2024 Lobbyist Registration Form - 6701 Collins Ave (David Martin) �%ol Coll;ns Ave .
� RECEIVEI�
M I AM I B EAC H OKce of Ihe Ciry Clerk �,+AR 21 zaz4
1700 Convention Center Drive
Miami Beach, FL 33139 �CITY OF MIAMI BEACH
305.8737411 OFFlCF OF rHE CITY U LEF11�
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed ar re�ained,wheiher paitl or not, by a pnncipal who seeks ta encouraga the passage, defeal or
motlifcalion o!any ordinance, resolution, action or Eecision of any wmmissioner, any action, tlecision, recommendalion of the City
Manager or any Ciry boartl or committee;or any ac[ion,tlecision or recommenda�ian o(any Ci�y personnel dunng�he lime periotl of the
entire decision-making process on such action, decision or recommentlation that fareseeaEly will De heard or reviewetl by the Ciry
commission, or a City board or committee. The term specifcally inclutles ihe pnncipal as well as any employee engaged in lobbying
adivities The term"Lobbyists"has specific ezdusions. Please refer to Ciry Cotle Chapter 2,Atlicle VII, Division 3, enli0etl"Lobbyists,"
toradditionalinformation.
Instmetions: Please complete all sections of this form and submit the compleletl form,with the applicable fee, ro ihe�ce of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s)of paper. It you have nothing to report in a particular
section, you must write "none" or "n/a" in that section. Any change to any infortnation originally filed, or any atltlitional Ciry
Commissioner or personnel who a2 also sought to be lobbietl shall require that the lobbyist fle an amentlmenl to ihe reqistretion form.
The lobbyis� has a con�inuing dury to supply information antl amend Ihe fortns fle0 Uvoughout Ihe penotl lha� the lobbying occurs.
Separate registration fortns shall be requiretl for each principal represen�ed on each specifc issue.
I. LOBBYIST INFORMATION:
Laxkin Michael W. �
NAMEOFL09BVIST (Lasi) (FlrsQ (MIEtlIeName)
Bercow Radell Fernandez Larkin&Tapanes PLLC 200 S. Biscayne B(vd., #300 Miami, Florida 33139
LOBBYISTBUSMESSNAMEANOA�ORESS (Num�e�antlS�reel) (Gi�y) (S�a�e) (ZipCoOe)
305-374-5300 mlarkin@brzoninglaw.com
LOBBVISTBUSINESSTELEPHONENUMBER CELWIARTELEPMONENUMBER EMAILA�ORESS
II. PRINCIPAL INFORMATION:
Martin David
NAME OF PRINQPAL (Last) (Flrsq (Mitltlle Name)
TMG 67 Communities LLC 3109 Grand Avenue, #349 Coconut Grove,Florida 33133
PRINCIPAL BUSME55 NAME AND ADDRE55 (Numberantl Staet) (Cily) (S[ale) (Zip Coae)
305-416-4556 dmartinQterragroup.com
PRINCIPALeU51NESSTELEPHONENIIMBER CELLULARTELEPHONENUMBER EMAILADDRESS
Pursuant b Clty CoOe SecUon 2d82(���1)�a): A principel of any corpo2ldn, patlnersM1ip,w oNer enti�y wM10 aOPears as e lob�yis[w beM1alf of that
enliry,wil�out special mmpensation or reimbursemenl br[�e appearance,wM1ether tlirecp I�i�M,or wn�i�genl,to expreu suppotl o(or opposiCion to
an ilem sM1all register wiM t�e CIeM as reQuireE by Ihis subsection Wt sM1all not be required ro pay any registration fees.
If the principal is a Corporation, Partnership or Trus6 the following informalian MUST be provided
pursuant to City Code Section 2d82(c):
• NAME OF CHIEF OFFIGER, PARTNER,OR BENEFICIARV(if none,write N/A): D Mar[in
. NAME OF ALL PERSONS HOLDING,DIRECTLV OR INDIRECTLV,A 5°h OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(iT none,write N/A�: D2Vld Maifin l00%
Page 1 of 5 ��
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III. ISSUE TO BE LOBBIED:
DescAbe with as much tletall ae le pracdcal, Including but not Ilmltad to a speclFlc Cescription where
applicable of a pending requeatfor proposal,InvlUtion to bid,or public hearing number.
