Harold Rosen/8?6 (?nCt~rut ~~~'W~
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, ~1Q9~'~(3~ p~ ~: 29
LOBBYIST REGISTRATION FORM ~ ~ T Y ~ ;. ,
LE~r~ ~ iJ~`r"=(C~
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 bond 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.
Rosen Harold
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o Rosen Switkes & Entin P.L. 407 Lincoln Road, PH SE Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 534-4757 (305) 538-5504 hrosen@rosenandswitkes.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
IC, LLC
NAME OF PR-NCIPAUCLIENT:
IC, LLC 2200 Biscayne Boulevard Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374-5700 (305) 847-3354 mkramer@crescentheights.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Russell W. Galbut and Irving
Cowan
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
Russell W. Galbut (50%), Managing Member
Irving Cowan (50%), Managing Member
II. SPECIFIC LOBBY ISSUE:
Conditional Use Approval (1) to permit the use of a robotic parking system in a commercial main use parking
garage at 1826 Collins Avenue, which includes a restaurant within the commercial space; and (2) to operate the
garage after midnight.
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(g) include a
statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the
commencement of service of City personnel to be lobbied.)
A) Full Name of Individual/Title B) An Financial, Familial or Professional Relationship
City of Miami Beach Planning Board None
City of Miami Beach Planning Staff None
City of Miami Beach Mayor/Commissioners None
City of Miami Beach Committees None
S"I f
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) $
B) PRINCIPAL
(Required). $
(OF LOBBYIST C E TION):
~ ,.-~ ~- ~~. i In
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":
^Yes ~ No• Are you lobbvinq on a present or pending bid for goods, equipment or services, or on a
present or pending award for goods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues':
^Yes ®No• Are you lobbvinq on a pending application for a Development Agreement with the City or
application for change of zoning map designation or chance to the City's Future Land Use Map?
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 anot-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..
^Yes ~ No: Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1S` OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
Signature of Lobbyist:
Signature of Principal/Client:
RusKel
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
[[~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
TI}is i lU day of ~~ , 2008~q
Nota
of
Managing Member of IC, LLC
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of 'a i- a
Sworn o and sub cribed be re rn~,,,, oAYAMIAtsUTAR
h ~ day of Q~`""Y °j~~c, tlotary Pt~Nc -Stale of Florida
. F My Camrnlpion Ezpiras Mar tti, 2011
'"~ = Commission p DD ti4A032
Si natu ' of Pub is otary t ~rid~dedTnroughwagonaii~otaryAw-.
Notariz~'tion of Principal's
EI~Uros 1N TO ~~CgJMPLETED BY CITY CLERK'S USE ONLY
LobbyiltM4l!lgl~'!MSltRlRFBftti P~ceivetTand verified by: _
F:\CLER\LOBBYISlILobbvist Registration Form 32708.doc
I do solemnly swear that all of the foregoing f~ ar " e an correct and that I have read or am familiar with the
provisions contained in Section 2-482 of the M' each Code and all reporting requirements.
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK office CityClerk _miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
Harold Rosen
I understand that no later than October 1$` of each vear, I must file the following forms, pursuant to Section 2-485 of
the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County
Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the
City Clerk's Office for lobbyist withdrawal in writing.
Signature: Harold sen
~1 i~~ Its
Date: