Michael Larkin/Eric Milon
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MIAMI BEACH
City of MfamfBeach Office of the City Clerk
1700 conventi?n 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.
La rki n
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:
Eric Milon
NAME OF PRINCIPAL/CLIENT:
222 S. Coconut Lane
BUSINESS NAME AND ADDRESS
(Number and Street)
Miami Beach
(City)
Florida
(State)
33139
(Zip Code)
(305) 992-0840
TELEPHONE NUMBER:
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:
· IDENTIFY ALL PERSONS HOLDING, DIRECfL Y OR INDIRECfL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Design Review Board and 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
.lV. U.l:)\..LV:)UKI: VI" II:KM:) ANU AMVUN I:) VI" LV~I:H.l:)1 \..VMt'I:N:)AI.lVN lU.l:)\..LV:)1: WMI: I MI:K nUUKLT,
FLA T RA TE OR OTHER).
A) LOBBYIST DISCLOSURE: (Required)
$320.00 oer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $320.00 oer 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:
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes X No:
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..
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:
Signature of Principal/Client:
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Form of Identification
Z= Pro ced ID
Form of Identification
ersonally known (Principal)
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LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
- Produced ID
K... Personally known (Lobbyist)
IGNATURE AND STAMP OF NOTARY:
ature of Public Notary - State Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn and subscribed before me 1.
Th;s -liday of :;. , :
S;gnature ~:- ~" ..: Murloa'
Notarization of Principal's signature
FOR CLERK'S USE ONLY .:2
Annual Registration fee: [ ] Yes [ ] No Amount Paid 2~ dle.. MCR #
Lobbyist Registration Form received and verified by:'-. ~~ . Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc
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Date paid3J 4? ~T
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Revised 12/08/04