Michael Larkin/Royal Palm Hotel Property, LLC Robert D. Falor, Mgr
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MIAMI BEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRA nON 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 Ordinance 2004-3435.
NAME OF LOBBYIST:
Larkin
(Last)
Michael
(First)
W
(M .1)
Bercow & Radell, P.A. 200 South Biscayne Blvd., Suite 850 Miami
BUSINESS NAME AND ADDRESS (Number and Street) (City)
Florida
(State)
33131
(Zip Code)
(305) 377-6231
TELEPHONE NUMBER:
(305) 377-6222
FAX NUMBER:
mlarki n@brzoninglaw.com
EMAIL:
I. lOBBYIST RETAINED BY:
Royal Palm Hotel Property, LLC, c/o Robert D. Falor, Manager
NAME OF PRINCIPAl/CUE NT:
Royal Palm Hotel Property. LLC
BUSINESS NAME AND ADDRESS
1545 Collins Avenue
(Number and Street)
Miami Beach
(City)
FL
(State)
33139
(Zip Code)
(305) 604-5700
TELEPHONE NUMBER:
(305) 604-2059
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 BENEFICIARY: Robert D. Falor, Manager
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: See Exhibit "B"
II. SPECIFIC lOBBY ISSUE:
Application to the Planning Board for Conditional Use Approval for a Neighborhood Impact Establishment*
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
Mercy Lamazares None
* As the action by the Planning Board is a quasi-judicial proceeding, the lobbyist will NOT lobby any member of the Planning Board.
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF lOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $360.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $360.00 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":
n Yes X No: Are you 10bbyinQ on a present or pendinQ bid for Qoods, equipment or services. or on a
present or pendinQ award for Qoods. equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
nYes X No: Are YOU 10bbyinQ on a pendinQ application for a Development AQreement with the City or
application for chanQe of zoninQ map desiQnation or chanQe to the City's Future Land Use
Map?
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..
n Yes X No: Are you representinQ a not-for-profit corporation or entity without special compensation
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.
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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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Signature of Principal/Client: ~-==:::
VI. LOBBYIST IDENTIFICATION: \
PRINCIPAL IDENTIFICATION:
o Produced ID
o Produced ID
Form of Identification
K Personally known (Lobbyist)
VII. SIG A RE AND STAMP OF NOTARY:
Form of Identification
~:1fPersOnaIlY known (Principal)
ature of Public Notary - State f Florida
Notarization of Lobbyist's signature
State of Florida, c..ounty of Miami-Dade
sworn2"'Jd.. sU..~C.~.ib d.l.r....e:f...o.. r 'me
This -5dClY of.' . . (). , 20_
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Signature of RJJblic Notary - State of Florida
Notarization of Principal's signature
Annual Registration fee: [ ] Yes [ ] No
~~~~~!:~ .~~~!~~~a.~!~~..FOr.~ ~~:~~~;~~?~~ ~.erified by:
Entered By: