Michael W. Larkin - 411 Michigan SOFI Owner, LLC 1/1 I - t4``c,1,‘I'c ,4--)
`1c1 S 5 A-�
DocuSign Envelope ID:59E01AEB-7F8D-4FEB-A4B8-741B1FB6B2C0 RECEIVED
/V\ I AtV\ I B[AC H NOV
302021
Office of the City Clerk
1700 Convention Center Drive CITY OF MIAMI BEACH
Miami Beach, FL 33139 OFFICE OF THE CITY CLERK
305.673.7411
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 City Code Chapter 2,Article VII, Division 3, entitled "Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Larkin Michael W.
NAME OF LOBBYIST (Last) (First) (Middle Name)
Bercow Radell Fernandez Larkin & Tapanes, PLLC 200 South Biscayne Blvd.,Ste. 300 Miami, Florida 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374-5300 mlarkin@brzoniuglaw.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Pallaoro Alessandro
NAME OF PRINCIPAL (Last) (First) (Middle Name)
411 Michigan SOFI Owner, LLC 55 E 59 Street, 24 Floor New York NY 10022
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
g 917-370-7467 pallaoro@bizzipartners.com
• PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
• Pursuant to City Code Section 2-4ggh)(1)(a): A'mricIpartir'any on, paltimerzenp,v, Wee; vildrwho appea''•
:My,without special compensation or reimbursement for the appearance.whether direct, indirect,or contingent,to
ister- • all not be required to pasagogistr
N
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
• pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): A. Pallaoro
99
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A): Please see the attached
W
2 Page 1 of 5
L
D2aato.Ramos F-99BFAF454769 --- - — - -- - —
Page 1 of 5 199BFAF454769 ,III Et ,I III
DocuSign Envelope ID.59E01AEB-7F8D-4FEB-A4B8-741B1FB6B2C0
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Code Amendment, Development Approvals & Planning Issues, including but not limited to the Historic
Preservation Board, Design Review Board, Planning Board, Board of Adjustment, Land Use Development,
City Commission and any City Workshops or Committees, if necessary, relating to the properties located
at 411-419 Michigan Avenue, and 944 5th Street in Miami Beach, Florida.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship (If yes, explain) YES NO
Title of Person to be Lobbied
Staff for the Planning & Building Department None X
Public Works & City Administration, PB, HPB, BOA None X
DRB,City Commission, and Mayor 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 filed.
c
• List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
• appearance of impropriety (if none,write N/A):
N
None
U-
LL
Q
LL
Q]
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$695 per hour
0
0
$ Page 2 of 5
Dwww tlocyerry cool 5-00933252-AD1F-996FAF454769 ,III Il 11 III I
Page 2 of 5 2998FAF454769
DocuSign Envelope ID:59E01AEB-7F8D-4FEB-A4B8-741B1FB6B2C0
The following six(6)questions MUST be answered:
1) Pursuant to 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 City Code Section 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 City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in
Section 2-481) 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 city 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?
4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific, technical or other specialized information or testimony in public meetings; any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance
_Yes x No: Are you providing only scientific, technical or other specialized information; appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services
within the past election cycle. See Section 2-491 for more information.
—Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle? If yes, please list the incumbent member(s)of the City Commission:
_Yes x_No: If yes, has it been less than 12 months since the elected official(s) whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
9 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
x service before lobbying the City Commission at a public meeting.
_Yes x_No: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle? If yes, please list the incumbent member(s)of the City Commission:
0
O
0
_Yes X No: If yes, were you promised or did you receive economic consideration in exchange for campaign
a consulting services?
LL
m
Cr.'
o TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
a
v Annual Registration fee: [ ]Yes['-]No Amount Paid$ r .)d't`- MCR# 1 �'((�
L--% Date Paid
M
S Lobbyist Registration Form received and verified by: - '
.
Revised 09/20/2018
00 ---- .--_
0
Page 3 of 5
' DDoc1 VVa�cvyenry 4DEC005.0093-4252-AD1F-99BFAF454769 Page.3 of 5 399BFAF454769 ,III ,I II
DocuSign Envelope ID:59E01AEB-7F8D-4FEB-A4B8-741B1FB6B2C0
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENS DURING THE REPORTING PERIOD.'
Signature of Lobbyist: v �" Date 11/12/2021
32132035oDeE6c i0_.
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all reporting requirumerrt edby:
Signature of Lobbyist: ,—Docusignedby: V Date 11/12/2021
�, 326213s5513rfl6410...
Signature of Principal: � ✓1 Date 11/12/2021
"-98Uroad(19(J49t...
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: Miami-Dade County of: Miami-Dade
Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me,
by means of❑ physical presence by means of 0 physical presence
or lI online notarization, or E online notarization,
this 12 day of November ,20 21, by this 12 day of November ,2021 , by
Michael W. Larkin Alessandro Pallaoro
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
X Personally Kno '""` X Personally Know
M Signature of Notary Public Signature of Notary Public
Diana Ramos Diana Ramos
g Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
N
1 Diana Ramos I Diana Ramos
N 1 Commission#GG 308355 I Commission#GG 308355 1
a I Notary Public-State of Florida 1 1 Notary Public-State of Florida
m 1 My Commission Expires Apr 10,2023 1 1 My Commission Expires Apr 10,2023 1
' 1 The (g persons: 1 1
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
S direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
g not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
W the appearance.