Legislation and Development Approvals&Permitting]ssues,including but no[]imited ro the HPB,
Design Review Board,Pla�u�ing Boa�d,Board uf.4djustmenq Land Use Development,City
Commissiory and any City W orkshops or Committees,if necessary,mlating to the property located
at 6701 Collins Avenue in Miami Beach,Florida.
IV. CITV AGENCIESIINDIVIDUALS TO BE LOBBIED:
Punuant to Ciry Cotle Sectlon ]-�82(a)�4�, Ilat the Ciry Commlasloner or City personnel nought to be
Iobbied, antl whether the lobbylat han antered into any contraclual relationahlp (pald or unpaid) wtth
sald City Commissloner o�Ciry penonnel from 12 montha preceding auch commencemeM of servlce
with ihe City to the present tlate,atating the general nature of the sub�ect conVactual relaGonahip.
Full Name oTlntllvlEual antl Contraclual Reie[lonehip(If yes,azplain) �ES NO
Title o(Poreon to be LobbieA
Staff for the Planning&Building Depariment None X
Public W orks&Ci Administration,PB,HPB,BO None X
DRH,City Commission,and Mayor as nxessary None x
Land Use&Suslainabili Committee None X
Punuant ro Cky Code Sectlon 2-482(g), every reglsMnl shall be required to afete the extent of any
businesa, flnanclal, famlllal or profeealonel relatlonahip, or olher relatlonship giving riee to an
appearance of en impropriety,with any current Clty Commlasioner or City penonnel who fa aought to
be Iobbied es Itlentlffed on the Iobbyiat registration fomi flled.
List any Buslneae, Finerwial, Famlliel or Pra/asslonel Relatlonahip, or other relatlonehlp giving rlea lo en
^ e earenca oi Im ro rle if none write N/A :
�`� None _ . __ —..
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION— Be Soecffic. (Note that a
contingency fee is prohl6lted pureuant to City Code Sec. 2-485.3�:
$(f5[I.Wperhour _ __
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T�e bllowla8 slx(8)qus�tlona MUST be�mweretl:
1) PutaueM m Ciry CoEe Sedion 1iEt,en[illetl'Pmhibi�etl Campeign ConVibutions By Lobbyiats On Proaremant leeuas':
Yes%No: In �
tll ydPo tl I 1 rvl T
2) Pursuant[o City COGa Seclion 3dB0,en�i0etl"P�oOibiletl Campaig^Contnbulions By Lob�ylsis On Real Esta�e Devebpment
IS611B5`.
_Yee g,No: A I bb 1 tlM Ik tl f D I t Aa mant wHh tM qN onoolkatbn
fw sh�nw of zonlno m�o tlnlonatlon or ch�nac ro Na CIN1 FUW n L�nE Uu M�o9
3) Pureuant ta Cily Cab Section 1JBE�h�, eny pereon (vcept Moee exempt hom Ne tlefinilion af'IobOykY as set brt� in
SeGlon P-481)who onty appeem an e represantative of e nab(or-profit coipora�ion or entM�out epedel mmpensa[ion or
reim�umemen�for iM eppeerance,wM1etFre�diroct or intliroct�o exprens auppoh of or apposilion lo any Ibm,e�ell repiste�wllh
iM1e city Gark es requiretl Ey ihie aedion,bu�chell not be repuiretl lo pey eny regiatrelian laea.
