Michael Larkin/Capponi Investment Group, LLC
tt.
MIAMIBEACH
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, 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 Ordnance 2004-3435.
Larkin
Michael
w.
NAME OF LOBBYIST:
(Last)
(First)
(M .1)
Bercow & Radell, P.A. 200 South Biscayne Blvd., Suite 850
BUSINESS NAME AND ADDRESS (Number and Street) (City)
Miami, Florida 33131
(State)
(Zip Code)
(305) 377-6231
TELEPHONE NUMBER:
(305) 377-6222
FAX NUMBER:
mlarkin@brzoninglaw.com
EMAIL:
I. LOBBYIST RETAINED BY:
Capponi Investment Group, LLC
NAME OF PRINCIPAL/CUENT:
Capponi Investment GrouP. LLC 1129 Roval Palm Beach Blvd.. Ste 72
BUSINESS NAME AND ADDRESS (Number and Street)
Roval Palm Beach
(City)
FL
(State)
33411
(Zip Code)
(305) 572-1220
TELEPHONE NUMBER:
(305) 572-9161
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY: Michael Capponi & John Reynolds
· IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Michael Capponi & John Reynolds
II. SPECIFIC LOBBY ISSUE:
Application for variance to Board of Adjustment (BOA).
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Jorge Gomez None
Richard Lorber None
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FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$275.00 oer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $275.00 per hour
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":
D Yes X No: Are YOU lobbyina on a oresent or oendina bid for aoods. eauioment or services. or on a
oresent or oendina award for aoods. eauioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes X No: Are YOU lobbyina on a oendina aoolication for a Deyelooment Aareement with the City or
aoolication for chanae of zonina mao desianation or chanae to the City's Future Land Use
Mao?
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 X No: Are YOU reoresentina a not-for-orofit corooration or entity without soecial comoensation
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.
~~~
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: .
Signature of principal/CI~ _
VI. LOBBYIST IDENTIFICATION:
D Produced ID
PRINCIPAL IDENTIFICATION:
f!>L--.lF-
Xproduced ID ~ 1":)0 (")0 r-; 2- i 2-;-- 0
Form of Identification
Form of Identification
}( Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
D Personally known (Princi
ULLIAN BEAUCHAMP
MY COMMISSION # DD 530416
EXPIRES: April 29. 2010
Balded Thru Notary NllIc UndeIwrbrs
State of Florida, County of Miami-Dade
Sworn to and subscribed bef~e me
This 31 S\ day of nrt-o e", 20jL(p
State of Florida, County of
Sworn and subscribed before me
This --!--day of 1'10\) , 20.0&
~ i/~ a ^-/}J-e-'UU~f)hfY
Signature 0 Public Notary .!. State of Florida
Notarization of Principal's signature
Signature of Public Notary Stat f FI r. a
Notarization of Lobbyist's signature
_______ FOR CLE
Annual Registration fee: [~ ] No A ount Pa'
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyisl\LOBBYIST fORM OS.doc
USE ONLY tt'I C,? Q I..r-
OU CR ~ (p 7 ~~ Date Paid
Entered By:
Revised 12/08/04