiv d and verified by: 0 t' C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Tem Mra Int m et Files\Content.0 tlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc Revised 04/27/2012 ? (-jjv of ,Nliami 1700 Convention Center Drive. Miami Beach. Florida 33139. CITY (_`.1._1_kk (")11'1CC 1Zjk,lcl V., (Ivmmdo. C'Itv Clerk Cit\Clerk,'(1 mil-milhel,ich1l.-ov Tel: 305.073.741 1 . Fax: 305.673.7254 LOBBYIST NAME: Michael W. Larkin I understand that no later than February 28 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, or I am no longer lobbying on that issue or for that principal, 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. Signature: Date: C-\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Forrnrevised 5-30-2012.doc a f Ownership Breakdown Crespi9 LLC Sunstone Brokers (50%) Rebond LLC (50%) Sunstone Brokers Pierre Elmaleh (100 %) Rebond LLC Michel Besnier (100%) Miscellaneous Cash .Receipt CITY OF MIAMI BEACH NO.X a At Q Cash Cl Credit Card hack# �.. Received of Pit� Address , w For r (THIS INFORMATION MUST BE COMPLETED . Office of Finance Director. By. Account Number: Dept: a EXT. t: p