Sebastian Velez - 955 Washington Owner, LLC AA Ami BEAc H qt-fi wri4_,",to Ave
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City of Miami Beach Office of the City Clerk ,
1700 Convention Center Drive, Miami Beach, FL 33139 L70 +r,iAF r8 �i i 9; 55
LOBBYIST REGISTRATION FORM
st
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.
•
Velez Sebastian
NAME OF LOBBYIST: (Last) (First) (M.I)
Urban Robot Associates 420 Lincoln Road, #600 Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
786-246-4857 sebastian(Zjirbanrobot.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
NAME OF PRINCIPAUCLIENT:
955 Washington Owner, 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: Russell Galbut
• 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:
Development-Approvals and-Permitting-Issue including, but not limited to the Historic Preservation Board, Design Review
Board, Planning Board, Board of Adjustment, Land Use Development Committee, City Commission, and any City Workshops or
Committees, if necessaru, relating to the pronertu located at 1947 Washington A venue, 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.
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$riper hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $( aper 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 oendina bid for goods.eauioment or services.or on a oresent 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 XNo: Are you lobbying on a pending aoplication for a Develooment Agreement with the City or aoplication 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 X No: Are you representing a not-for-orofit corooration 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 ILED V N IF THERE HAVE BEEN NO
EXPENDITURES OR COMPE► • • ■ • : ► . : •: 4 :[H:d-._.:-.=
Signature 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 Co , : ;1"E't ' :-._ il ∎,-, d- • .- eporting requirements.
Signature of Lobbyist: -/ if
r _ ,A�
Signature of Principal/Client: �,, oA
Y
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: �o��o `gym
Produced ID Produced ID �. cu
Form of Identification , Form of Identification
/ S B.??T
'' Personally known(Lobbyist) LPersonally known(Principal) g N o
VII. SIGNATURE AND STAMP OF NOTARY: 8 s
T
C
: a
State of Florida, County of Mia ,u g e ®AYAMI AGUTAR ' /State of Florida, County of Miami-Dade nl
Sworn to d subscribe; b4ft,.*7:r Pln�•State of Florida ( E�Sworn d subscri d befp rre me
T i 4 day •f A-,_• 1':- Commis�n•FF 196144 /; This � . day of � o ,2016
r ', 'I
cool fel 'ilti:1-14., . MP Witt Wires Mar 16,2019,L ,,,,e
Sig atur of Public�,tary- a •= Sigpat re of Public Notary-State 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$ 'S°a at) MCR# IR U 1 In Date Paid 0 a-Otr' I b
Lobbyist Registration Form ceived and verified by: NO vt /
M I AM I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeach8.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673 7254
LOBBYIST NAME Sebastian Velez
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
appe. ,-d to the Miami-Dade County Commission on Ethics and Public Trust.
/OW ti‘
%ter` `
Sign re: Date:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
SUPPLEMENTARY DISCLOSURE OF INTEREST
Interests in Estis, LLC
Percentage of Interest
Ester Percal 50%
6330 Pinetree Drive
Miami Beach, FL 33141
Howard Galbut 12.5%
2200 Biscayne Blvd.
Miami FL 33137
Russell Galbut 15.63%
2200 Biscayne Blvd.
Miami FL 33137
Abraham and Nancy Galbut 15.63%
2200 Biscayne Blvd.
Miami FL 33137
David Galbut 3.13%
2200 Biscayne Blvd.
Miami FL 33137
Robert Galbut 3.13%
2200 Biscayne Blvd.
Miami FL 33137
Interests in 955 Washington Ownership, 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 o
44.1/0
2200 Biscayne Blvd.
Miami FL 33137
Ronalee Galbut o
44.1/o
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
.
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