Rafael E. Andrade - South Beach Heights I, LLC co _bead
M I AM I BEACH ooe Area. 0'4
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 3313?ro= 2 P rtE 1; 0
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.
Andrade Rafael E.
NAME OF LOBBYIST: (Last) (First) (M.I)
Law Offices of Rafael E. Andrade,P.A., 1224 Washington Avenue, Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 216-2028 ralph @randradelaw.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, ore-mail address.
I. LOBBYIST RETAINED BY:
South Beach Heights I, LLC
NAME OF PRINCIPAL/CLIENT:
South Beach Heights I, LLC 2200 Biscayne Blvd Miami FL 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:Marissa Galbut, President
• 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:
.nified-Development_Sites_and-Distribution of Fhr Area-Ordinance .�g V C
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
Mayor&City Commission,City Manager's Office,City X
Attorney's Office,all City Staff,&all City Boards&Committees 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
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
1
W. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) r t.I n 2.-2 F r 1: 0 I
Flat Fee /No3 AI\ t-� f"le
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): , i - ;,:: ,1__-..
(REQUIRED).
Flat Fee ! .1L 1'.,`; - '
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 lobbying on a present or pending bid for goods,equipment or services,or on a present or pending
award for goods,equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 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 2-482(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.
YesXNo: 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 STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
,,, --_-----------------CP
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and _•rrect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code a • . so g requirements.
}''Signature of Lobbyist: V
Signature of Principal/Client: . /I, IN
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID—
Form of Identification Form of Identification
/Personally known(Lobbyist) Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County o•: ,tIP 10•. •.`� • State of Florida co .•t •f■ i i- a
am •, DAYAMI AGUTAR e t■
Savor • d subscrib-• f•) I ;Savor nd su• cn T'n•
�' �b •State of Florida ,' 1 :-. ` e AYE- ir
T ' day o 4;1: A..- ommis�ion FF 196144 'this , d� ,o -
, ub S Florida
1F�! - '�!� �` 1 CommISalon i FF 196144
// � ),, -.1: f My Comm.Expires Mar 16,2019 `1 /,./emu. "%,7-';'"":''''''-_-‘1741:--,- $ •
Sig atur of Publi• throughNatlonalNbta'yAssn• 1 Si nature"of Public/No °� ' , Expires Mar 16,2019
-S�t�'t3 FI•.��"..� �f��•�:` NeTlonal Notary Assn.
Notariz ion of Lobbyist s ig�atTre— —TT — '' Notarization of Princi•c am* {-i _
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ Yes[ ]No Amount Pai $ ?) CR# .0 t Date Paid 3/.230A6
Lobbyist Registration Form received and verified by: 11.1.4-( A
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
AA I AM .1
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.go^vr f II "
CITY CLERK Office ? ►4
Rafael E. Granado, City Clerk CityClerk @miamibeachfl:gov,a,
Tel: 305.673.7411 ,Fax:305.673.7254 t,1.6''' `
LOBBYIST NAME: /e4t-g
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 of each year, 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.
Sig;ure: )/20//
ate:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
44 t- `1
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SUPPLEMENTARY DISCLOSURE OF INTEREST
Interests in South Beach Heights I, LLC
Percentage of Interest
KGM Equities, LLC 100%
2200 Biscayne Blvd.
Miami FL 33137
Interests in 500 Alton Road Ventures, LLC
Percentage of Interest
KGM Equities, LLC 100%
2200 Biscayne Blvd.
•
Miami FL 33137
Interests in 1220 Sixth, LLC
Percentage of Interest
KGM Equities, LLC 100%
2200 Biscayne Blvd.
Miami FL 33137
Interests in KGM Equities,LLC
Percentage of Interest
Sonny Kahn 2004 Irrevocable Trust 37%
2200 Biscayne Blvd.
Miami FL 33137
Russell W. Galbut 2004 Irrevocable Trust 37%
2200 Biscayne Blvd.
Miami FL 33137
Bruce A. Menin 2004 Irrevocable Trust 26%
2200 Biscayne Blvd.
Miami FL 33137
•
_
l: C...1 4. ........::::,,,.
�. ;ICY.' fC -
• - . - _•:1nterests in Sonny Kahn2004 Irrevocable Trust' •
•‘:-'.;.:i•-.....:',.
g._-:: �:
Percentage:of.Interest ,
Sonny Kahn •, - 100%a.. ;
2200 Biscayne
0 scayne Blvd. :_
: 33137 .:r
Miami FL - .
