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Michael W. Larkin - Andrew Mirmelli DocuSign Envelope ID:884F9F49-2B8D-44B8-88DA-58E7DCCB5F8B RECEIVED MIAMiBEACH Oroe of the City Clerk JAN 24 2023 1700 Convention Center Drive ,,,, _" -- Miami Beach.FL 331r39 CITY OF MIAMI BEACH 305.673.7411 brFICE OF THE CITY CLERK _ LOBBYIST REGISTRATION FORM -• . . . • - Lobbyist means e1 peaces employed or retained,vAiether paid or'net,by a principal who seeks to encourage the passage,detail or modification of any ordinance.resollution,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 persarnt during the time period ci the entire decision-making process on such action,derision or recommendation that foraswby will be head or dewed 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 spec&exausfons..Please reforto City Code Chapter 2.Artide VII,Division 3,entitled'Lobbytsts, for additional Information: Instructions; Please complete ail sections of this form and submit the completed form,with the applicable fee.to the Maas of the City Clerk. If you need more specs al complete an answer.use a separate sheets)of paper.If you have nothing to report in a particular section, you must write 'rune' or 'sir' In that section, My,dtanme to any information originaby filed, or any additional City Commissioner or personnel Wipers also sought to be lobbied stall require that the lobbyist Oa an amendment to M 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 forme shall be required for each principal represented on each specific issue, .. I. -LOBBYIST INFORMATION: - - - : .Lar"kin • " Michael W. NAME OF LOBBYIST-_-�---_ - ( ) - ,(First) --• --- - - (Mrdde Name) - Bercow Radell Fernandez Larkin&Tapanes,PLLC 2200South Biscayne Blvd.,Ste.300 Miami,Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number end Street) (City) (mi) (gyp Code) • (305)3745300' mlarkin®brzoninglaw.com _..- ' LOBBYIST BUSINESS TELEPHONE NUMBER " . CELLULAR TELEPHONE NUMBER • . EMAIL ADDRESS II. PRINCIPAL INFORMATION: • - • Mirmelli - Andrew - - - NAME OF PRINCIPAL O (Fiat) (MiddN Name) _ _, 237 20th Street Garage,LLC 1210 Michigan Avenue Miami Beach Florida 33139 PRINCIPAL BUSINESS NAME AND ADDRESS ,• -(Nlrnber end Street) . ,- (City). - ... •. .(Slate) , •,gip Code) - 212-453-i715 " :: svardi@thinkhospitality.coni 8 PRINCIPAL BUSINESS TELEPHONE NUMBER, '-. ' :, , CEUAMR TELEPHONE NUMBER EMAIL ADDRESS . eissusiiiii tlitOddtial0f1`2:48201)( X4-A'NJrtrdirelet•ilifIOx"Iie bail f+lblefih iiiiiiMriliteiWhgiOpsrle ef enbellarafihlt en/Ny,wldlout specisl=Donationorrelmblrssm+srt f a the eppeawrpe,ntnular direct Indirect a con6rgere,to'prier.support of or apposition to n en Rem snd,reykter>wllh the Clerk es required by,tbie subsection but aid net btr'required to pay'eny regiatration.t es, Ift e 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 WO A.Mirmelli . 'NAME OF•ALL-PERSONS HOLDING,DIRECTLY OR INDIRECTLY:%1 5%OR MORE OWNERSHIP INTEREST IN SUCH '. CORPORATION.PARTNERSHIP OR TRUST(If none,write WA): .. Please see the attached. N th ... - _ ,_ ai Pape 1,of S if L, V rn,..,v ,,,,,r,.,oclEOA-CB7B-4728-8D08-7414D554C52F 1 Page 1 of 6 I 17414D554C52F i 'III i) 'I III DocuSign Envelope ID:884F9F49-2B8D-44B8-88DA-58E7DCCB5F8B III.ISSUE TO BE LOBBIED:' '-• •- Dascribe with as much detail as Is practical,including but not limited toe specific description when applicable of a pending request for proposal.invitation to bid,or public