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James Rauh - Garden of Eden RestaurantvA~e~/ em~ ,~I sr" m MIAMIBEACH ~ 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. Rauh James E. NAME OF LOBBYIST: (Last) (First) (M.L) Go 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: I. LOBBYIST RETAINED BY: `° Garden of Eden Restaurant, LLC i NAME OF PRINCIPAL/CLIENT: .. Garden of Eden Restaurant, LLC. - ....210,23~d Street Miami Beach FL 33139 BUSINESS NAME AND ADDRES$r: ~y ..,(Number and Street) (City) (State) (Zip Code) (305) 397-8760 ` ' ~''' " '^~ (305p 397-8736 Lawrencerizzo mail.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) out this section if principal is a Corporation;. Partnership or Trust • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Lawrence Rizzo • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached Disclosures of_Interest. II. SPECIFIC LOBBY ISSUE: Variance to extend the hours of operation for an outdoor bar counter past S:OOpm Issue to be lobbied (Describe in defail): ' III. CITY AGENCIES/INDIVIDUALS TO°~BE LOBBIED: (Pursuant to City Code Section 2-482(g) include a K..... , statement of the extent of-any business; financial, familial, professional or other relationship, giving rise to an' appearance of an impropriety, with. any City:pe~sonnel 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 IndividuaUTitle B) An Financial, Familial or Professional Relationship City of Miami Beach Board of Adjustment None -j ;~; t ~ (~ ~ 4 ~ ~,~ ~ -r ,-I E 1~ ~ ` City of Miami Beach Planning Staff None , f l City of Miami Beach Mayor/Commissioners ~,: City of Miami Beach Committees None N gQ .~ ~~ Z ~~~ Q~(~Z one . 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": ^Yes ~ No: Are you lobbving on a present or pending bid for goods, eauipment 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": QYes~ No: Are you lobbvina 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.. QYes ®No: Are you representing snot-for-profit corporation or entity 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 -James Rauh I do solemnly swear that all of the, foregoing facts are true and c~ct and that I have read or am familiar with the provisions contained in Section 2-482 gf~W~iami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: L ence Rizzo, Managing VI. LOBBYIST IDENTIFICATION: ^ Produced ID N Form of Identification S ~ ~' '~ Personally known (Lobbyist) W VII. SIGNATURE AND STAMP OF NOTARY: d ~ ~ W State of Florida, County of Miami-Dade Sworn ed before me * ~ ~ ~ s o ay of to , 2010 a ~ ~N ~~ a ign re o blic Notary - Stat of Florida _. .- ber, Eden Restaurant, LLC PRINCIPAL IDENTIFICATION: Produced ID ~M r %L ~~?j~~ Cp2 Form of Identification ^ Personally known (Principal) ~+a, BRAD STE ' ~~ SS70N DDS16 ~T 'M0'~'rrn'ner N. A"8~2t 2012 State of Florida, County of Miami-Dade "0~'D~+m,y„0.~ Swor to and su ri efore me This~day f , 2 10 Signa ure of Public Notary -State of Florida Notarization of Principal's signature TO BE PLETED BY CITY CLERK'S USE ONLY ual Registration fee: [ Yes [ ] No Am nt Pald $ ~ M R # $ byist Registration Fonn received and verified by: LER\LOBBYISlILobbvist Registration Form 32708.doc w a'Ln . O _~ EXHIBIT "B" DISCLOSURE OF INTERETS NAME AND ADDRESS % OF INTERST GARDEN OF EDEN RESTAURANT. LLC Lawrence Rizzo 25% 5959 Collins Avenue # 1108 Miami Beach, Florida 33140 Kelly Jones 25% 100660 Lago Cantini Street Las Vegas, Nevada 89141 Charles Schafer 25% 4765 Rushford Place Colorado Springs, Colorado 80923 . Christopher Lee 25% 206 Front Street Brooklyn, New York 11210 m 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@m iamibeachfl.gov Acknowledgement of fines/suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: James E. Rauh, Esq. I understand that no later than ,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. Signature: j jt~~ Z~-ro Date: