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Russell W. Galbut - 1100 West Properties, LLCI pD t 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. Galbut Russell W. NAME OF LOBBYIST: (Last) (First) (M 2200 Biscayne Boulevard Miami FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5700 (305) 847-3354 rgalbut crescenthei hts.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: ~°, p I. LOBBYIST RETAINED BY: ~! ° ~.~ ~ ~~'f 1100 West Properties, LLC r-~ rr; ~ ~`"~ NAME OF PRINCIPAUCLIENT: ~-, ~,,,,, Mondrian South Beach c/o Mor ans Hotel Group, 475 10`" Avenue New York, New York 10018 `!' ~' d BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Codee) ~ $ I (305) 674-4848 (786) 258-2870 a albut _hudcap.com -~ TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) ~- ~ Fill out this section if principal is a Corporation, Partnership or Trust [Section 282 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Abraham Galbut, as President of 1100 West Holdings, LLC, Manager of 1100 West Properties, LLC IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached Disclosures of Interest. SPECIFIC LOBBY ISSUE: Request for modifications to conditions of the Final Order, and any other Order, for a previously issued Design Review Approval for a new landscape plan for the entire site, as well as for alterations to the existing exterior elevations, including modifications to the windows, doors, and porte-cochere, and the construction of new 2-story cabanas at the rear of the site. Specifically, a proposal to modify the conditions of the Final Order, and any other Order, relating to the completion of the public baywalk under DRB File No. 20181, for the property located at 1100 West 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 said City personnel' commencement of service with the City to the present date, stating the general nature of the subject contractual relation. A Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship City of Miami Beach Design Review Board None City of Miami Beach Planning Director/Staff None City of Miami Beach Mayor/Commissioners None Cit of Miami Beach Cit Mana er/Asst. Cit Mana ers None ~~ r' i '~ ' iV. DISCLOSURE OF TERMS -AND AMOUNTS OF LOBBYIST COMPENSATION {DISCLOSE WHETHER .HOURLY, FLAT RATE OR OTHER): - A) LOBBYIST DISCLOSURE: (Required) $0. No compensation for lobbying. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $0. No 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": I-lYes ~ 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": f7Yes ~I No: Are you lobbvinq on a pending application for a Development Agreement with the City or application for change of zoning map designation or change 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 a .not-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. 1-1Yes ~ No: Are .you representimq anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: Signature of Lobbyist: Signature of Principal/Client: Abraham Galbut, as President of 1100 West Holdings, LLC, Manager of 1100 West Properties, LLC VI. LOBBYIST IDENTIFICATION:: PRINCIPAL IDENTIFICATION: ^ Produced ID ^ Produced ID Form of Identification. Form of Identification ;~ Personally known (Lobbyist) ^ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County,c~f 'ar~ni_G1ad~ .. _ _ . Sworn ands s ra~~~k~efore me DAYAMIAGUTAR T day of °%'~p~gtarY Public -State of Florida . _~Mvl C~ommission Expires Mar 16, 201 ~ /~/ ~/~ ~:~Jli:Ommissioa # DD 644032 / TO BE COM egistration fee: [ °] Yes [ ] No Amount Pais Registration. Form received and