Michael W. Larkin - Donahue Peebles
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8/15/2019 Michael W. Larkin - Donahue Peebles
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IV.
DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION( DISCLOSE WHETHER HOURLY, FLATRATE
OR
OTHER):
A) LOBBYIST DISCLOSURE:(
Required):$
445.00
B) PRINCIPAL' S DISCLOSURE(
OF
LOBBYIST COMPENSATION):
REQUIRED). $
445.00
The
following information must be
answered:
1
Pursuant
to
Miami
Beach
City
Code Section 2- 488 Enti tled" Prohib ited
Campaign Contributions By Lobbyists On Procurement
Issues :
Yes X No:
Are
you
lobbying
on
a
present
or®
endngbi®
goods.equpment
or
servces.oron
a
Desentor
pe= award for goods. equipment
or
service?
2)
Pursuant
to
Miami
Beach
City
Code Section
2-
49 0 Enti tled" Prohib ited Campaign
Contributions
By Lobbyists On Real Estate
Development Issues :
Yes X
No:
Are
you lobbying
on
a
gendina
application for a Development Agreement with
the City
or application
f
change of zoning
map designation or chanae to the
City'
s Future Land Use Map?
3)
Pursuant to M ia mi B ea ch C ity
Code Section
2 - 482 ( h) Any person (
except
those
exempt
from
the definition
of lobbyist as se
forth
in
Section
2-481
above)
who only appears
as
a representative of a not-for-profit corporation or entity withou
speca
compensaion or
rembursement
for the appearance,
whether direct,
or
indirect,
to
express support of
o
opposition to
any
item, shall register w ith th e clerk as requ ired by
this
section but,
shall
no t be
required
to pay any registratio
fees.
Yes
X
No:
Are you representing
a not-
for-profit
corporation
or entity without
special compensation
or
reimbursement.
V. SIGNATURE UNDER OATH:
ON
FEBRUARY 28
OF
EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO
THE CITY
CLERK
A SIGNED
STATEMENT
UNDE
OATH,
LISTING
LOBBYING
EXPENDITURES, AS
WELL
AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH
EDB
THE PRECEDING
CALENDAR
YEAR, A
STATEMENT SHALL BE FILED EVEN IF
THERE HAVE BEEN
NO
EXPENDITURES
OR
COMPENSATION
DURING
THE
REPORTING PERIOD.
Signature
of Lobbyist
I do so lemnly swear
that al l
of the foregoing facts are true and correct and that I have read or am
familiar
with the provisions containe
in Section
2 -
482 of the
Miami
Beach City Code and
al l
reporting
requirements.
Signature of Lobbyist:
Signature of
Principal/Clien
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Produced
ID
9
0r °
v®
QP
iee°
Produced ID
Form
of
Identificati ;,
A. `®
0°°®
TAR
y.
o°°
i
Form ofIdentification
V.̀
ersonally
known(
Lobbyist)
o _
11J°
My
Comm.
EXPir. •
0
Personally known( Principal)
fir
H
c
d `
a
NoveMber 05, 2013 .
VII. SIGNATURE AND
STAMP
OF
NO jla;u
No.®
D
833467
State of
Florida,
County
of
Miami-
Dade
m
N
O®
e `5tate of Florida,
County
of Miami-Dade
SwornV
and
subscri d
befor
me
a,
s3
gq®
Sworn
r
d
subscribed bef9Ie
me
This J
da y
of 2013
N
This
day
of (
0
ga ,
2013
00
0
SigrbW6
of
Public
Notary—
State
of
Florida...,:,
Sig
e o
i
otary-
State
of
Florida
Notarization
of
Lobbyist's
sgnature
Notarization of Principal's signature
TO
BE COMPLETED BY
CITY CLERK'
S
STAFF
O
Y
Annual
Registration
fee: ]
Yes
No
Amount
Paid$
4
MCR#
2-
S & Itl
ate Pa'
Lobbyist Registration
Form received and
verified
by:
ok
C: \
Users\clerhatl\
AppData\ Local\ Microsoft\Wndows\Temporary
Internet
Files\ Content.Outlook\83LGQDDH\Lobbyist
Registration
Formrevised 5-
30-2012.doc
-
8/15/2019 Michael W. Larkin - Donahue Peebles
3/4
F:\
CLE
istration Form.
doc
Revised 04/
27/
2012
0
City
oMam
Beach,
1700 Convention Center Drive, Miami Beach.,
Florida
33139, www
rniamibeachtl.
gov
CITY
CLERK Office
Rafael
E.
Granado,
City
Clerk
City
Clerka.
miamibeach fl. gov
Tel:
305.673.
7411 ,
Fax: 305.673.7254
LOBBYIST NAME: Michael
W
Larkin
I
understand
that no
later
than
February
28
ofeachyear,
m ust file the follow ing form
pursuant to
Section
2-
485
of
the
Miami Beach
City
Code,
with the City Clerk's Office for
a
active lobbying issues.
1 LOBBYIST EXPENDITURE AND COMPENSATION FORM
Failure to file these forms on a timely basis
will
result in my name being transmitted to th
Miami-Dade
County Commission
on Eth ics and
for
code
violation evaluation
In
addtion,
once
an
issue I
have regstered
to
lobby
on
has
been
resoved,
or
I am no longe
lobbying
on
that issue or
for
that
princpa,
I am required to immediately notify the City Clerk'
Office
of
lobbyist withdrawal in writing.
Pursuant
to
Section
2-
485 (d), the
City
Clerk shal
notify any
lobbyist (
or
princpa)
wh
fails
to
timely
file
a Statement and in
addition to any
other
penalties which may b
imposed
as
provded
in Section
2-
485.
1 ,
a fine
of
50.
00
a day
shall
be assessed
for
a
Statement(
s)
filed
after
the
due
date.
The
City
Clerk
shal
notify
the
Miami-
Dad
County
Commission onEthics and
Public
Trust ofthe failure of
a
lobbyist (
orprincpa
to
file
the
Statement
or
pay
the assessed
fines
after
notification.
Any
lobbyist,
who
fails to
file the
requred
Statement
by
April 30th, 2012, shal
b
automatically
suspended
from
lobbying
untilal
fines are
pad,
unless the fine has bee
appealed
to the Miami-
Dade
County Commission on Ethics and Public
Trust.
d_-
C
6I)
Signature:
Date:
C: \
Users\
clerhatl \AppData\
Local\
Microsoft\Windows\Temporary
Internet Files\
Content.Outlook\83LGQD DH\ Lobbyist
Registration
Formrevised
5-
30-
2012.
doc
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8/15/2019 Michael W. Larkin - Donahue Peebles
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