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James Rauh/Southpointe Heights, LLC City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 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 tward 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 farm "Lobbyists" has specific ezcluslons. Please refer to Ordinance 2004-3435. RAUH, JAMES E. NAME OF LOBBYIST: (Last) (First) (M.I) 2700 S.W. 37 AVE. MIAMI, FL 33133 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-444-5002 305-448-5566 JRAUH(d1TERMINELLO.COM TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: SOUTHPOINTE HEIGHTS, LLC NAME OF PRINCIPALlCLIENT: 2200 BISCAYNE BLVD. MIAMI, FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code} 305-374-5700 305-847-3354 TELEPHONE NUMBER: FAX NUMBER: (Optional} EMAIL: (Optional) a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: RUSSELL W. 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: DESIGN REVIEW APPROVAL FOR 42 COLLINS AVENUE Issue to be lobbied (Describe in detail): Ili. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to city code section 2-as2(g) include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the commencement of service of City personnel to be lobbied.) A Full Name of Individual TiNe B) An Financial, Familial or Professional Relationship C'7 N DESIGN REVIEW BOARD NO ~ ra°- -°C °° ~ C C'- ~ r~-; to -~ ~ t c-~ W r-r~ -- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOtlRLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $5,000 (FLAT RATE) THROUGH THE FIRST PUBLIC HEARING; $300/ HOUR THEREAFTER. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):$5,000 (FLAT RATE) THROUGH THE FIRST PUBLIC HEARING; (Required). $300/HOUR THEREAFTER. The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes XNo: Are you lobbying on a present or pending bid for goods, equipment or services. or on a present or pending award for goods. equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Reai Estate Development issues": ^ Yes XNo: Are you lobbying on a pending application for a Development Agreement with the City or application for chance of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not for-profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees. ^ Yes X No: Are you representing snot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: nw~ nnTnoro aST nr rwnu vi of Lobbyist I do solemnly swear that all of the foregoing facts provisions contained in Section 2-482 of the li Signature of Lobbyist: Signature of Principal/CliEtif;"___~~~~~ VI. LOBBYIST IDENTIFICATION: end correct and that I have read or am familiar with the City Code and all reporting requirements. PRINCIPAL IDENTIFICATION: ^ Produced ID ^ Produced ID Form of Identification Form of identification Personally known (Lobbyist] ~ Personally known (Principal) VII. SIGNATURE AND ~~ Shy pue, DAYAMIAGUTAR State of Florida, County of ° ~~ Notary Public -State aSi~tdef Icrida, County of Mia i-p~~ ~~~ S n t d subscrib d b ~ : • ~ Conxnission Expires M$d~M d subscri d before '~~ d of ':~+ Commission # DD day of ~ 'n.,..:•`•` ` Bonded Through National N Sig at of Public otary -State of Florida Sig a ur f Public o - S to o Notariz 'on of Lobbyist's signature Notariza n of Principal's signature Notary PubNc -State of Florida My CamrNssion Expiros Mar f6, 2011 Commission # DO 644032 Bonded Through Nalbnal Notary Assn. TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ Yes [ ] No Amount Paid $ MCR # ~ Date Paid Lobbyist Registration Form received and verified by: F:~CLER~l088YI5T~Loblsyist Registration Form 32708.do[ Revised 03/27/2t~8 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33 3 39, www.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 ' LOBBYIST NAME: JAMES E. RAUH I understand that no later than October 1st of each year, I must file the following forms, 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 Form 2) Disclosure 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, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. ~o a gnat e: ate: F:ICLERILOBBYISTlLobbyist Registration Form 32708.doc CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1. LIMITED LIABILITY COMPANY If the property which is the subject of an 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.* SOUTHPOINTE HEIGHTS LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST SOUTHPOINTE HEIGHTS HOLDINGS, LLC 100% 2200 Biscayne Boulevard Miami, F{orida 33137 Member and Manager OFFICERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Chairman RUSSELL W.GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 President BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Sr. Vice President SHARON CHRISTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Florida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Asst. Treasurer IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH -NDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE. NOTE: Notarized signature required on page 8 6 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1. LIMITED LIABILITY COMPANY If the property which is the subject of an 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.* SOUTHPOINTE HEIGHTS HOLDINGS, LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST CH INVESTMENT HOLDINGS, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager 100% OFFICERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Chairman RUSSELL W.GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 President BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 5r. Vice President SHARON CHRISTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Florida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Asst. Treasurer lF 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 6 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1. LIMITED LIABILITY COMPANY if the property which is the subject of an 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.* CH INVESTMENT HOLDINGS, LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST SK BUSINESS TRUST 2200 Biscayne Boulevard Miami, Florida 33137 Member 37% RF BUSINESS TRUST 2200 Biscayne Boulevard Miami, Florida 33137 Member MENIN 1998 FAMILY TRUST 2200 Biscayne Boulevard Miami, Florida 33137 Member MANAGERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Manager RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 Manager BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Manager 37% 26% IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, -NCLUD/NG 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 6 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held by each. Where the beneficiaries/beneficiary consist of corporation(s), another trust(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." SK BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary OF INTEREST 100% NOTE: No#arized signature required on page 8 7 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held by each. Where the beneficiaries/beneficiary consist of corporation(s), another trust(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." RF BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary OF INTEREST 100% NOTE: Notarized signature required on page 8 7 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is. owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held by each. Where the beneficiaries/beneficiary consist of corporation(s), another trust(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.* MENIN 1998 FAMILY TRUST TRUST NAME NAME, ADDRESS, AND OFFICE BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary OF INTEREST 100% NOTE: Notarized signature required on page 8 7