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James Rauh/Mama Vieja m ..... MIAMI BEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRA nON 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, NAME OF LOBBYIST: (Last) JAMES (First) E. (M.!) Rosen Switkes & Entin P.L. 407 Lincoln Road PH SEe Miami Beach. FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 534-4757 TELEPHONE NUMBER: ( 305) 538-5~j04 FAX NUMBER: irauh@rosenandswitkes.com EMAIL: I. LOBBYIST RETAINED BY: Mama Vieja LLC NAME OF PRINCIPAL/CLIENT: 1691 Michigan Avenue, Suite 325, Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 695-0288 TELEPHONE NUMBER: (305) 695-0284 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: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Application for Conditional Use Permit Issue to be lobbied (Describe in detail): 1.. 5 C; ;)"$ f\. 9 SN ~'1-- III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Planning Board No IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $250.00 hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 2 50 . 00 hour 1 y 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": D Yes ~ Are YOU lobbyina on a oresent or oendina bid for aoods. eauioment or services. or on a oresent or oendina award for aoods. eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes ~ Are YOU lobbyina on a oendina aoolication for a Develooment Aareement with the City or aoolication for chanae of zonina mao desianation or chanae to the City's Future Land Use Mao? 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.. D Yes [J.~ Are YOU reoresentina a not-for-orofit corooration or entity without soecial comoensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURE S RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE P EC E SHALL BE FILED EVEN IF THERE HAVE BEEN NO EX U REPORTING PERIOD. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: D Produced ID [l Produced ID Form of Identification Form of Identification .'j,ersonaIlY known (Lobbyist) '-4rsonally known (Principal) 1l; ConnieSGheM ~~ · · Myc-..I.I~DO..l VII. SIGNATURE AND STAMP~_~AO:lnstanza Toth \;..~ ExpIreeAupt27.2IlIlII g :~'~:. Commission #DD287204 State of Florida, Coun of Miami-D~~ ~,;l Expires: Feb 03,5!Mof Florida, County of Miami-Dade Sw rn ~n subscr' before me "'-:~~lt~:. !3onded.Thrusworl'\~nd subscribed before me ;, 00 0 , 20 r:l!3' Bood,.. '1>.~ 1"OOyof :rU AJI, . 2026 , Signature of Public ota - State of Florida Signature of Public N ary State of Florida Notarization of Lobbyist's signature Notarization of P ncipal signature lJ 12J../~ Date Paid , FORCLE~!! ONLY. Annual Registration fee: [ ] Yes [~o Amount Paid ~ ..:..Mc?R # :S-=J.\lO Lobbyist Registration Form received and verifie~~ F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fa . c Revised 12/08/04