Russell Galbut/1100 West Properties, LLCm 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 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 bond 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.
Galbut Russell
NAME OF LOBBYIST: (Last) (First) {M.I.)
c/o Crescent Heights of America 2200 Biscayne Boulevard Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street} (City) (State) (Zip Codo)
(305) 573-4127 (305) 573-8489 rgalbut@crescentheights.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
1100 West Properties, LLC
NAME OF PRINCIPALlCLIENT:
c/e Morgans Hotel Group 47510'" Avenue New York NY 10018
BUSINESS NAME AND ADDRESS (Number and Street} {City) (State) (Zip Code)
(305-) 674-4848 NIA agalbut@hudcap.com
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:
IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
See Exhibit "A" attached.
II. SPECIFIC LOBBY ISSUE:
Amendment to DRB Order No. 20181
Issue to be lobbied (Describe in detail}:
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(g) include a
statement of the extent of any business, financial, familial, professional or other relationship, giving rise 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/Title B An Financial, Familial or Professional Relationship
City of Miami Beach Planning Board None
City of Miami Beach Mayor/Commissioners None
City of Miami Beach Committees None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
No extra compensation for lobbying
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). No extra compensation for lobbying
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 ~I No: Are you lobbvinq 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
Real Estate Development Issues":
^Yes ~ No: Are you lobbvinq on a pending application for a Development Agreement with the City or
application for chance of zoning map designation or chance 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 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..
^Yes 6a No: Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
Signature of Lobbyist: Russell Galbut E
Signature of Principal/Client: F
Abraham AI. Galbut, President of 1100 West Holdings, LLC, Manager of 1100
West Properties, LLC
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
® Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of / ,County of State of Florida, County of
Sworn to and subscribed before me Sworn to and subscribed b o ~~. ~"a DAYAMIAGUUIR
This _ day of , 2008 T ' day of J Koury PubNc - i9tate of FIOrW~
My ComrniMiOn ExpMat Mir t8, 2011
GaMniNion / OD 614032
Signature of Public Notary -State of Florida Si at of Public otary St lor~0"r~~•
Notarization of Lobbyist's signature Notarization of Principal'
TO BE COMPLETED BY CITY CLERK'S U E ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ Date Paid
Lobbyist Registration Form received and verified by:
F:ICLER\LOBBYISTLobbvist Registration Form 32708.doc Revised 03/27/2008
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 the Miami Beach City Code and all reporting requirements.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION {DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
No extra compensation for lobbying
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
{Required). No extra compensation for Iobbylny --
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 6~ No• Are you lobbving on a present or pendinsl bid for goods equipment or services, or on a
present or pendinst award for Goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entified "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development issues°:
^Yes Na• Are you lobbyin4 on a pending application for a Development Agreement with the City or
application for chance of zoning man designation ar chance 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 anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or apposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees.,
I-7Yes 6d No- Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement..
V. SIGNATURE UNDER OATH:
PERIOD.
F
Signature of Lobbyist Russell Galbut
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 the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of PrincipallGlient:
West Properties, LLC
Vl. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
® Personally known {Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of County of
Swom to and subscribed before me
This _.__ day of , 2008
Signature of Public Notary -State of Florida
Notarization of Lobbvlst's signature
Galbut
Manager of 1100
PRINGIPAL IDENTIFICATION:
^ .Produced ID
Form of Identification A
Personally known {Principal) ,~4~gLIC-5~0~ ~
N0~„.,,..,, JU ~ ssion #DDSa X010
State of Florida, County of Miami-D ' C~~ ~ gO~°~ 'cO tNc
D.~IRU Alf"
Sw and subscribed re me aorruE
Signature ~c otary - 5tat of Fl rida
otarizatl Principal's signature
TO BE COMPLETED BY CITY CLERK'S USE ONLY
Annual Registration tee: [ ]Yes [ ] Ka Amount Patti S MCR # i Date Paid
Lobbyist Registration Form received and verified by:
FiCLER1LOBHYI5llLobbyist Registration Form 32708 doc Revised 03!27!2008
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK office CityClerkCa~miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME: Russell Galbut
I understand that no later than October 15` of each vear, 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 for lobbyist w' hdrawal in writing.
E ~~'~'~~
Sig e: Russell Galbut Date:
MIADOCS 3130691 1