verified by: State of Florida, County of Miami-Dade Sworn to and subscribed before me This _ day of , 2010 Signature of Public Notary -State of Florida Notarization of Principal's signature CLERK'~U Form 2010.doc Date Paid 10 I do solemnly swear that, all of the foregoing facts are true c rrect and that I have read or am familiar with the provisions contained in Section 2-482 of tFj~ami Bed ~~~d~11-Fel5orting requirements. ' IV: DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER - HOURLY, FLAT RATE OR OTHER): ; -~ . • ~ A) LOBBYIST DISCLOSURE:. (Required) $0. No compensation for lobbying. '- B) 'PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)... $0. No compensation. for lobbying. ~ , - The following, information musf be answered 1) Pursuant to.Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists " Dri Procurement Issues": ^Yes ~'_-No: Are you lobbying on a present or pendinq.. bid for goods, equipment or services, or on a present or pendinq 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 lobbying on a pendinq application for, a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Maps . 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. - V. SIGNATURE UNDER OATH: ON OCTOBER. 15~ 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 of Lobbyist -.Russell W. Galbut l do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiarwith the • provisions contained in Section2-482 of the Miami Beach City Code and. all ~eportin requirements. • Signature of Lobbyist: , - Signature of Principal/Client:.. Abraham Galbut, as Presiden o 1, 00 West Ho dings, LC, Manager of 1100 West Properties, LLC VI: .LOBBYIST IDENTIFICATIOM: PRINCIPAL IDENTIFICATION: ^- Produced ID ^ Produced ID - . ffffff - . Form of Identification Form of ldentificati I ,a,~,~~~~~~!/~' " Q~issnr~~~ ~h //~. ' ^ Personally known (Lobbyist) Personal) known Prin .p * 9JpN ~~" y { opal) ~ .~''~fg`~°~~"N. VII. SIGNATURE AND STAMP OF NOTARY. f .. w~.y : * ,= . State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade-' ; SRA@30781 ~ '~~~ " Sworn to.and subscribed before me Swor d su ibe b fore me . si99~'•.t~di .' Q This _ day of ,.2010 f Thi of ~i,,/~~~j~ ~Ilfll 11 O~ \\o\\` " ~=w Signature of Public Notary -State of Florida - re of ub is Notary -State of Florida Notarization. of Lobb isf signature Notarization of Principal's signature . f TO BE COMPLETED BYCITY CLERK'S'US ON Y Annual;Registration fee: ( Yes [ ] No Amount Paid $ .~ , MCR # Date Paid `Lobbyist Registration form received and verified by: ' f:\CLER\$ALL\aFORMSILOBBYIST FORMS\Lobbyist Registration Form 2010:doc Revised 05/2 /2010 .r.;. .. m MIAMIBEACH City of Miami Beach, 1'700 Convention Ceriter Drive, .Miami Beach, Florida 33139, vrww.miamibeachfl:qov CITY CLERK office Tel: 305.673.7411, Fax: 305.673.7254 CityClerk miamibeachfl.gov Acknowledgement of fines/suspension from lobbying for failure to comply with City of .Miami Beach lobbying Laws LOBBYIST NAME: Russell W. Galbut I understand that no later than October 1st of each year, lobbyists subject to lobbyist registration requirements shall submit to the city clerk a signed statement under oath listing. all lobbying expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which the lobbyist has been engaged to lobby. A statement shall be filed even if there have been no expenditures or compensation during the reporting period. The statement shall list, in detail, each expenditure by category, including food and beverage, entertainment, research, communication, media advertising,. publications, travel, lodging and special events. Failure to timely file the expenditure and fee disclosure report will result in a fine of $50.00 per day. Any lobbyist who fails .to file the- required expenditure report by December 1, shall automatically be suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. In the. event a lobbyist fails to either file the report and/or pay the assessed fines, the Clerk shall. notify the Miami Dade County Commission on Ethics and Public Trust. