James E. Rauh/South Beach Heights I, LLC (4)m MIAMIBEACH
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 dty board or
committee; or any adion, decision or recommendaton of any city personnel during the time period of the entire decision-making process on such
action, dedsion or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term
specifically Includes the prindpai as well as any employee engaged fn lobbying activities. The term "Lobbyists" has specific exclusions. Please
refer to Ordinance 2004-3435.
RAUH, JAMES E.
NAME OF LOBBYIST: (Last) (First) (M.1)
2700 S.W. 37 AVE. MIAMI, FLORIDA 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-444-5002 305-448-5566 JRAUH@TERMINELLO.COM
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
SOUTH BEACH HEIGHTS t, LLC
NAME OF PRINClPAUCLIENT:
2200 BlSCAYNE BOULEVARD MIAMI, FLORIDA 33137
BUSINESS NAME AND ADDRESS (Number and Sireet) (City) (State) (Zip Code)
305-374-5700
TELEPHONE NUMBER: FAX NUMBER: (Opiional) EMAIL: (Optional)
or
• 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:SPECIF~IC ~LOBB,Y'~ISS;UE: SEE ATTACHED.
Issue to be lobbied (Describe in detail):
_. .
Iii. C'I~':~,!:`<AGEN,~C:IE$/IND,IUtIDU~-L'S~TO:='B..E{:;:LOBBIED.: (Pursuant to cl Code Section z-asz
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 statemen! 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 Title B Any Financlai, Familial or Professional Relatlanshl
DESIGN REVIEW BOARD NO
3~1:~~0 S.";~~ ~~~ ;~11~
i s :s wn ~n~ aooz
Zo bo
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)~~ ~ s_b~_ F I; /~T ~f: T"H~CZ~b 1~t f 1RsT ~f18V tC FtGAsCW 6 J
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~ ] y I COO F~ ~T FE'S T MQ o ~` N ~t/ZS T
(Required). ~~t.\t tr~l'eo~4LlnYfs i X7,0 a ~!'1R.. ~ou<~t, THftt~APTE7G.
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":
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
~Re`al Estate Development Issues":
^ Yes LV• No: Are you iobbvina on a pending application for a Development Agreement with the City or
application for change of zoning map designation or change to the Citv's Future Land Use
Mae?
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 snot-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.
reimbursement. .
I do solemnly swear that all of arse
provisions contained in S ion 2-482 of
ie and correct and that i have read or am familiar with the
City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Princi I/Cli
VI. LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
^ ProducedlD
Form of Ident~cation
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Flori o rt of Ai i- e
Swom o and u I ore m~l1YA1NAGUlAR
.~ ~,
s ~- 81ab of Florida
_' = atbn E>tpina Mar 16, 2011
Si natu of b 844032
Notariz ion` ~ ~~~
~ ProducedlD
Form of Identification
Personally known (Principal)
U.
State of Florida, Count
Swo d subscri ed
hi day of
C
Si natu of Publi of
N tariz ion of Princii
° ' Noary Public • Stata of Fbrida
~~ n Expires Mar 16, 2011
~ ~~ Commission A DD 64032
'°fi+' ' Bonded Through Natlaial Notary Assn.
-State of Florida
oars signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r-
Annual Registration-fee. °[ ]Yes ( :] No `AmounYPaid S ` ': <MCR-# `~Date'Pald
Lobbyist.Registretion F.orm.recefved and verifleii by:...:
F:\CLER\LOBBYIST\Lobbyist Registration Form 32708:doe ' ` . Revised 03/27/2008
V. SIGNATURE UNDER OATH:
SPECIFIC LOBBY ISSUE: Design Review Approval of Renovation and redesign of
existing three story hospital structure to mini storage enclosed with retail uses; reposition
of the existing ten story medical office building to a flex office space to allow flexibility
for office and apartment/live-work spaces, which includes recladding the exterior curtain
wall system to a window wall system and architectural modifications to the street level;
and architectural modifications to existing three story parking structure for property at
630 Alton Road (sometimes referred to as 600 Alton Road)
. 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.*
SOUTH BEACH HEIGHTS I LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
SBH HOLDINGS I, LLC
2200 Biscayne Boulevard
Miami, Florida 33137
Member
SBH MANAGEMENT COMPANY, LLC
2200 Biscayne Boulevard
Miami, Florida 33137
Member and Manager
OFFICERS:
SONNY f(AHN
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
OF MEMERSHIP INTEREST
99%
1%
IF 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 S
6
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
'I. 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 stack owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnerships} 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.*
SBH MANAGEMENT COMPANY LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
CH INVESTMENT HOLDINGS, LLC
2200 Biscayne Boulevard
Miami, Florida 33137
Member and Manager
OFFICERS:
SONNY KAHN
2200 Biscayne Boulevard
Miami, Florida 33137
Chairman
RUSSELL W. GALBUT
2200 Biscayne Boulevard
Miami, Fiorida 33137
President
BRUCE A. MENIN
2200 Biscayne Boulevard
Miami, Florida 33137
Sr. Vice President
SHARON CHRISTENBURY
2200 Biscayne Boulevard
Miami, Florida 33137
Vice President
OF MEMERSHIP INTEREST
100%
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 INDIVIDUAL'S NAME, ADDRESS, .OFFICE AND
PERCENTAGE OF STOCK, ON A SEPARATE PAGE
NOTE: Notarized signature required on page S
6
GITY OF M1AM1 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 leasetl 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.* ,
SBH HOLDINGS 1, LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
CH INVESTMENT HOLDINGS, LLC
2200 Biscayne Boulevard
Miami, Florida 33137
Member and Manager
DAVID GALBUT
2200 Biscayne Boulevard
Miami, Florida 33137
Member
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
°lo OF MEMERSHIP INTEREST
89.89%
10.11%
IF THERE ARE ADDITIONAL CORPORAT-ONS, 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 awned 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 MEMERSHlP 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%
lF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP.
NAMES} 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
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 % OF INTEREST
SONNY KAHN
2200 Biscayne Boulevard
Miami, Florida 33137
Beneficiary
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
beneficiarieslbeneficiary 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 S
7
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLIGATION
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), partnerships} 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 % OF INTEREST
BRUCE A. MENIN
2200 Biscayne Boulevard
Miami, Florida 33137
Beneficiary
100%
NOTE: Notarized signature required on page S
7
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk~miamibeachfl.gov
Tel: 305.673.741 ] ,Fax: 305.673.7254
~a
LOBBYIST NAME: ~ /-'M' ~~
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.
Da e:
F:\CLERILOBBYIST1Lobbyist Registration Form 32708.doc