2024 Lobbyist Registration Form - 819 5th Street (David Belle)��. ��9 STM SYce� �
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1700 Convention Center Drive
Miami Beach, FL 33139 � �� . . , .
305.6737411 �
LOBBYIST REGISTRATION FORM
Lobbyist means all persons amployed or reteinetl, whet�er paiE or not, by a pnncipal who seeks lo encouraga the passage, defeat or
motl�calion of any ortlinance, remWlian, action or decision of any commissioner, any action, Cecision, rawmmendetion ot Ihe Ciry
Manager or any City�oaN or commiHee;or any actioq tledsion or recommendation of any City personnel tlunng the time pe�iotl of the
entire decisioo-making process on such actioq Cecision or recommentletion that breseeaDly will Ce heaN or mvieweC by t�e Ciry
Commission, or a Ciry boarA or wmmittee. Tha lerm specifcally iridutles the principal as well as any employee engegetl in IOGCying
activities. The lertn 'LobbyisC has specif�c exclusions. Please refer to Ciry Cotle Chap[er 2,ArtiGe VII, Divisbn 3,enlitleC 'Lo�Cyisis;
for edditional inbrtnation.
InsW ctions: Plaese wmplete ell sec[ions of ihis form and SuCmil ihe completetl fortn,with the eppliceGle tee,to lhe O(fice oi the Ctty
CIeB. If you need more space to complele an answer, use a separate shcel(s)of papec I(you have not�in9 �o report in e paNicular
sec[ion, you must wnte "none' or `n/a' in lhat section. Any chaige to any information onginally (IeC, or any additionel City
Commissioner w personnel who are alw sought ta be lobbied shall require ihat ihe IobDyist fle an amentlmenl ro t�e registralion fortn.
T�e bbbyist �es a continuing tlury to supply in(ormation antl amand the fortns fled throughou� iha perioE t�at ihe lobbying occurs.
Separate ragislrotion fortns shall be requiretl for each pnndpal reDresentetl on each specifc issue.
I. LOBBYIST INFORMATION:
LarMn Michael W.
NAME OF LOBBVIST (Last) (Firsp (Mitl01e Name)
Bercow Radell Femandez Larkin&Tapanes, PLLC 200 S. Biscayne Blvd., #300, Miami,FL 33131
LOBBVISTBUSMESSNAMEANDADDRESS (Numbarand5beeq (GIy) (��e) R�G�e)
305-374-53W mlarkin�brzoninglaw.wm
LOBBVISTBUSWESSTELEPNONENUMBER CELLUTARTELEPHONENUMBER EMAILADORE55
II. PRINCIPAL INFORMATION:
Belle David
NAMEOiPRMqPAL Qasp (First) (MidEleNeme)
Crowing Rooster Arts lIXl Lafayette Street, Rm.602, New York, NY 10013
PRINCIPALBUSINESSNAMEANDADDRESS (NumberaMSVeeQ (Ctty) (State) (ZipCotla)
(91� 705 -2675 david�crowingroostecorg
. PRINCIPALBUSINESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILADDRESS
PursuaiM1�o Ciry Cotla Sectlon 2�82�hN�Ne): A pnntipel ol a�ry mryoiation. Dahriarship. or dher mGy wlw appenrs as e IODDyst on OehaH d tlial
enMy,wlMout special compensaGm or raim0ursamen�fw tM1e appeaiance,wM1et�er tlireq.intlirecl,a wmingont,ro ezpress support of a opposition to
an i�em aM1ell repls�e�wi11M Me CbM as reQuiretl by��is subsecibn bW s�all ml be requi�etl�o pay a�ry regis�rz�ion fees.
� If the pNncipal is a Corporatlon, Partnership or Trust, tha following infortnatlon MUST be provided
pursuant to City Code Sedlon 2-482(e):
_ • NAME OF CMIEF OPFICER,PARTNER,OR BENEFIGIARY Qf none,wrib NIA�: D. Bf1IE
. NAME OF ALl PERSONS HOLDING,DIRECTLV OR INDIRECTLV,A SX OR MORE OWNERSHIP INTERE3T IN SUCH
GORPORATION,PARTNERSXIP OR TRUST Q(noM,wdb N/A): P1edSf 522 fhf ekkdCh2Cl.
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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.
Develo�ment Approvals &Permittin¢Issue including but not limited to the Historic Preservation
Board Design Review Board Planninp Board Board of Adjustment Land Use Develovment, Citv
Commission and any Citv Workshoos or Committees if necessary relating to the rorooertv located
at 819 5th Street in Miami Beach Florida.