hearing number. •- Development Approvals&Permitting 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 property located at 2000 Collins Avenue 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) iiES NO .Title of Parson to be Lobbied c. - ._ 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 Land Use&Sustainability Committee - - ' 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 List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearanceof impropriety(if none.writs WA): 0 None • 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): • • $825.00 per hour.- m U Page 2of5 DocVerify ID:oorn95EOA-C 878-4728-SDOS-7414D554C52F I Page 2 of 6 274140554C52F 11111211111611111 III12 1iSYII III DocuSign Envelope ID:884F9F49-2B8D-44B8-88DA-58E7DCCB5F8B "The follow/Inglis(I)questions MUST be iinsweredt 1) Pursuorit to City Cod•Section 2401.entified T.Pichtbitid Campaign Corinbufsios By Obbyisb On Procumment issueek-. Yes Ilia you lobbvinis on a meat or pending bid for cloocis.eoulanient or Novices.or on g present or pendia§award for rioods.imiulornent or service? 4. :Pursuant to City Code Section,2411.entitled!Prohibited Carnpoign•Contrixons By LobbyisbOn-Olsoi Estate Deindopramt Issues% Y. ZINC Amyssiaggikifteftiabmiosr. boSlymiesEllcaVoltith for chows of mina moo designation or chance 1othçlWs Future Land Use Mao? •3) • .. . •. - • , . 7Pintierk to City Cods Section.24112(h).any penal(except those giwp!from the defirtOon of lobeis set iatitt to Section 2.481)who only imposts as a mpresentafivecia not-for-profit corporation or amity without special or npansallon Cr reimburisment for Ii appearance'.*hefty direct or hand to express support of or opposilianto any Hem,stragisisruldi the aly dedcas required by this section,but.shall not be required topey any regisralion fees, • Yes X1404.; Are yogi reassendno a not-for-met 00fDOlatiOrl or entity 'without special comormsation_or Piss Welty Code Sectirin 2461,eta two'lobbyist spetifically excludes the following person=Export tvkis es who provide only scientific tachnicil or other spedslized kdormation or testimony inpublic mestingr any person who only appears . as a rspreserdativa of a neighborhood associldion without compensation or reimbursement for the appseranes.whethsr direct: indeed or awitingent,to exams support of oropposidon to any Wm;and any person who only appears as a representative of nol4orirofit .ciarnmunity ibasod ,orgarization for lho„purpose of reasesfing a ward without Nodal compensation or reimbursement forthe appears**. Yes ir ffig Ank You orovIdingontV scientific: technical ot other soecializal Information: appearing as a: %,•-• :."-Wiciresentszve of a neiohborhood imuirkiation without soectel cornpenssUon or roimboriornent Of finirosoritino a not-for•orofit baud organization for the purpose of reouestina a want without , . . 'Pedal compensation or reimbursement? . , - - • .• - . _ . 5) Pursuant to City Code S.stfion,2491(1)..no campaign:consultant shut lobby:ths City Convnission for period cif 12 months following the swearing kt of any elected olficisks)for**On the campaign consulted.provided campaign=insulting services Within Mopes!Mallon cycle.See Section 2491 for more irdonnefion. • Yes L . .„ Haim vou wadded campaign consultino tiervicse to an Incumbent Member of the City Commission within the oast election mods?its.