•
•
Interests in Russell W.Galbut 2004 Irrevocable•Trust` ='
•
•,r ''.'> Percentage of interest
Russell W. Galbut _ .. _ ,.: .
100%h
2200 Biscayne Blvd. _ r
•
Miami FL 33137
Interests in Bruce A. Menin-2004 Irrevocable Trust .h:,_ •. •
•
•
•` r Percentage:of.Interest: 1 •-
Bruce Menin ' . 1 • •• .,j, 00% =� 3
2200 Biscayne Bivd.
;z.
Miami
mi FL 33137
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Salvatore, Jason
From: Rafael E.Andrade, Esq. <ralph @randradelaw.com>
Sent: Friday, August 19, 2016 4:00 PM
To: Salvatore, Jason
Subject: RE: City of Miami Beach Update of Lobbyist Registration Information
See responses below in RED.
Regards,
Ralph
Rafael E. Andrade, Esquire
Law Offices of Rafael E.Andrade, P.A.
1224 Washington Avenue
Miami Beach, Florida 33139
T 305.531.9511
F 305.673.5734
C 305.216.2028
ralph @randradelaw.com
www.randradelaw.com
NOTICE: This e-mail is from a law firm, Law Offices of Rafael E. Andrade, P.A. ("Firm"), and is intended solely for the use of the
individual(s) to whom it is addressed. If you believe you received this e-mail in error, please notify the sender immediately, delete
the e-mail from your computer and do not copy or disclose it to anyone else. If you are not an existing client of the Firm, do not
construe anything in this e-mail to make you a client unless it contains a specific statement to that effect and do not disclose
anything to the Firm in reply that you expect it to hold in confidence. If you properly received this e-mail as a client, co-counsel or
retained expert of the Firm, you should maintain its contents in confidence in order to preserve the attorney-client or work product
privilege that may be available to protect confidentiality.
From: Salvatore, Jason [mailto:JasonSalvatore @miamibeachfl.gov]
Sent: Friday, August 19, 2016 1:56 PM
To: 'Rafael E. Andrade, Esq.'
Subject: RE: City of Miami Beach Update of Lobbyist Registration Information
Hi Ralph,
I also need the following two for the Consulting business:
1. Potential ATM Procurement
Principal:Communitel, Inc. —Compensation:$1,000 per month
2. City's Green Waste Facility
Principal:Southern Waste Systems, LLC—Compensation:$2,500 per month
Thank you,
1
M! AMI E iC
Jason Salvatore - Office Associate I/l
Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Tel: 305-673-7411 www.miamibeachfl.gov
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,
historic community.
From: Rafael E. Andrade, Esq. [mailto:ralph @randradelaw.com]
Sent: Friday, August 19, 2016 12:51 PM
To: Salvatore, Jason
Subject: RE: City of Miami Beach Update of Lobbyist Registration Information
Jason:
Please receive the following information in response to your letter dated July 29, 2016:
Issues:
1. Design-Builder Services, Renovation and Expansion; MBCC RFP No. 2014-294-ME
Principal: Clark Construction Group, LLC—Compensation: $2,000 per month payable through Llorente &
Heckler, P.A.
2. Unified Development Sites and Distribution of Floor Area Ordinance; City Wide
Principal: th Beach Heights I, LLC—Compensation: $10,000 flat fee
If you have any questions or require additional information, please do not hesitate to contact me.
Thank you.
Regards,
Ralph
Rafael E. Andrade, Esquire
Law Offices of Rafael E. Andrade, P.A.
1224 Washington Avenue
Miami Beach, Florida 33139
T 305.531.9511
F 305.673.5734
C 305.216.2028
ralph @randradelaw.com
www.randradelaw.com
NOTICE: This e-mail is from a law firm, Law Offices of Rafael E. Andrade, P.A. ("Firm"), and is intended solely for the use of the
individual(s) to whom it is addressed. If you believe you received this e-mail in error, please notify the sender immediately, delete
the e-mail from your computer and do not copy or disclose it to anyone else. If you are not an existing client of the Firm, do not
construe anything in this e-mail to make you a client unless it contains a specific statement to that effect and do not disclose
2