Yes%No: A tl M( flt ti tib wMi t I I ti
nlmbunamant9
4) Pursuant la City CoOe Sectian YJ61, iM tertn "bbbyiaP'spedl�rally axGueac IM followinp pereone: EnpeR wtlrieeeea wbo
provqe ony acen�ifq technical or Mher specializetl infoimaGon or betimony In public meptings;eny penan wM only eppeem
es a repmae^tetive o(e naiphbo�hootl eaeodation wiNoul campansation w reimbureemen�farthe eppaerence,wl�e�her Olrecl,
intlirad or contingeM,to axpreen eupporl of or oppoailion lo any ilam;enE eny perwn who only eppean ea e represenletive oi
no4brpmlM mmmuniry CexE orgenlzalion lar I�e purpose ol requeetinB e giant w�iM1out apecial �pmpeneation ar
relmbundnen�far tM1e appearance.
Yes x No: N
btiv f mqhborh atl I 11 wIN t lal 11 I E t or
fo fi M tl @ tl / tlw f tl t MN t
soeclal comum�uon or nimeunxmntl
5) Punuent to Cily Cotle Sedion PJ81�1�, na rampaiBn wneupent e�ell lobby the City Gommiss�on Wr a pariaE of 14 mont�s
follawinB ihe eweaAnB In ot any electetl oHKiel(s)br vrTom t�e campaigm m�sullanl pmvi0etl cempeign coneN�ing earvl�e
wi�hin�M1e paet ekdion qcle.See Sedion 2A91 kr more inbrtnetion.
Yas%No: M IME M kl I t I M t bv f N CIN L k '
I M I ?11 k IIHh i bet bHl ftlxCiNC hl
Yee X No: H h k b I N 1E t� I N I t d HI i N 1 � W d i
— — coneulWa wrvlus was�wom In7
6� Pwauant ta City Code SaGion IJ82pN<N�. e bEDyiet who�as wit�in iha pae�eleGlon cyGe pmvitletl cempelgm m�wltinq
services lo an incumEent membar oi Me Ciry Commiesion�which lobbying ectivtly ie not otheiwiae pmM1lbitatl by Cotle mdion
�. 2-4B1) shall tllecloee euc� Darliculer service on hielhar lobbyisl repietre�ion fo�m tl h II II tl� I h N kr
q ob k I bb ' th Ct CommieeianeteouWomeeano.
. Yes%No: u•vo vau orovlMtl c�motlan son�u �no wrvlce�to m IncumMnt mwnMr of ih�Cib Cwnmb�lon
� ILI tM t b fb k91f b IhiN 1 M t bN 1 fM CINC mk�lon'
��. Yes x No: @ 1 E Eltl C � � �de tl i h ! I
. — — <oneulWo�arvic��9
TO BE COMPIETEO BY CITY CLE0.N'S SThFF ONLY
. Il uel Wpl 1 �I M1 : � �Y1 [ �N Nnounl P Itl 2 MCN/ - Ueb P!M
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.. tu, �� rne r oebnsrro . nrv�,ie_r � -�. . o _�roanaee.a . Ravhetl09/10/3038
Page 3 of 5
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VI. SIGNATURES UNDER OATH:
ON FEBRUARV 28 OF EAGM VEAR EACH LOBBYIST SHALL SUBMIT TO TME OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH LISTING LOBBVING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEDING CALENDAR VEAR WITM REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBVIST HAS BEEN ENGAGED TO LOBBV. A STATEMENT SHAIL BE FILEO EVEN IF THERE HAS BEEN NO
EXPENOITURE OR CO N6111�IION DU�"RING THE REPORTING PERIOD.'
htIW.OA�, w. �aA�iN, �ate ._
SignaWreofLohbyisC _ _. __-_ .___—_ .—_...__ __.-
I do solemnly swear or affirm thal all o!the fnregoing facts,sta�emenls, antl tliscbsures in �his form are irue antl correct,
anA [hat I have �eatl or am famlliar wilh the provisions conlained in COapter 2, Art. VII, Division 3, enti�led "Lobbyists" of
the Miami eeach Ciry Cod �I ba�eI9urtin�g��rAaquirements.
Siyn2Wre of Lobbyist ��"�' �' �".`_�� . Da�e ._.
