JJ Wood - 1747 Bay Road Properties, LLC iii--ii o.--I V%OC
MIAMIBEACH 0
City of Miami Beach Office of the City Clerk ,
1700 Convention Center Drive, Miami Beach, FL 33139
20i NAY 12 P 2: 54
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not by a principal who seeks to encourages thei.passage, defeatLor-
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.
Wood JJ
NAME OF LOBBYIST: (Last) (First) (M.I)
Urban Robot Associates 420 Lincoln Road, #406 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
786-246-4857 ii( urbanrobot.net
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Russell Galbut
1NAME OF PRINCIPAUCLIENT:
1747 Bay Road Properties, LLC c/o Crescent Heights 2200 Biscayne Blvd. Miami Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-374-5700
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:q.C(htl2d-E.
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: 5(( a e 4
II.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues including, but not limited to the Historic Preservation Board, Design Review
Board,, Planning Board,—Board of Adjustment, Land Use Development.-Committee,_C_ity__Comm.ission, and any City Workshops or
committees, if necessaru. relatina to the propertu located at 1747 Bau_Road, Miami Beach Florida.__T!
Issue to be lobbied(Describe in detail):
Ill. 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
Staff for the Planning Department, Building Department, None. X
Public Works and City administration, PB, HPB, BOA, None. X
City Commission, and Mayor as necessary None. X
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
None.
None_
None_ by
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Formrevised 5-30-2012.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$10bper hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): Oner hour
(REQUIRED).
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 XNo: Are you lobbying on a present or pending bid for goods.eauipment or services.or on a°resent or°ending
award for goods.eauipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: Are you lobbying on a pending application for a Develooment Agreement with the City or application for
change of zoning mao designation or change to the City's Future Land Use Mao?
3) Pursuant to Miami Beach City Code Section 2-482(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 aC No,: Are you reoresenting 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
EQB THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING P • •
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Signature of Lobbyist
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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 Beach City e -n' :II reporting requirements.
Signature of Lobbyist: /for /•2mil
Signature of Principal/Client: % f le"bia
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VI. LOBBYIST IDENTIFIC'TION: PRINCIPAL IDENTIFICATION: 4•
Produced ID Produced ID 0 d a
Form of Identification Form of ldentificatio g 3.3 7
/Personally known(Lobbyist) Personally known(Principal)
O O Q
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VII. SIGNATURE AND STA
43",' DAVAMI AGUTAR m
State of Florida, $ N PUDHc-State of Florida St- - of Fl,rid County of Miami-Dade
County of Miami i_,f�-,�1 0 y
Commission#FF 196144
Swor o a d subscrib bef �re mes, �.�� S a • su scrib ,d a me
99 --<�� .� My Conlin.Expires Mar 10.2019 Th ] > da of ui" \ 2016
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Sign ture of Public '•tary—State of Florida Signature of P +Tic Notary—State of Florida
Notarizat :n of Lobbyist's signature Notarization of • *1 ', ' signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY i
Annual Registration fee: [ ])Yes[ ]No Amount Paid$ e650 •W MCR# Date Paid COS-13-1b
Lobbyist Registration Form received and verified by: 3O!■
M I AM I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME JJWood
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-Dade County Commission on Ethics and.Public Trust.
, .4141.
Jp• . ot-t '')/C • %Al
Signatur-': Date:
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SUPPLEMENTARY DISCLOSURE OF INTEREST
Interests in 1747 Bay Road Properties, LLC.
Percentage of Interest
1747 Investments, LLC. 32%
2200 Biscayne Blvd.
Miami FL 33137
Sharon Mirmelli 30%
2200 Biscayne Blvd.
Miami FL 33137
MJK Group, LLC. 18%
2200 Biscayne Blvd.
Miami FL 33137
Philip Mirmelli 10%
2200 Biscayne Blvd.
Miami FL 33137
Sean Mirmelli 10%
2200 Biscayne Blvd.
Miami FL 33137
interests in 1747 Investments, LLC.
Percentage of Interest
Ronruss Partners, Ltd. 100%
2200 Biscayne Blvd.
Miami FL 33137
Interests in Ronruss Partners, Ltd.
Percentage of Interest
Ronruss Corporation 1
2200 Biscayne Blvd.
Miami FL 33137
Russell Galbut 44.1%
2200 Biscayne Blvd.
Miami FL 33137
Ronalee Galbut 44.1%
2200 Biscayne Blvd.
Miami FL 33137
Marisa Galbut 5.52%
2200 Biscayne Blvd.
Miami FL 33137
Jenna Galbut 5.52%
2200 Biscayne Blvd.
Miami FL 33137
Interests in Ronruss Corporation
Percentage of_Interest
Russell Galbut 49.5%
2200 Biscayne Blvd.
Miami FL 33137
Ronalee Galbut 49.5%
2200 Biscayne Blvd.
Miami FL 33137
Abraham and Nancy Galbut 1%
2200 Biscayne Blvd.
Miami FL 33137
Interests in MJK Group, LLC.
Percentage of Interest
Keith Menin 33.33%
2200 Biscayne Blvd.
Miami FL 33137
Marisa Galbut 3333%
2200 Biscayne Blvd.
Miami FL 33137
Jared Galbut 33.33%
2200 Biscayne Blvd.
Miami FL 33137
. . . . .
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