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify thenCity Clerk's Office for lobbyist withdrawal in writing. . Galbut Da e: . - ,.. , ..... _. ... ... " ~ i' 1 '4'' ~~1? X91 r~1'~I I~1 ~ ~;:H PFt%Ft..t~.i't~'11;1~T .1~.~:t'TR~J~i' C~t)r~RD A_P1'I.,:i~;,~-".l'1(3ti " T7IS~;I.~~t71t1±, ~1~ Il~'i'I."~1'~S'I' 1100 '4~115~' PR~}PL12'1'I.LS, ~,~:~; 11f:)0 ~~Jst Iloldirlgs, Z.,I:,C lt)C)~'/o . (~;ole'vCc€.I.1L~t,a~ o:(' 111)0 "~'i'est 1'IO}:)~I.S€~•.~, ~1:_C;) ego '~-Tor~T~~ns I-1~tel (.:~a~ou~~ ~tx~ Y~~rk; Nc~~r York l (?01 ~ 1"1011 VVFS'I'"N4)H.ai)I~(~5,.1..I:C; 1:1t.)() "~r~st Hc~lclln<~ss 11,1,1'.,(" 1'00°./0 ~~~f~1~ ~ILCI1`1.17~r o~ 1.1 Ot) ~~'~S~ ~ 1o1.t11I~5" t.;1:.,L} 4'?S ICIt}a. Avei~.uc; u p iro . ~;io ~lorgr~n~ Flotel C ~y ) y p I.V ~.'L`5' ~ O.I.~C..1\E'+~V S ~.)rit. S IJt~~ f5 1.1. i.~t/. 1~~1.I~~~7,1~.~i~li:J l.f11~1.7 A3~~.F.1 L.LI.. ., - 1 e ~-1c~rlcirian ~%1ia€ni In~~~,st€t~et7t; i:.<i_.~' . ~?()"'" ;17~, 1 t)`~, Ar~-e.nua `~1e~~- York;1~`ew ~r'orl; i (~()1 ~ . ~an.ctr~€ary l~;rest ~~-~nue; LLB:.' ~t)"ru ~jo.~-~LIC~SO?.] ~.il~~l:t~~ <~77013isca~~iie ~I~-d., ~i~rite =1~')t? :'VIial"sli, l~inri~a ~ ~ l3"7_ :'4'~U'~.D~:C ~.~ 1~'1IA.:1'lI Iwv 1~1/:S'T~•Ir;I~T.:1..1..f • : 10~1cxr~al~s Groin, LLC 1. t)t)°ri, 47~ 1Ot17~~'~.ventie , I°: e~~-" `€'c?.rk;..Ner~r `~ t>rk 10 ()1 MORGANS GROUP, LLC -Morgans Hotel. Group ~C'o. ` 475 10th Avenue New York, New York 10018 . Residual Hotel Interest LLC c/o Northstar Reality Finance Corp. • - 399 Park Avenue; 18th Floor New York, New York 10022 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation. ` SANCTUARY WEST AVEN~JE, LLC Sanctuary West Holdings, LLC (Sole Owner of Sanctuary West Avenue, LLC) 4770 Biscayne Blvd., Suite 400 • Miami, Florida 33137 SANCTUARY WEST HOLDINGS, LLC . ~ Sanctuary West Management, LLC 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 . Gladys Brownstein • Honey Waldman SANCTUARY WEST :MANAGEMENT, LLC Abraham Galbut & Nancy K. Galbut; his wife 4770 Biscayne Blvd., Suite 404 • Miami, Florida 33137 Keith Menin c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut y c/o 4270 Biscayne Blvd., Suite 400. Miami, Florida 33137 2 97.1% 2.9% (See attached flow chart) 100% 95% ` 2.5% 2.5% 24% 17% 13% 5~.t1~ ~'rol.ich Ki~-I-II?er~y I~~~chlich, i1 ~ ~~ite 7°~0 c1a 1770 .1~3i:sca}-ne Bled., Suite ~Oll 41ian~Ii. l~la.r.ida 33 137 Ro):s~ rC;'~. ~~.~lt?trt anti :Rita. Cia)1-~trt, l-I~s ~~•ile 7°,% c;/o X1770 i3isca~-ne I31vd., Suite ~~~(~. . ~~Iiami. l~lc~rida 3313T Da~~id C7a11-~trt ar7ci. Crit~~ (3albtxt. iris tivirir 7'f'a~ e;'c~ =1771) i3isoa;;%r7c.131vci., `Mlle =10() .'~~iaLni. ,Fli~.rida 331.37 . ~ Tnan I3t~c;nt ~~,~ c'o ~77tJ }3is%a}%ne Bll;;l,., Suite =1t)t) l~~iail~i; I'lor~ida. 3.3137 ~[:~:=11'1 (=lc~lcli~z~:s, ~.LC:`. 20°0 c:'c.~ 22f)t) ~l~isc~~~t}~n~; ~131t~ci. ~~1~iat~~i. Florida 33137 ~iollIl~ )•;.a)171 c./c:> ?2Oi7 .Ia:isc-~~~7~e i:3i~-d. :~f1ial~~i. 1')orida.3:i 13"J l:~:ric:c~ l~alrn e/o ?2i)0 13i:~ca~-ne 431-d. 1~1ian~i: 1~')c~rida 33137 s~.bral~ a~-t7 .1'-1 ay uli c!o 2'00 I3iscavne i:3.l~-ci. 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