�.__—. .._- —__ __.. — —_
�Q ' 03 �o12`I
SignaWreofPrincipaC ._ ._ ___. Date�___
��C�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Stare or Alorida _. State of_ Florida
Caunry oE . Mtami-Dade Counry oP. _Miami-Dade _
Swom to(or affirmed)and subscribed before me, '� Swom [a(or afry/meA)and subscribad before me,
by means of O physical presence , hy means oF Y�physical presence
orO online nolarizetlon, ' or O onllne notadzatlon �.��y.( ��/
this dayof___. __��0__ by this`�layof �T�`"" .20�/lby
_ _— _—
Michacl W. Larkin David Martln __
_ ... _._ __ -
N4ME OY LOB�VIS'I NAML OF PRINCMAL
ProAucedlfl____ _ __�'mduceAlD__. __
FOHM OF IOEM IFIf,AI ION FORM OF IOENI iFlCAI ION
_. Personally Known ._ Personally Known
.
—__ __— --_.
.._ _ __"— -. ...—
Slgnature of Notery Pu61ic SI naq tu2 of`o�ary U ic
(1....�n A...,....
l:�x�w .� +�����u.
-- --
_ ---
Name of No�ary, TypeQ PrinteA or Stamped Name of Notary,Typed, Printetl or Stamped
(NOTARV SEAL) (NOTARV SEAL) �. „ '�,}
�,, ." . , . ��.. . .. , .. . ,.w
.__.- . _----- :�� � . _ �:. � ��k
' The�erm"lobbyisf'spedficelty excludes the(ollo ing FlNrsnns_ , ""�'�"��
C-Kpert witnesses who provldo only scienNllq technlcel or other speciallzed in(orma9on or les6mony in pu�llc meo�ings�,any person who
onry appoars as e reprosenlalivc o(a neiqhborhood assodation wllhout aompeneallon nr relmbursomonl for ihu upPonranca,whelM1er
dlmcl, intllrect or cvnlingent, lo exprass supporl of or opposltion lo eny ilem; ond eny pason who only xppesrs as a ropresentallvo ot
not-�or-pmft communlry baseA orgenlzaUon lo�Ne purposo ol requostiqq e yrant wi�hout spoclel componsation nr reimbursemen�for
tnF appearanm.
P2ge 4 of 5
OaruSign Envebpe10:000698E3fi�]3-CCMA415BEIOEOS1B148
VI. SI6NATURE3 UNDER OATH:
' 9RUARY 2E OF EACH VEAR EACH LOBBVIBT SHALL SUBMIT TO THE 4FFIGE OF THE CITY CLHIiK A
S£0 ETATEb'L'NT UNDER OATX. L18TIN6 LOBBYINO EXPENDITUREb. AS WELL A8 GOMPENE.sTpN
uare-.�n cne�uw ee�rsmm� ee eunew vF�n NnTN R�Reen rp 7XE 3VECIFIC 188UE ON WMICN THE
OBBYIST HA9 iEEN ENQ OED TO LOBBV A STATEMENT EHALL BE FILED EVEN IF TNERE HA8 BEEN NO
T P
Signalure af lobbYi61: �� �. �µ' Dele o+r2 rzo
I do solemnly ewear at e/fl�m ihat ell of the laregoing fecls,elelemenls,and OleGosures in ihis torm ere Irue and cortecl,
antl t�el I have reaG or em femllier with lha proWsbns conteined In Chepter P,Art.VII, DIvi6lon 3, enlillad"LobGyists'oi
the MiaM 8eech CI1y Cotl �raponinIg��r,e�p� uiemems.
SlgneWreofLobbyleL �� w' �"µ' Dale
.,v�rweseoono
SlgneWieo/PrincipeC _ Dele .
