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James E. Rauh - 1701 Collins (Miami) Owner, LLC o MIAMI BEACH I ,3 City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 V 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 board 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.1) Terminello&Terminello, P.A.,1111 Lincoln Road,Suite 400,Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786)276-2343 (305)448-5566 jrauh @terminello.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact Information changes:address,phone, or e-mail address. 1. LOBBYIST RETAINED BY: 1701 Collins(Miami)Owner LLC NAME OF PRINCIPAUCLIENT: SLS South Beach 8000 Beverly Boulevard Los Angeles CA 90048. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (323)525-2425 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: Sam Nazarian, Managing Member,SBE Entertainment Group LLC • 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: Progress Report and related proceedings regarding Conditional Use Permit issued under PB File No.2051 and code violations relating to the property located at 1701 Collins Avenue. Issue to be lobbied(Describe in detail): III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)Include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said,city commissioner or personnel from 12 months preceding such person's commencement of service with the.cIty to the present date stating the aeneral:nature of the sub ect.contractual relationship. Sec 2-482(a)(4)Full Name of.lndividual and Contractual Relationship(Explain) YES NO title of person to be lobbied Planning Board X Planning Director and Planning Staff X City Manager,Mayor and City Commissioners X Pursuant to City Code Section 2-482(8)Every registrant shall be required to state the extent of any business,financial,familial or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied as Identified on the lobbyist registration form filed. Sec 2482 An Flnancial,Familial or Professional Relationship C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGODDH\Lobbyist Registration Formrevised 5-30-2012.doc �i' IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $375.00 per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $375.00 per hour (REQUIRED). The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-188 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes X_No: Are You lobbying on'a present or nendina bid for goods equipment or services or a present or pending award for goods,equipment or service? 2) Pursuant to Miami Beach City Code Section 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes X 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 City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2.182(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. Yes X No' Are you representing a not for profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 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 STAT ENT SHALL BE FILED EVEN E HAVE BEEN NO EXPENDITURES COMPENSATION DURING THE REPORTING PERIOD. e Lobbyist I do solemnly swear that all of the foregoing facts are true correct and�thatl have read or am familiar with the provisions contained in Section 2-482 oft is 'Beach 'ty Code and all reporting requirements. Signature of Lobbyist: Sigh ture of Principal nt: o N Q for 17 ollins M' i) er, LL ;,�i:�;• °:s LL N WI.; LOBBYIST IDENTIF ION: PAL IDENTIFICATION: - �O P� ° Q - 0 61 G � 0; o Produced ID Produced ID__ _ �;�,' �;,• Col Form of Identification Form of Identification o 3 co nci z CJ a E 'E Z Personally known(Lobbyist) Personally known(Principal) 3 � E E -3 v D C N C C1 SIGNATURE AND STAMP OF NOTARY: o e ! eD ch r St a of Florida,County of Miami-Dade State of Florida,County of Miami-Dade d ,,, „ a r- =e0�;� r o�nd subscribe befo me Sworn d ubscribe before me m o g a f � 3 This day 20 g A. r, = ° • •' t a� o i ature ub otar State of lorida Signature of u c tary—S to of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ D MCR# Date Paid L Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Conte nt.Outlook\83LG ODD H\Lobbyist Registration Formrevised 5-30-2012.doc i r F:\CLEI listration Form.doc Revised 04/17/2022 V LA i � r dB CH City of Miami Reach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 ,Fax:305.673.7254 James E. Rauh,Esq. LOBBYIST NAME: I understand that no later than February 28 of each year, I must file the following form, 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 AND COMPENSATION 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 addition, once an issue I have registered to lobby on has been resolved, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist(or principal)who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami- de County Commission on Ethics and Public Trust. 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