IV. CITY AGENCIESIINDIVIDUALS 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 contrectual relationship.
Full Name of Individual and Contractual Relationship (If yes,explain) �ES No
Title of Person to be Lobbied
Staff for the Plannin & Buildin De artment None X
Public Works& Ci Administration PB HPB BO None 7<
DRB, Cit Commission, and Ma or as necessar None X
Land Use&Sustainabilit Committee None X
Pursuant to City Code Section 2-482(g), every registrant shall be required to state the e�Rent 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.
- Lisl any Business, Financial, Familial or Professional Relationship, ot other relationship giving rise lo an
a arance of im ro riet if none,write N/A :
^ None
- V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soecific. (Note that a
' ` contingency fee is prohibited pursuant to City Code Sea 2485.3):
$850 00 per hour
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7T�followinp�Ix(8)Quntions MUBT M msvnrM:
1) Pursuant to Ciry Cotle Section 4d8E,entitletl'Pro�iGiteE Campagn ContriWtions By Lobbyisis On Procurement Issues":
Yes x No: A I Eb 1 1 EI bid f otl i t I 1
— — o ai a m ro a i � i 'r
2) Pursuant ro Ciry Cotle Section 2�190,enti0ed`Prohibitetl Campaign ContnOutions By Lobbyists On Real ESWIe Development
Issues':
Va� x No: A e v ��^�+F�^^ e.naina oolieatlen Tor a Oavalownent Aaroement with tha Cilv or aoollcation
b h ot o in^ d ' nation or chena�to th�CM's FUNn Land Uw Mao7
3) Pureuanl lo Ciry CoAe Section PIBY(h�, any person (excepl lhose ezempt hom Me definitian o( YobbyisP as sel faM in
Section 2-081)who only appears as a represen�ative of a no4(or-pmfl corporation or entiry withwt special compensalion or
reim�ursemenl Por the appearence,whether tliract or indirect ro express support of or opposition lo any item,shall regisler wi[h
the dty cleM as required by Nis seclion,but s�all not Ce requiree ro pay any registretion fees.
Ves x No: A tl �wbf - Itt tl �nHN without so�cial eomwnsalton or
raimbursemant?
4) Pursuant to Ciry Cotle Section 7187, lhe term 'IobDyisC specifwlly ezcluAes ihe following persons: Enpart witnesses who
provWe only scientifc,techniwl or other specializetl information or lestimony in puNic meelings;any person who only appears
as a representative of a neighborhootl association wilhaul wmpensation or reimbursement br t�e appearance,whether Airect,
inEirecl or contingenl,lo eapress suppotl o(or opposition lo any ilem;antl any person w�o only appears as a representa�ive of
not-for-pmft wmmunity Easetl oiganization for the puryose of reQuesting a g2nt wit�out special wmpensation or
reimbursement tor ihe appea2nce.
Yas Na: A o 'di I f t'flc lachnical or otho so�clelWtl information: aowvina as a
btl f nei hb a d I tb Ith 1 I I tl I b [
t' t-f Bt bas d Wtl for N t satl t 'th t
soaclal comoematfon or nimbunement?
5) Pursuant to Ciry Cotle Section 2d87�7), no wmpagn consultant shall lobby the Ciry Commission for a penotl of 12 months
following �he sweanng in of any elected official(s)(or whom the campaign consulWnt provided campaign consulting services
wiMin the pas�election cycle.See Section 2-091 for more in(ormation.
Vas xNo: H id tl 1 n Itina �arvkes to an 'neumbent m�mDar o!th�Cltv Cammission
ithf ths o at i cti n evele9 M vea oleaas Ilat the IneumDent mamMAs)of the CIN Commlaslon:
Y�s x No: u�•• ^ I[ E I s iha 72 t� 'nca ihe elactetl oR'c'allal w�om vou nrovidetl eamoalan
consultlna sarv'ces waa aworn In?
6) Pursuant to Ciry Code Sedion Yd82�a)(4�a., a lobbyist who has wit�in Ihe past election qcle provided campaign wnsulting
services to an incumbenl member o!the Ciry Commission(w�ich bbbyirg aclivity is not otheiwise prohibited by COEe section
2-091) shall disclose such particular service on his/her lobbyist registration fortn a tl h II II d I h rt I
- b ( r lobbv'na the C'N Comm'ss'on at a oublic mcetlna.
