James E. Rauh Shelborne Associatesm MIAMIBEACH
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-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
teen "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Rauh James E.
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o Terminello &Terminello P.A. 1111 Lincoln Road Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 276-2343 (305) 673-5505 jrauh@terminello.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Shelborne Associates, Costello Investments, Inc., Shelborne Ocean Beach Hotel Corp., and Beach Group III, LLC
NAME OF PRINCIPAUCLIENT:
Shelborne Hotel 1801 Collins Avenue Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 531-1271 (305) 531-2206 mkramer@crescenthei hts 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: Russell W. Galbut
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OF2~--~1IIOF~E
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ~
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See attached Disclosures of Interest. :-~ `f ~a
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II. SPECIFIC LOBBY ISSUE: ~"~ ~' '` ~¢"?
Application for Modification of a Conditional Use Permit for an existing Neighborhood Impact Establishment, includinc,~a-Caf~ ~'"°
and Outdoor Cafe restaurant without dancing and entertainment, Brasserie restaurant with entertainment, Loungg ba with ~~ )
entertainment, Lobby Bar and Restaurant without dancing and entertainment, Nightclub space with dan ing and e~rtainment,
and Taqueria pool bar and outdoor cafe without dancing and entertainment. t$ o ~~~ v ~
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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 IndividuallTitle B An Financial, Familial or Professional Relatio
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
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $ 375 per hour.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $ 375 per hour.
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":
ayes ®No: Are you lobbvina on a present or Dendina 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 lobbvina on a Dendina application for a Development Agreement with the City or
application for change of zoning map designation or change to the Ciiv'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 6a No: Are you representing anot-for-profit corporation or entifir without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON .OCTOBER 1St 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.
Sign r o Lobbyist -James Rauh
I do solemnly swear that all of the foregoing facts are true correct and that I have read or am familiar with the
provisions contained in Section 2-482 of the Miami Beach Ci r Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client: ~/
Russ f of Shelborne Associates, Costello Investments, Inc.,
Shelbome Ocean Beach Hotel Corp., and Beach Group III, LLC.
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
[~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
.,~ Swor to and subscribed before me
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Signature P lic No ary - e of Florida
N o. ~'~ : Notarization of Lobbyist's signature
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Annual Registration fee: ]Yes [ ] No Amount Paid $
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° Lobbyist Registration Form received and verlfled by:
D m F:\CLER\LOBBYIST1Lobb ist Registration Form 32708.doc
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^ Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of Miar
Sworn to and su c ' d beforE
T i day of , 201
1
Si atur of Publ c otary - Std
Notarization of Principal's si~
CLERK'S_l.JSE ONLY
Date
ni-Dade
~~,.4~`,'a'r"'~4,, DAYA(AAIAGUTAR
+° '~•. ~1- Polio • State of Florida
:' •~ M!-Con~bn Alan 16, 2011
Commtaaion 8 DD 844032
~~
Bonded 1Mouah Nadohal ~ Assn.
Revised 03/27/2008
EXHIBIT "B"
DISCLOSURE OF INTEREST
NAME AND ADDRESS %. OF INTEREST
. 1747 BAY ROAD PROPERTIES, LLC
1747 Investments, LLC 32
2200 Biscayne Boulevard
Miami, Florida 33137
Managing Member
MJK Group, LLC
2200 Biscayne Boulevard
Miami, Florida 33137
Member
Sharon Mirmelli
1210 Michigan Avenue
Miami Beach, Florida 33139
Managing Member
Philip Mirmelli
6500 North Bay Road
Miami Beach, Florida 33141
Member
Sean Mirmelli
1415 20th Street, #103
Miami Beach, Florida 33139
Member
1747 INVESTMENTS, LLC
Ronruss Partners, Ltd., a Florida Limited Partnership
2200 Biscayne Boulevard
Miami, Florida 33137
Managing Member
RONRUSS PARTNERS, LTD.
Ronruss Corporation, as General Partner
2200 Biscayne Boulevard
Miami, Florida 33137
Russell Galbut, as a Limited Partner
2200 Biscayne Boulevard
Miami, Florida 33137
Ronalee Galbut, as a Limited Partner
2200 Biscayne Boulevard
Miami, Florida 33137
Jenna Beth Galbut, as a Limited Partner
2200 Biscayne Boulevard
Miami, Florida 33137
[CONTINUED TO NEXT PAGE)
Page 1 of 2
18%
30
10%
10%
100
1%
43.72
43.72
5.65
Marisa Ann Galbut, as a Limited Partner
2200 Biscayne Boulevard
Miami, Florida 33137
RONRUSS CORPORATION
Russell W. Galbut, as a Director, President and Shareholder
2200 Biscayne Boulevard
Miami, Florida 33137
Ronalee Galbut, as a Shareholder
2200 Biscayne Boulevard
Miami, Florida 33137
Abraham A. Galbut, as a Shareholder
4770 Biscayne Blvd., Suite 1400
Miami, Florida 33137
MJK GROUP, LLC
Keith Menin
2200 Biscayne Boulevard
Miami, Florida 33137
Manager
Jenny Beth Galbut
2200 Biscayne~Boulevard
Miami, Florida 33137
Member
Marisa Ann Galbut
2200 Biscayne Boulevard
Miami, Florida 33137
Member
5.91
49.5
49.5
1%
33.33
33.33
33.34
Page 2 of 2
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
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: `J ~Mc' S ~g-K t~
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-DADS 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, 1 AM REQUIRED TO IMMEDIATELY NOTIFY THE CITY
CLERK'S OFFICE OF LOBBYIST WITHDRAWAL IN WRITING.
Sig
Date: