Russell W. Galbut - 1747 Bay Road Properties, LLC miAmi EA
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33130
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.I.)
2200 Biscayne Boulevard Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 374 -5700 (305) 847 -3354 rgaibut@crescentheights.cam
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I LOBBYIST RETAINED BY:
1747 Bay Road Properties, LLC
NAME OF PRINCIPAL/CLIENT:
1747 Ba Road Pro • dies LLC 2200 Bisca ne Blvd. Miami FL 33137
BUSINESS NAME AND ADDRESS
(Number and Street) (City) (State) ,(Zip Coded
(305) 573 -4127 (305) 573 -8489 mkramer(c cxescentheights.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Russell W, • Gaibut, as President
of Ronruss Corporation, General Partner of of Ronruss Partners, LTD., Managing Member of
1747 investments, LLC Managing Member of 1747 Bay Road 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. e•3
,rya✓
II. SPECIFIC LOBBY ISSUE: n
0
Any and all issues m
Issue to be lobbied (Describe in detail):
cn
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III.
CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(grincluars a
statement of the extent of any business, financial, familial, professional or other relationship, giving Mse n
appearance of an impropriety, with any City personnel sought to be lobbied further, pursuant to City Code:Secti- • -
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months pre 2iin9 the
commencement of service' of City personnel' to be lobbied.)
A) Full Nelms of IndiividuallTitle B) Any Financial, Familial or Professional Relationship
City of Miami; Beach Board of Adjustment 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)
r
LOBBYIST DISCLOSURE. (Required Q $0, No additional compensation: for lobbying. ;
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
Required). 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*:
1 0 1 1 1, ° • ..;., ,C= .: SR. i• • • 1 • ° 1 • L- 11 °< °d.- 1 °1.1) °. • • °. ' s0.a ° •_1 . ° . °ails 1 • 1 cL i •, •
.Cent 4 °1 '.Poinaaward for tt , equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues':
a . ° • : • • • ° • NI : : • • . e .
�' -..: .11.4 �. • • :° :: • A" * `, € 1: - .a 1 __ 1 • : • • .. . __ .: .l� 1.__.i, d : ... 1� �a .lEs 1 . �. 1- A:I11..-. it ,A.00. ..: �1 - .. . 4
aopiication for change of zoning mao designation of charge to the C1tv's Future Larjd Uge Mao?
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 a h n,'whether direct, or
indirect, to express .support of or opposition to any item, shall register with e cleric, as required by this
section but, shall not be required to pay any registration fees..
fly's ill NQ: Are you representing a not -for pro +core!
fib eregon or edgy without special compensation or
rejrnburstnient.
V... SIGNATURE UNDER OATH:
ON OCTOBER 1 } k O E L B
_ �► ! QYis" Br4 �T X THE erry ;ARK SINEt
OTATENI T YNDgR OATH. LISTING LQBBYINQ AXPEO�?i R S • As W J ,A 9CIPAPPISATIQN
RECEIVE p. IN THE CITY Oi:
- , MI BEACH FOR TRH PRIrCEDIIict c AMIDAR YEAR. A STATEMENT SHALL
BE PI ED EVEN IF THERE HAVE • BEEN NO EXPENDITURE? QR CO PENSA p1 O,T E REPORTING
PJOQ• /
Signs re of L °.° • Ist—
9 y us ell W. Galbut
I do solemnly swear that all of the foregoing facts are true and correct a - t I ave read or. am familiar with the
provisions: contained in Section 2 f.
482 Of the Miami . -f_ % . - ,i, ,...• - sl , ments:
Signature of Lobbyist: �
/
Signature of Principal/Client : �
Russell W Galbut, on • f of 1747 Bay Rd. Properties,. . L(.0
VI LOBBYIST IDENTIFICATION, PRINCIPAL IDENTIFICATION:
Er Produced ID aL113--1 q'ca - 3 8v -U C'J Produced ID el q 13--/ 3`1- --.3 &Q -- a
Form of. Identification Form of Identification
0 P , = • rally known (Lobbyist) 0 Personally known (Principal)
VI . NATURE AND STAMP OF NOTARY:
i
of F - rida, County of Miami-Dade 1 Sta • ' bride County of Miami- Dade
Th A d sub before me Sw ° and s ubsc r ibed R ° me / '
of 2O1 Thi day � i3 e p Notary Public Mate DD829 Florida / , + , - - r3ama M Amnia ww _ � A'�"r`. 'n°� * My Commissign 866
g !of Public Not '" °i' Aranda of Florida s tate '7 e of Public: Notary — S . - , - , '' Expires 1010912012
No > n , o 74 ° . Es Commission DD829866 N . -- rization.of Principal's a " t . , .
aF a Expires 10/09/2012
• a P4 T 11:, : Y TY • RK'S USE ONLY
Annual.
Rv loon ► $ ;+irs j) No Amount Pith _ `►.�%s e -- 5 , 7 -- 5 , 7P - Cr" R '�T" Dab, Peii+d '! / i �.�b.:•►
Loft lgIstration Form r d and varlt�d;by; ..R7/171er!!ir_ .
F:1CLERR.QBBY{STIobbykt. i$tration Form 32708.4 • Revised WTI
BE H
IAMI AC
City of Miami Bosch, 1700 Convention Center Drive, Miami Beach, Florida 33139,
CITY CLERK office arekliSiaMillailitadtgo
Tel: 805.673.7411, Fax. 305.6 .7254
Russell W Galbut
. L BYIST NAME:
u derstand that no later than tQctober 1 of each year, I must fibs the following forms, pursuant to Section 2-485 of
th Miarrii Beach City Cole, vwith the City Clerk's Office for all active lobbying Issues.
1) Lobbyist Expenditure Foi'n
2) Disclosure Form
.Failure to file these forms on a timely basis will result in my name being tranareftted to the Miami -Dade • County
Commission on Ethics and for code violation evaluation.
In 'addition, once an I ue I have registered to lobby on has been resolved, I am required to immediately notify the
City Clerk's •; c e for 'b p ,1st ithdrawal in writing.
, 1 t
Al / 2 lir
51' ' r M _ ii r Ibut Date:
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