Michael Larkin/GG Realty, Inc.
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lv\ I ;A"^' 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, dedsion or recommendation that foreseeably will be heard or reviewed
by the dty commission, or a dty board or committee. The term specifically incudes 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 200 S. South Biscayne Blvd., suite 850 Mia,FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-377-6231 305-377-6222 mlarkin@brzoninglaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAlL:
I. LOBBYIST RETAINED BY:
GG Realty, Inc.
NAME OF PRINCIPAL./CLIENT:
GG Realty, Inc. 16711 Collins Ave., suite 2501 Mia Bch, FL 33160
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-778-4428
TELEPHONE NUMBER:
305-945-2838
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 BENEFIOARY:
Gregory Gerasimov and Dmitriy Vernitskiy
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II.
SPECIFIC LOBBY ISSUE: ^pplication for variances
with regard to property located at 354 Washinqton Ave.
Issue to be lobbied (Describe in detail):
m. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
. -
Jorge Gomez none
.
Richard Lorber none
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$360.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ ~ n 0 00
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
DYes 'K No: Are YOU lobbvina on a Dresent or Dendina bid for aoods. eauiDment or services. or on a
Dresent or Dendina award for aoods. eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes ~o: Are YOU lobbvina on a Dendina aDDlication for a DeveloDment Aareement with the City or
aDDHcation for chanae of zonina maD desianation or chanae to the City's Future Land Use
MaD?
3) Pursuant to Miami Beach City Code 2-484 (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..
D Yes IX No: Are YOU reDresentina a not-for-Drofit corDoration or entity without sDecial comDensation
or reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST 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 FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD. ~ W,
Signature 0 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
requirements.
Signature of Lobbyist:
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VI.
LOBBYIST IDENTIFICATION:
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PRINCIPAL IDENTIFICATION:
Signature of Principal/Client:
D Produced ID
~roduced ID 1/L(l)l.C-bJ.f"-UO''-I '1 .c9. 6j I ~D
Form of Identification
Form of Identification
1\ Personally known (Lobbyist)
D Personally known (Principal)
VII.
NATURE AND STAMP OF NOTARY:
re of Public Notary State 0 lorida
Notarization of Lobbyist's signature
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FOR CLE
Annual Registration fee: [ Yes [ ] No Amount Pai
Lobbyist Registration Form received and verified by.
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Signature of Public Notary - State of Florida
Notarization of Principa