Gene Grabarnickm MIAi~IBEACH
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 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.
Grabarnick Gene
NAME OF LOBBYIST: (Last) (First) (M.L)
c/o 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: 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 Variance to exceed allowable hours of operation of an outdoor bar counter through 2:OOam 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) An Financial, Familial or Professional Relationship
City of Miami Beach Zoning Board of Adjustment None
City of Miami Beach Planning Staff None
City of Miami Beach Mayor/Commissioners None ,'~ ~ ~ ~ I j ~ +~, ~, E -~ -~, ~ ~
City of Miami Beach Land Use & Development None .~ ~..
Committee
City of Miami Beach Committees
None $~ ~~ ~d ~ I
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) Member of South Beach Resort Development, LLC. No additional
compensation for lobbying.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). Member of South Beach Resort Development, LLC. No additional compensation for lobbying.
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 lobbying 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 lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map designation or change to the Citv'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 anot-for-profit corporation or entity without special compensation or
reimbursement.
I do solemnly swear that all of the for oing f s are
provisions contained in Section 2-482 o mi Bea
Signature of Lobbyist:
Signature of Principal/Client:
correct an hat I have read or am familiar with the
rde orting requirements.
Louis Taic, as ' Manager of So. Beach Hotel, LLC, on behalf of and as
Managing Member of South Beach Resort Development, LLC
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
^ Produced ID ^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE D STAMP OF NOTARY:
State of Florida, Coun ~' '-Dadet`'~RIA V. ERRICKSON
%'•- Notary Public -State of Fbrida
Swor to and b ri ~ RE
T d /j ':~ Commission Expires Apr 10, 201
Commission # DD 526009
- %FOp c~~A,`
''"~~~~~~"' Bonded t3y National Notary Assn.
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
Form of Identification
Personally known (Principal)
of Florida, County of Mir
i t and subsc ibed befo
day of // /G , 20
8'ignature of Public Notary - Sf3f~"6i'F
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S U
u.. e,,,...,.,~ o~ca c - iuro ~ e 7
Notary Pubic - Slate ~ Fkxida
Nf' Carrnission Expires Apr 10, 2010
CortMraasion # DD 526009
Bonded By Naional Notary Assn.
Lobbyist Registration Form received and verified by: `
F:\CLER\LOBBYISIILobbvist Registration Form 32708.doc .v2fl Revised
V. SIGNATURE UNDER OATH:
m MIA^J~IBEACH
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:
Gene Grabarnick
I understand that no later than October 1St 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 add~ion, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the
City erk's Office foyYobbyya~wijpdfa~al in writing.
~.Zo-~~'
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 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.*
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%
1
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP.
NAME(S) AND EACH INDIVIDUAL'S NAME, ADDRESS, OFFJCE 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
TRUST F/B/O THE CHILDREN OF CHANTAL
AND LOUIS TAIC U/A DATED APRIL 2, 1998
58 East 79th Street
New York, New York 10075
Member
OCEANFRONT EQUITIES CORP.
58 East 79th Street
New York, New York 10075
Member
LOUIS TAIC
58 East 79th Street
New York, New York 10075
Manager
OF MEMBERSHIP INTEREST
50%
50%
0%
/F 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 M1AM1 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%
lF 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 % OF INTEREST
JASON TAIC 1/3
58 East 79th Street
New York, New York 10075
Beneficiary
ALEXANDER TAIC 1/3
58 East 79th Street
New York, New York 10075
Beneficiary
STEFANIA TAIC 1/3
58 East 79th Street
New York, New York 10075
Beneficiary
LOUIS TAIC 0%
58 East 79th Street
New York, New York 10075
Trustee
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