°tease list the incurnborit memberist of the Citv Commission: _ , • .. , . _ •. _YNNOr three:Wei it been terse duet12 Menthe since thi sleeted officiafisi whom von oroVided conailtIna matrices was sworn In? , „ 6) ..-. Pursuant 10 City Code Section 2412(04)11„.a lobbyist who has within tho oast election cycle provided campaign consulting '*avian to an incinnbeni member of the Cly Commission(Midi lobbying activity is not alhawise prohibited by Code section 2.491)shall disdos•such articular semico on blether lobbyist reoation form ;pi shall only disclose,such articular Yes x No: Ha you COMMISINV consuieno sori4aOsioOn incumbent inernber of the Cite Cetniniesieck within the post olection cycle?If vos.Moose list tnw Mewl:0m monitorial of the City Commlaolom _ Yet X NO: V Woo,woo YOU oromIsed or dkl vou maitre ddsr.lIoiisexdtanos for campakin consulting services? • - TO SE COMPLETED WI CITY CLEW'S WAR ONLY - • - • • c _ • t.75, A.vnastR. Imstacfes j 3Yf jNs Arm* • SICIt -•- • 0 FACLUMgr I laFORMSALOBBYEST fORMALPtiblist Recktraltion Venn Revised 09-20-18 REGodoc • ' • nevlssd 09/28/201. ' Page 015 0 DocVerify ID:9CF95E0A-CB7B-4728-8008-7414D554C52F www.docverify.com I Page 3 of 6 37414D554C62F 1111 1101/1211111 I • • DocuSign Envelope ID:884F9F49-2B8D•44B8-88DA-58E7DCCB5F8B • VI. ' SIGNATURES UNDER OATH: ON FEBRUARY 29 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 gXPEND$TURE OR COMPEHSATION°DURING THE REPORTING PERIOD.' . . , . Signature of Lobbyist ' • V Date 01/24/2023 ozoQDoscD3�e�1e... 'I do solemnly swear or album 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,Division3,entitled'Lobbyists'of the Miami Beach CityCode and aN reporting Pre: , Signature of Lobbyist - .Date 01/24/2023 LAY oeMMD3,6D0004tO... _- - Signature of Principal: if L( i' Date w24nroa VII. NOTARY SIGNATURE AND SEAL:. , . --. ... LOBBYIST: .. PRINCIPAL State of Florida State of Florida County of: .Miami-Dade .• • . + -- County of: Miami-Dade ' . , Sworn to(or affrmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of D.physical presence,, ., . „by means of f]physical presence: , -, or l online notation. or tB online notarization, _ . . ,. this _ day of '_ 01/24/2023 20_,by • •this-_.,.day of` . '•01 r,4r2n74 ;20_,by Michael W.Larkin ' , . . ' Andrew Mirmelli • NAME OF LOBBYIST NAME OF PRINCIPAL - 'J -.-'it`-1 .:._''.•-;'•,.1._'.. . educed ID•" .t,.' Produced ID FORMA OF IDENTIFICATION FORM OF IDENTFICATION X P@r50na11y - , . .a XPersonally r>. Signature of Notary Public `Signature of NotaryPublic - , Diana Ramos Diana Ramos Name of Notary;Typed,;Printed or Stampod - • - Name of Notary.-Typed,Printed or Stamped • N Diana Ramos I ( Diana Ramos 0 Commission#GG 308355 ( 4 Commission#GG 308355 u, 6lotary Public-State of Florida 1 1 Notary Public-State of Florida 1 The oy Commission Expires Apr 10,2023 1 oy Commission Expires Apr 10,2023 . 1 o _ � a 41.7..:"';°:;r •� T�� +�_.¢ ♦ ` e islizs .Rtmamvz.oemaoa '•. _ •�—. ;—..c ;p� ExQ 'wWw�w�w.AI r....qv wr.w•ws•w., /w. a..awv.r.•w.�r. .-.T •per.+• -r. -�r'—^• who only tears as a reprssentalive of a rns+ghbotiood auodation wittiest Compensation or reimbursement for the appeannos.* ether © died,Ydtrad or contingent,to express support of or opposition b any item;and any person who only appears as a representative of. not-for-proon community based organization for eiwpurpose of requesting<a grunt without special oorrippossion or rshnburssmsnl for ' the appearance. _ PM*4of5 LL U DocVerify I9CF95EOA-CB7B-4728-8D08-7414D554C52F Pa e 4 of 6 47414D554C52F ,III ::' II III www.docverify.com �9 ----.