Allan Shulman - Santa Barbara 230, LLC 230 Zt)�
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
2015 y12 pii=; 4: 20
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage thel_passa,ge;1defeat[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.
Shulman Allan
NAME OF LOBBYIST: (Last) (First) (M.I)
Shulman and Associates 100 NE 38th Street, Space 2, Miami Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)438-0609 (305)438-0170 Allan(a)shulman-design.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Santa Barbara 230, LLC
NAME OF PRINCIPAUCLIENT:
Santa Barbara 230, LLC c/o Trans Inns Management 150 Davie Blvd., Suite 401, Ft. Lauderdale, FL 33316
BUSINESS NAME AND ADDRESS (Number and Street) (City)' (State) (Zip Code)
(561)287-5400 james.vosota@voshospitality.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: See Attached disclosure
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
ii.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues, including, but not limited to the Historic Preservation Board, Planning Board,
Board of Adjustment, Land Use Development Committee, and City Commission, if necessary, relating to the property located at
230 20th Street, Miami Beach, FL.
Issue to be lobbied(Describe in detail):
lll. 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 general nature of the subject contractual relationship.
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Department and Building Department Staff None
PB, HPB, BOA, City Commission, as necessary* None
Pursuant to City Code Section 2-482(g)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 2-482(g)Any Financial, Familial or Professional Relationship
/1
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•
IV. - DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)$
B) PRINCIPAL'S�]IC�SURE(OF LOBBYIST COMPENSATION):
(Required). II,,)�
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 -X No: Are you lobbvina on a present or pendina bid for aoods.eauipment or services.or on a present or pending
award for aoods.eauipment or service?
.2) Pursuant.to.Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
- Yes X No: Are you Iobbvina"on a pendina application for a Development Aareement with the City or application for
chanae of zonina map desianation or chanae 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.
Yes:X -No: Are•you representina.a not-for-profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th 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
:MR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
,..; EXPENDITURES OR COMPENSATION DURING THE RE RTING PERIOD,
---- - - - --- - ---- - - Signa re of Lobbyist
- :.I.do solemnly swear that all of the foregoing facts are.true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beak.. City Code and all reporting requirements.
_ Signature of Lobbyist: � � • A— —.4 I
ice.
Signature of Principal/Client: _ �1ii. ••ry
VI. LOBBYIST IDENTIFI PRINCIPAL IDENTIFICATION:
• a c,
Produced.ID """ Produced ID
Form of Identification 4 n g t Form of Identification
sonally known(l. bbyist) V 4 o. Personally known(Principal)VIr/��/I
SIGNATURE AND STAMP OF NOTARY: 3. 9 H • Q N■
4 ° x " CO d
State of Florida,County of Miami-Dade V N State of Florida, County of Miami-Dade
Sworn to an• subscribed before me -;; Sworn and subscribed before me
This f-4f ••► ►lys�;�, ,2' 4 N S o x This `"( day of
A N 4(' '
a) o i MY COMMISSION#EE8606Gi
Signature of Public Notary—Sta of Florida ature of . ublic Note - -1 I°NOIRES December 26,20;6
Notarization of Lobbyist's signature otarization of- r',
FtoNaeNotary8enIre coin
TO BE COMPLETED)3Y CIbY CLERK'S STAFF ONLY I [�
Annual Registration fee: [ ]Yes[ o Amount Paid$ 7 5b1 0vv MCR# L(0�'I 12.54 Date Paid S/I Zl i.7
Lobbyist Registration Form receive and verified by:
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M1AMBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Allan Shulman
-1_.understand that no.later than February 28th of each year, 1 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..1 have registered to lobby on has been resolved, 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
•provide.d 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-Dade County Commission on Ethics and Public Trust.
,A
0570$72-0/3�
Signa re: Date:
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CITY OF MIAMI BEACH
DEVELOPMENT. APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of the application is owned or leased by a CORPORATION, list the principal
stockholders and the percentage of stock owned by each. Where the principal officers or stockholders consist of
another corporation(s), trustee(s), partnership(s) or other similar entity, further disclosure shall be required which
discloses the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity).*
Santa Barbara 230, LLC
C/O Trans Inss Management, Inc.
150 Davie Blvd. Ste 401., Fort Lauderdale, FL 33316
NAME, ADDRESS,AND OFFICE %OF STOCK
SB 230 Hospitality, LLC Member 50%
Spectrum Building I
4901 NW 17th Way, Suite 503
Fort Lauderdale, FL 33309
BBM3II, LLC, Managing Member 50%
2900 McKinnon St., Apt#1101
Dallas, TX 75201
SB 230 Hospitality, LLC
4901 NW 17th Way, Suite 503, Fort Lauderdale, FL 33309
NAME,ADDRESS,AND OFFICE %OF STOCK
James D. Vosotas, Managing Member 50%
Spectrum Building r
4 901 NW 17th Way, Suite 503
Fort Lauderdale, FL 33309
Dan Vosotas, Member 50%
Spectrum Building I
4901 NW 17m Wan, Suite 503
Fort Lauderdale, FL 33309
BBM3 II, LLC
2900 McKinnon St., Apt#1101, Dallas, TX 75201
CORPORATION NAME and ADDRESS
NAME,ADDRESS, AND OFFICE %OF STOCK
Branden Muhl, Managing Member 33.3%
235 West 48th Street.,Apt. 37C
New York, NY 100036
Blaine B. Muhl, Member 33.3%
2402 West 114th Street
Leawood, KS 66211
Britain B. Muhl, Member 33.3%
2402 West 114th Street
Leawood, KS 66211
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS,INCLUDING CORP. NAME(S)AND EACH INDIVIDUAL'S
NAME,ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE,
NOTE:Notarized signature required on page 8
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