Michael W. Larkin - Skybridge Real Estate, LLC IAA 1 BEACH
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 South Biscayne Blvd., Suite 850 Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
. (305) 374-5300 (305) 377-6222 mlarkin(aD-brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
1. LOBBYIST RETAINED BY:
Falk Preussner and Natascha Preussner, Managers
NAME OF PRINCIPAUCLIENT:
Skybridge Real Estate, LLC 420 West Rivo Alto Drive Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786)282-5153 sven.sommer@mac.com
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: Natascha Preussne,Manager
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Falk Preussner(50%;/Natascha Preussner(50%)=100%
II.SPECIFIC LOBBY ISSUE:
Developmental Board Approvals and Permitting Issues for 420 West Rivo Alto Drive, Miami Beach, FL 33139
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 to be lobbied,and whether the lobbyist has entered
into any 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 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Commission,Planning Staff, Building Staff, None
Development Boards
Pursuant to City Code Section 2-482(8)Every registrant shall be required to state the extent of any business,financial,.familialzor professional
relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or_city pstsonnel.who is
sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2-482 Any Financial,Familial or Professional Relationship
/A = a
F:\CLER\$ALL\aF0RMS\L013BY1ST FORMS\Lobbyist Registration Form.doc -T
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$500.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required)._$500.00
The following infoeTnation 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 gr services.or on a present or
ggndjng award for goods.equipment or service?
2) Pursuant to Miami Beach City Code 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
Yes X No: Arg you l a on a pendina application for a Development Aareement with the City or
application for change of zoning man gnatoon or change to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code 2484(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 XNo: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUaRV 281h 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 req me
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID G IfC iM a Y��s'S �C
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known
ti*aY„yet IQNACIb MEN��
(Principal)VII. '��'”p° CRISTINA DIANA GONZALEZ SIGNATURE AND STAMP OF ''0 * MY COMMISSION t FF 163412,
_,.. ,.:
EXPIRES:September 25,2018
NOTARY:' MY COMMISSION#FF083128 r.�r ` BondedThruBudgetNotaryServues
''�p!rr�...... EXPIRES March 23,2018 fa F
State of Florida,County f Miami-D41047�>>3se FlorldaNOta servlce.com State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sworn and subscribed before me
This day of o ccm 8 2014 This-Ziday of ,2014
Signature of Public Nota Statb of Flo&a a Signature of Public Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Princioal_s signature
TO RE COME'FIFO BY CITY C-1 ERKIS STAFF ON'V
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
I\AIA�01 BEACH
City of Miami Beach, 1700 Convention Center Drive. Miami Beach, Florida 33139, www.miamibeachtl.-ov
CITY CLF..RK 0 Rice
Rafael f:. Granado. City Clerk CityClerkcimiamibeachfi.gov
Tel: 305.673.7411 , Fax: 305.673.7254
I
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
Statements 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
Formrevised 5-30-2012.doc
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