Michael W. Larkin/Mitchell Rubinson & Edda Rubinson
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MIAMI BEACH
City of Miami Beach Office of the City Clerk
1700 Con~tion 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 Ordinance 2004-3435.
Larkin
Michael
w.
NAME OF LOBBYIST:
(Last)
(First)
(M.I)
Bercaw & Radell, P.A. 200 South Biscayne Blvd., Suite 8S0
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:
Mitchell Rubinson and Edda Rubinson
NAME OF PRINCIPAl.jCUENT:
3525 Flaminao Drive
BUSINESS NAME AND ADDRESS
(Number and Street)
Miami Beach
(City)
Florida
(State)
33140
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Board of Adjustment Application
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
DRB and BOA
None
, IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$320.00 Der hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $320.00 Der 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 lobbving on a oresent or oending bid for goods. eguioment or services. or on a
oresent or oending award for goods. eguioment 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 lobbving on a oending aoolication for a Develooment Agreement with the City or
aoolication for change of zoning mao designation or change 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..
n Yes X No: Are you reoresenting 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.
a!tloCi ~
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 Se on 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
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o Produced ID
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/ Form of Identification
wersonally known (Principal)
Form of Identification
~SOnaIlY known (Lobbyist)
SIGNATURE AND STAMP OF NOTARY:
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State of Florida, County of Miami-Dade
Swor~,\<y1d subscribj;~ pefore me /Y'7
Th;qj!h_daY~p_' 2r!2J
Signature of Public Notary - State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY ~.... k__
Aoo",' Reg;'"","oo fee, [ ] Yo< [ ] No Amo"", Paid ~ MCR #2a!'l9-~Dato Paid ~
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