Michael Larkin/Miguel Diego
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.
Larkin
Michael
W.
NAME OF LOBBYIST:
(Last)
(First)
(M .1)
Bercow & Radell, P.A.
BUSINESS NAME AND ADDRESS
200 South Biscayne Blvd., suite: 850
(Number and Street) (City)
Miami, Florida
(State)
33131
(Zip Code)
(305) 377-6231
TELEPHONE NUMBER:
(305) 377-6222
FAX NUMBER:
mlarkin@brzoninglaw.com
EMAIL:
I. LOBBYIST RETAINED BY:
Miguel Diego
NAME OF PRINCIPAL/CLIENT:
7 Farrv Lane
BUSINESS NAME AND ADDRESS
Miami Beach Florida
(Number and Street) (City)
33139
(State)
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
mdiego@med.miami.edu
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: Miguel Diego
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
BOA, ORB, HPB, City Commission
Issue to be lobbied (Describe in detail):
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III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
City Commission BOA ORB HPB and staff
IV. UI:>\"LV:>UKJ: VI'" 1 J:KM:> ANU AMVUN I:> VI'" LVttttT 1:>1 \"VMt"J:N:>AIIVN lUI:>\"LV:>J: wnJ: 1 nJ:K nVUKL r,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $ 375.00 oer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 375.00 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: Are YOU lobbying on a oresent or oending bid for goods. eauioment or services. or on a
oresent or Dending award for goods. eauiDment 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 lobbying on a Dending aDDlication for a DeyeloDment Agreement with the City or
aDDlication for chanae of zoning maD desianation or change 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 X No: Are you reDresenting 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.
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Signature of 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:
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
[J Prod uced 10
[] Produced 10
Form of Identification
Form of Identification
,\1 ~ Personally known (Lobbyist)
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:~~ VII. SIGNATURE AND STAMP OF NOTARY:
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I "" s: CD z State of Florida, County of Miami-Dade
!-Q';;! ~ Sworn to and subs e before me ~^1
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~ ~ I Signa ure 0 u Ie No ry - Slate of Aorida
~ ~ Nota izati n Lob yist's signature
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! ",' / FOR CLERK'S. USE ONLY /J"
I.,,, ,=" Annual Registration fee: [ J\lfYes [ ] No Amt Paid .20 ~c- MCR # {j'1
Lobbyist Registration Form received and verified by.:.. A~ 4 Entered By:
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~ersonally known (Principal)
State of Florida, County of Miami-Dade
Sworn and SUbSC. r,' d befoc e,7"'=I-
This Zlday of f 20.g. I
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Revised 12/08/04
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