2 Page 4 of 5
Dy ID 84DEC005 0093 4252-AO1 F-99BFAF454769
rwww Page 4 of 5 499BFAF454769 ,III ,I III tiww dor docverify com
DocuSign Envelope ID:59E01AEB-7F8D-4FEB-A4B8-741B1FB6B2C0
M AM BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: Michael W. Larkin
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for 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 of each year, 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
a
! DocuSigned by:
a III(l V
1 1212021
LL 229203xoscc4 t o
Signature of Lobbyist Date
U,
m
0
0
S F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc
0
a
ul
2 Page 5 of 5
' DocVerify ID:84DEC005.0093-4252-AD1F-99BFAF454769 C�y a�� 4
www.docverify.com Page 5 of 5 599BFAF454769 1111 tc m C11111
EXHIBIT B
Disclosure of Interest for 411 Michigan SOFT Owner LLC
411 Michigan SOFT Owner LLC
55 E. 59TH ST., 24TH FLOOR
NEW YORK, NY 10022
411 Michigan JV LLC 100%
411 Michigan JV LLC
55 E. 59TH ST., 24TH FLOOR
NEW YORK, NY 10022
SREI SOFI LLC 88%
Lauren Pressman 2%
411 Michigan Sponsor LLC 10%
SREI SOFT LLC
500 Winstead Building
2728 N. Harwood Street
Dallas, TX 75201
Eric and Wendy Schmidt 100%
555 Bryant Street, #347
Palo Alto, CA 94301
411 Michigan Sponsor LLC
55 E. 59TH ST., 24TH FLOOR
NEW YORK, NY 10022
SK 411 Michigan LLC 50%
411 Michigan BP LLC 50%
SK 411 Michigan LLC
520 West 27th Street, Suite N° 302
New York, NY 10001
Sumaida + Khurana
SS 411 Michigan LLC 50%
EXHIBIT B
Disclosure of Interest for 411 Michigan SOFI Owner LLC
AK 411 Michigan LLC 50%
411 Michigan BP LLC
55 E. 59TH ST., 24TH FLOOR
NEW YORK, NY 10022
Bizzi & Partners Realty LLC 50%
Alessandro Pallaoro 50%
SS 411 Michigan LLC
5 Park Lane, West Harrison, NY 10604
Saif Sumaida 100%
AK 411 Michigan LLC
Amit Khurana 50%
520 West 27th Street, Suite N° 302
New York, NY 10001
Attn: Amit Khurana
Sumaida + Khurana
Paramdeep Singh 50%
7 Roads End
Brookville, NY 11545
Bizzi & Partners Realty LLC
55 E. 59TH ST., 24TH FLOOR
NEW YORK, NY 10022
Davide Bizzi 100%
2 Kohtu Street Apt. #3 Tallinn, 10130 Estonia
E A t F
docv'erifyy 8 ,, -4,5 O •
0CCVER\�
Lobbyist_Registration_Form_-_MWL - executed.pdf
DocVerify ID: 84DEC005-0093-4252-AD1 F-99BFAF454769
Created: November 12, 2021 11:31:54 -8:00
Pages: 5
Electronic Notary: Yes / State: FL
This document is a DocVerify VeriVaulted protected version of the document named above.It was created by a notary or on the behalf of a
notary,and it is also a DocVerify E-Sign document,which means this document was created for the purposes of Electronic Signatures and/or
Electronic Notary.Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.
Go to www.docveriy_com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.
i
E-Signature Summary
E-Signature Notary:Diana Ramos(dra)
November 12,2021 11:34:35-8:00[C4812BC73FAB][162.244.152.118]
dramos@brzoninglaw.com 7 ,L;.1 ,I7 ri, . Vii;.pk1 I ftili
1/11 je..1114 il
`at t [1.
l 1 TI IA 4i4.4 I L
IiiiiiilliiiiiiiiiiiilliiiiiiiiiiiiiiiiiilliiiiiiiIiiiiiiiiiIiiIIIIiii
DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System.Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature.and not intended to be an accurate depiction of the persons actual signature
as defined by various Acts and/or Laws.
DocVerify ID:84DEC005-0093.4252-AD1F-99BFAF454769 ,III 1516011111
I III
www.docverify.com Generated Cover Pape 99BFAF454769
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH -7404
No, 429205
El Cash flCreditCard °Chad(# $ .
• 20 71
itioelved of r.)
Miscellaneous- MCR-2022
MONT° 1i3er2uz e,..nrivi
For
Payment Amount: 1.750.00
A
(THIS INFORMATION MUST BE COMPLETED) °free of Finance Director
By
r• F Li (Tic)
Arccount Number:
.
preparer: ),41'".r"' • :1-- Dept err; -711 k