Y�s x No: H ro fdetl c s Id 1 t an I bs t M t ih Cllv C i I
ith' th t I ti0 I 71( I II tt� I b t be 1 ) (th C'NG 1 I
_V�s x No: f �os 'sW or Oltl ' e economle cona'deraCon In ezchanaa for umoalan
consultina servicn7
TO BE COMPLETED BY CRY CLERK'�S�S>TAFF ONLY
Annual MpIatrRlon M: [ ]Y�s[ �No Amouni P+IE S��MCR/z,,,)3� �� Deq P�itl �9 ��
- LobEylat Rpl�tratlon Fmm ncNwE m!wrifl�d by: �M
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VI. SIGNATURES UNDER OATH:
ON FEBRUARY 78 OF EACH YEAR EACH LOBBYIS7 SHALL SUBMIT TO 7HE OFFICE OF 7HE GTY CLERK A
SIGNED S7ATEMENT UNDER OATH. LISTING LOBBYING EXPENDI7URES, AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEDING CALENDAR YEAR WITH REGARD 70 THE SPECIFIC ISSUE ON WHICH 7HE
LOBBYIST HAS BEEN ENGAGED TO LOBBY A STA7EMENT SHALL BE FILED EVEN IF 7HERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.'
4/16/2024
Signature of LobbyisC �6C I .�l @ �u4- Date
��.w�E�.w��
I do solemnly swear or affirm that all of lhe foregoing facts, statemenls, and disclowres in this fortn are tme and correct,
antl that I heve read or am familiar with the provisions wntained in Chapter 2, Art. VII, Division 3, entdlad "Lobbyisis" of
Me Miami Beach City Cotle a�dMall repoAing requiremenls.
4/18/2024
Signa[ure of Lobbyist ����o�N- Date
4/15/2024
Signature ofPnncipaC . � Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State o( Florida State of Florida
Counry ot: Miami-Dade Counry oi: Miami-Dade
Swom to(or a(firmed)and subscribed before me, Sworn to(or affrtned)and subscnbed before me,
by means of O physical presence by means of O physical presence
or Opnline notanzation, or qtonline notarization,
this_day of oanai2oz� 20_, by this_day of . 20_,by
Michael W. Larkin David Belle
NAME OF LOBBYIST NAME OF PRINCIVAL
Produced ID ___ _Produced ID Y^�.....P �
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_Personally Kno /1.6'�a... _ i _Personally Kn
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SignaWre of Notary Public Si9naWre of No[ary Public
- Betty Llerena Betty Llerena
Name of Notary.Typed, Pnnted or S[ampetl Name of Nofary,Typed,Printed or Stamped
(NO Bitly u"�"' (NOTARY SEAL e'^�'��•""•
Comml�sion M NH 22101! Commlasbn K HH]3101!
Notary Po�lic-Slate M FIwWa Nolary Pudic-Stale ot FbnCa
My Commissbn Expires Mer 05,IO2fi My Gommission Eepiras Mar O5,2026
�T�1B IBflll 0119:
� Ex0>rt wilnesaes wlw provWe only scientif¢,�echnical or o��er special¢eE infortnetion or testimony in�publk meetings;any person wM µ
only appears as e repmsenfeGve ol a neigh0orhootl association without compensation or reimWrsement for��e appearanca,whether
tlirec4 i�Mired or contingent, lo express suppotl ot or oppositian lo any item;and any parson who only eppears as a representalive of
not-for-pmfi�community baSeO orgeniration(or the puryose of requesGng a granl without spedel compensation or mim0ursemenl for
�he eppee2nce.
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Ciy ol Miami Bea<h, 1]00 ConvenNon Cemer Drive,Mlomt Beoch,florida 33139,www.miomibeachfl.qov
ORice of ihe Ciry Clerk
Rofael E. Gmnado. Gry Clerk CiryClark@miaml6eachA_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 thal may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Sta[ements filed after the
due date. The City Clerk shall notify the Miami-Dade County Commission on Elhics and
Public Trust of lhe failure of a lobbyist (or principal) lo file the Statement or pay lhe
assessed fines after notification.
Any lobbyis[, who fails lo file the required Statement by April 30"' 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 expendi[ures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged ro 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.
� �•�� 4/18/2024
MicL.d. (U. �µ4iw
Signature of Lobbyist Date
FICLENyLLYfORMSLLO0BYI5T FORMS1MC�iu I1pYv�Em Fam MrsM OYt1�1p AEG hc
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CiTy of Miami Beach
City Hall
1700 Conventian Center �r.
Miami Beach , FL 33139
305-673-7420
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Cl1STOMER COPY