Michael Larkin/Seth Gadinsky (2)m 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 deasion of any commissioner; any action, deasion, rernmmendation of the
City Manager or any aty board or committee; or any action, deasion or recommendation of any city personnel during the time
period of the entire deasion-making process on such action, deasion 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)
Bercow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 377-6231 (305) 377-6222 mlarkin(a~brzoninglaw com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Seth Gadinsky
NAME OF PRINCIPAL/CLIENT:
1680 Michigan Avenue Suite 1001 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 276-2387 (305) 675-7759 SethCalGadinskyrealestate.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optiona-)
out this section if principal is a Corporation, Partnership or Trust [Section 2-482
• 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:
Conditional Use Approval for Walgreens Store at 1011-15 Alton Road
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
Mercy Lamazares None
Richard Lorber None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERr
A) LOBBYIST DISCLOSURE: (Required) $ 375.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 375.00 oer hour
The following information must be answered:
1) Pursuant to Miami Be;~ch City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procuremer~~ -:~:~.~~-_'':
^_ Xes X No: Are you lobbying on a present or cending bid for goods, eguiDment or services, or on a
aresent or cending awaM 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":
^Yes X No: Are you lobbvina on a cending aaDlication for a Develoiament Agreement with the City or
application for change of zoning map designation or chance to the City's Future Land Use
Ma°?
3) Pursuant to Miami Beach C"ity 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 snot-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..
^Y~ X No: Are you representing anot-for-profit corporation or entity without scecial compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ 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.
Signature d'F 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:
~' _-
ignature of Principal/Client:
~ LOBBYIST IDENTIFICATION:
~ ~ C, Produced ID
.~ ~ Form of Identification
~ ~~ Personally known (Lobbyist)
~V'Ii
z ~ w A, SIGNATURE AN STAMP OF NOTARY:
~'~'~~°'~¢ fate of F r' a, County f iami-Dade
~B wor bscrib e
~.~ his /day .Ct7h~
5gnature of Publ~ Notary - Sl~fe of Florida
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
rgPersonally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me ~""+~ Maw Hebem
This day of 20_ ;~~~ My Commission DD301004
q r,, Expires March 29, 2008
Signature of Public -State of Florida
Notarization of Principal's signature
FOR CLE~ NLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid ~ ~ ~ MCR I~/ Date Paid