Dean B. Lewis (2)m PsiANll$EACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
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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-flaking 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.
Lewis Dean B.
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o DB Lewis Architecture 120 NE 27~h Street, Bay 500 Miami Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 572-1220 (305) 572-9161 dblewis@dbla1.us
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
South Beach Resort Development, LLC
NAME OF PRINCIPAUCLIENT:
South Beach Resort Development, LLC 420 Lincoln Road, Suite 357 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 672-4554 (305) 672-4553 gene@southbeachrd.com
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: Louis Taic
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
See attached.
II. SPECIFIC LOBBY ISSUE:
Application for Conditional Use Permit for Neighborhood Impact Establishment at 1458 Ocean Drive (a/k/a 1437
Collins Avenue), Miami Beach, Florida 33139.
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) Any Financial, Familial or Professional Relationship
City of Miami Beach Planning Board None ~ ~ ~ ~ (, c tt ~, ~ -~ ,) ~ ~ ~ ,~
City of Miami Beach Planning Staff None
City of Miami Beach Mayor/Commissioners
City of Miami Beach Land Use & Development None
None (Z . ! ! ~~
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Committee
City of Miami Beach Committees None ~~ .~ ~~ ~ ~;} !~
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) $
B) PRINCIPAL'S DISCLOSURE O LOBBYIST COMPE A~T OwN,,),:
(Required). $ ~ `J,$^(~Or ~~ ,(f~-~
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 6a 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..
I-IYes 6a No: Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 15f OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
PERIOD.
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Signature of Lobbyist -Dean B. Lewis
I do solemnly swear that all of the foregoing facts are true and c ect and that I have read or am familiar with the
provisions contained in Section 2-482 of~hrESlGliami Beach City C~d~ll reporting requirements.
Signature of lobbyist:
Signature of Principal/Client:
Louis Taic, ~ Manager of So. Beach Hotel, LLC, on behalf of and as
Managing Member of 58uth Beach Resort Development, LLC
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
/~ Produced ID ~~ ~
Form of Identification
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP\4FtN(9rilai~Y~~
to of lore a County of Miami,p ~~81,1!@d~a''',~,,'
S orn to and criged before: •c~,~Ql~eS ~'
T is ~ d o ~ 1 , 2008 04-0212013
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Annual Registration fee: [ ]Yes [ ] No Amou id $
Lobbyist Registration Form received and verified by:
F:\CLER\LOBBYIST1Lobbvist Registration Form 32708.doc
^ Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of
Sworn (p and sub r' ed b o~®~ ,,, MARIA V. ER ICK50N
This (,~ day /' /(~ ~`~s Notary Public -State of Florida
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Signature of Public Notary f~'fry'$~ FIc~48~ 8Y National Notary Assn.
Notarization of Principal' s g t e
ITY CLERK'S USE_ONLY
Revised
m ;'ViIAMIBEACH
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
Dean B. Lewis
LOBBYIST NAME:
I understand that no later than October 15t of each year, 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.
t ~/ ~
Signature: an B. Lewis Date:
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. LIMITED LIABILITY COMPANY
If the property which is the subject of an application is owned or leased by a CORPORATION, list the
principal stockholders and the percentage of stock owned by each. Where the principal officers or
stockholders consist of another corporations}, trustee(s), partnership(s) or other similar entity, further
disclosure shall be required which discloses the identity of the individual(s) (natural persons) having the
ultimate ownership interest in the entity.*
SOUTH BEACH RESORT DEVELOPMENT, LLC, a Florida Limited Liability Company
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
SO. BEACH HOTEL, LLC
58 East 79th Street
New York, New York 10075
Managing Member
OF MEMBERSHIP INTEREST
66 2/3%
GENE GRABARNICK
& PAULINE GRABARNICK,
HIS WIFE, AS TENANTS BY THE ENTIRETY
6480 Allison Island
Miami Beach, Florida 33141
Members
GARETT GRABARNICK
5700 Collins Avenue, No. 5L
Miami Beach, Florida 33140
Member
25%
8 1 /3%
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP.
NAME(S) AND EACH /ND/V/DUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF
STOCK, ON A SEPARATE PAGE.
Last page must be signed and notarized
Page A-5(1)
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. LIMITED LIABILITY COMPANY
If the property which is the subject of an application is owned or leased by a CORPORATION,
list the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the individual(s)
(natural persons} having the ultimate ownership interest in the entity.*
SO. BEACH HOTEL, LLC, a Delaware Limited Liability Company
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE % OF MEMBERSHIP INTEREST
TRUST F/B/O THE CHILDREN OF CHANTAL 50%
AND LOUIS TAIC U/A DATED APRIL 2, 1998
58 East 79th Street
New York, New York 10075
Member
OCEANFRONT EQUITIES CORP. 50%
58 East 79th Street
New York, New York 10075
Member
LOUIS TAIC 0%
58 East 79th Street
New York, New York 10075
Manager
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP.
NAME(S) AND EACH INDIVIDUAL'S NAME, ADDRESS, OFFICE AND
PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
Last page must be signed and notarized
Page A-5(2)
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of an application is owned or leased by a CORPORATION,
list the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the individual(s)
(natural persons) having the ultimate ownership interest in the entity.*
OCEANFRONT EQUITIES CORP., a Delaware Corporation
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
LOUIS TAIC
58 East 79th Street
New York, New York 10075
President and Secretary
100%
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP.
NAME(S) AND EACH INDIVIDUAL'S NAME, ADDRESS, OFFICE AND
PERCENTAGE OF STOCK, ON A SEPARATE PAGE,
Last page must be signed and notarized
. A-5(3)
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
2. TRUSTEE
If the property which is the subject of an application is owned or leased by a TRUSTEE, list the
beneficiaries of the trust and the percentage of interest held by each. Where the
beneficiaries/beneficiary consist of corporation(s), another trust(s), partnership(s) or other similar entity,
further disclosure shall be required which discloses the identity of the individual(s) (natural persons)
having the ultimate ownership interest in the entity.*
TRUST F/B/O THE CHILDREN OF CHANTAL AND LOUIS TAIC U/A DATED APRIL 2, 1998
TRUST NAME
NAME, ADDRESS, AND OFFICE
JASON TAIC
58 East 79th Street
New York, New York 10075
Beneficiary
ALEXANDER TAIC
58 East 79th Street
New York, New York 10075
Beneficiary
STEFANIA TAIC
58 East 79th Street
New York, New York 10075
Beneficiary
LOUIS TAIC
58 East 79th Street
New York, New York 10075
Trustee
OF INTEREST
1/3
1/3
1/3
0%
3. PARTNERSHIP/LIMITED PARTNERSHIP
If the property which is the subject of the application is owned or leased by a PARTNERSHIP or
LIMITED PARTNERSHIP, list the principals of the partnership, including general and limited partners.
Where the partner(s) consist of other partnership(s), corporation(s), trust(s) or other similar entity,
further disclosure shall be required which discloses the identity of the individual(s) (natural persons)
having the ultimate ownership interest in the entity*
NOT APPLICABLE
PARTNERSHIP or LIMITED PARTNERSHIP
NAME, ADDRESS, AND OFFICE % OF STOCK
N/A N/A
Last page must be signed and notarized
A-6