VII. NOTARY SI6NATURE AND SEAL:
LOBBYIST: PRINCIPAL
Steteol Florida Sleteof Florida
Counry of Miami-Dade Coumy oP. Miami-Dade
Swom lo(o�effirmed)antl 5ubscAbad before me, Swom to(or afirmeA)ena auDscnbetl Oefore me,
by m�ens ot O phyaicel Dreeence by meens of�physicel presence
or tl online nolanzetion, or O online notarizetion,
this_tley of n n+nm< .20_,by this_day of .20_,by
Michael W.Larkin David Martin
NM1E OF LDBBYISt NAME OF PWNCIPAL
PmtluceA ID _Produced ID
FO l�n � � FORMOFIDENTIFIGTION
% Penonelly Kn � � _Persanelly Known
Signeturo of Notary u�ic����������� SiBnalure of Nolary Public
Diana Remos
Neme ot Notary,TyDetl,Printetl or Slampatl Neme ot Notery,TypeO,Ptlnbd w Stampe0
olmMe�me� •-V^i`� (NOTARY SEAL)
CanmM�bnYNNONY31
N Wary PAllc-Sl�le M FbMe
My commlawn Eypin�Apr+6 303'I
'T 9 Vareons:
Expetl witneecee wha proviEe only ecien�itic,tecbnicel or other apecializeE In/ortnelbn or testlmony in pu�lic maellnBs'.eny person w�o
anly eppeam es e ropmeen�ellva a�e nsign0orhoatl eeeocie�lon wit�out compeneeGon or reimWreemem for t�e eppeerence,whemer
tlimd,Intllred or contlnpenl,lo arpreea suOW N of or oppoailion N eny Ilem�,ena any perean w�o only eppearo es e mpeaen�stive o�
noLfor-profl�communlly �eseJ o�genizetlon lor t�e purpoee ot requseY�p e pnnt without epecbl compeneation m�elmbunement lor
Ihe eppearence.
PBge 4 OI S
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DocuSqn EmeYqelD'.DOO610E2E]Y1�CGN-&t13-BE30E0510t48
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dry ef Miamilea[h,V00 Conremlon Ce�ier Dme,Miami Bmch,Floddo 33139,uww.mlamibeacFA_gov
Olflca of ihe Clry Clark
Ralael E.G�a�ado,Cly Clark CIryCIerkBmiom�beochllgo.
Te1�.305b]31d11, Fa.�. 305.N3J25d
NAME OF LOBBYIST: Michael W.Larkin
7) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuanl to City Code Sectfon 2-085(d), the City Clerk shall notify any lobbyist (or
principel)who fails to file timely a Lobbylst Fee Expenditure and Compensation Statement
(StetemenQ. In addition to eny other penalties that mey be imposed as providetl in
SeGion 2-485.1, a flne of $50.00 a dey shall be assessed for Stetements filed aker Ne
due date. The City Clerk shall notify the Miami-Dade Counry Commission on Ethics antl
Public Trust of the failure of a lobbyist (or principal) to flle the Statement or pay the
assessed fines aker notiflcation.
Any Iobbyist, who feils to file Me required Stetement by April 30'" of each year, shall be
automatically suspended from lobbying untll all fines are paid, unless the fine has been
eppealed lo lhe Miami-Dade County Commission on Ethics and Public Trust.
I hereby ackrwwledge that on February 28 of each year, I shall submit to the Ctty Clerk a
signed Statement under oalh listing all lobbylst expenditures, as well as compensation
received, for the preceding celender year with regard to the specilic issue on which I hava
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once en 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 Offlce of the City Clerk.
3) ANNUAL LOBBVIST REGISTRATION FEE
I understantl ennual ragistratlon of ell lobbyiats ehell be required for eech 12-monih period
commenang October 1 of each year, and the fee for such annual regisiration shall be
$500.00 pursuant to Section 2-482 of Me Miemi Beach City Code.
�n�ao w�.<.,
,� w. �w o3,�,no�
Signature of Lo byist � Dete
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03/25/2024 02:59PM Carmen V. I ' '
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MISCELLANEIXIS �� Z' N (/` � < . n = z
Reference 1: MCR433223 3 e ` � G -. '"
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MCR OPEN (MCR) $1 ,200.00 0 3 � A . � � .
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CHECK $350.00 � �� � � _ `� ��
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CNECK $850.00 � �. ,� - !� ". -
Check Num6er00009351 � � - '
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Thenk you for vour payment
. CIISTONER COPY