--� ilsl'A L.°itr DocuSign Envelope ID:884F9F49-2B8D-44B8-88DA-58E7DCCB5F8B IMI BEACH City 0f Miami Mock 1700 Convention CenterDri re,Miami Beach,Florida 33139,www.miamibbochf.gov Office of the:City:Cleek Rafael E.,Granada,City Cleric City CleriamromibeochR,gov Tel;305,673.7411,Fox:305.6737254 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 April30t 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. Ihereby acknowledge that on February 28 of'each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, aswell:as compensation received,for the preceding calendar year:with regard to the specific issue on which l'have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue 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 l.understand annual registration of all lobbyists shall be required for each 12-month period ry 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: DocuSigneed by: ze e;,53e:ce4,e... 01/24/2023 Signature of Lobbyist Date 0 W o ,FACLERWLL1rF01MMOINTIOFORMItatepe PrnnllrereiOSi1y7DfEG C Page 5 of 5 LL � DocVerify ID:9CF95EOA-CB7B-4728-8D08-7414D554C52F Page 5 of 6 _ 57414D554C52F DUIralgrall III www docvenfy.com -- • DocuSign Envelope ID:884F9F49-2B8D-44B8-88DA-58E7DCCB5F8B • 237 20th Street Gara9e,LLC, Disclosure of Interest Andrew Minn.11i 100% 1210 Michigan Ave • Miami Beach, Florida 33139 • • 0 og co M N LL veil rn rn` �j w� co CL` co co Q� o a rn U rn D.eVerr6 :isl can-icn r--���®~:.�,:. N 11114 'Ill II I www.do er'fycom95EOA-CB7B-4728-8D08-7414D554C52F L Page 6of6 67414D554C52F ,III ♦I III E F docv'erifyy . ° se? OCCVE.00i Lobbyist Registration Form - MWL - 237 20th Street Garage LLC 1.24.2023 - executed.pdf DocVerify ID: 9CF95E0A-CB7B-4728-8D08-7414D554C52F Created: January 24, 2023 04:59:07 -8:00 Pages: 6 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.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document. E-Signature Summary E-Signature Notary:Diana Ramos(DR) January 24,2023 05:00:27-8:00[D29ECOAB955C][74.220.90.117] dramos@brzoninglaw.com i r 1111111111111111111111111111111111111111111111111111111111111111111111 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. 1 DwocVerify ID:ww.do ver com95E0A-CB7B-4728-SDOB-7414D554C52F [Generated Cover Pagel. 74141:0554C52F 7 „I 1Rgei aill III I MBF `,' City Hall =.w ,�` �� 1700 Canventian Center Dr. Miami Beach , FL 33139 cc �' + , ' W 905-673'7�120 ' Nn ' Welcome } .t, rt r c 005910 OOO6 Carmen V. 01/24/2023 09:38AM z°O r MISCELLANEOUS . ��_` �� " �� Or • � Reference 1: MCR431256 ,� `- , MCR OPEN (NCR) ,, � � �#�. 3, 2023 Item: NCR . n 1 @ 350,00 MCR OPEN (MCR) 350,00 • . .,• , �" g _ 350.00 t ti W �, R srr Subtotal 350.00 • ¢ ..,, .:"'* oc a ,,,-7 s�`� eq QJ,,,k `"":'a" s, x. ' a` a`..7 Total 350.00 a o CHECK 350.00 W Check Number00007838 ;�. i3 =,,NN �` R, Change due 0.00 -.X.',„:. ; ;7-,,....c. ;,--,',4, ; �co oc = -o " paid by: BERCOW RADELL FERNANDEZ & LARKIN �. t#, 111111111111111111 ; s? s '. � o Z ++ L E ,ssroonnss�hK�ouww „_� 7,90 a s �. GJ s. M ma m ram•. s 'L Vl " 'O ,O r� L R� a , ,i c' •+�i 1P1 ...+.r.•+n V O L c• o p a N otimit3/ '(n �" v1 } V .._.. < iv [a c: O Q .as,.smw�mi ,,�.» • .,»«•..• .0�.�oniw i poem . V OC Q LL O1 N � U �^ ..i Q G. ' a>twwwww /•9 9 A '''.; • .w•..,.W„=� t.p .�:.,..,.,.� , ....y.-..�...�».�......«r......., r.r�,M�.k��..aw�'..' ,a ;<.. �":. .,w „`���., '�o* .�u Thank you for your payment CUSTOMER COPY