Jeffrey M. Hydem MIAMIBEACH
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loo[, o T<G
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 aty personnel during the time period of the entire decision-making process on such action,
decision or recommendation that foreseeabty 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. Ptease refer to Ordinance 2004-3435.
Hyde Jeffrey M•
NAME OF LOBBYIST: (Last) (First) (M-I•)
clo Automotion Parking Systems LCC 411 West Hempstead Turnpike Hempstead, New York 11552
~~~~~~ State) (Zip Code)
BUSINESS NAME AND ADDRESS (Number and Street} (City}
~~ (516) 656-5600 (602) 794-6318 jeffreyh automotionparking.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
lC, LLC
NAME OF PRINCIPAUCLIENT:
IC LLC 2200 Biscayne Boulevard Miami FL 33137 _ _
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305} 374-5700~~~ (305) 847-3354 ~~~ r~r~cr'escentheights.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: Russell W. Galbut and Irving
Cowan
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
Russell W. Galbut (50%), Managing Member
Irving Cowan (50%), Managing Member
11. SPECIFIC LOBBY ISSUE:
Conditional Use Approval (1) to permit the use of a robotic parking system in a commercial main use parking
garage at 1826 Collins Avenue, which includes a restaurant within the commercial space; and (2) to operate the
garage after midnight.
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(8) 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 IndivldualRitle B) An Financial, Familial or Professional Relationshi
City of Miami Beach Planning Board None
City of Miami Beach Planning Staff None
City of Miami Beach Mayor/Commissioners None
City of Miami Beach Committees None
/S~
IV.• DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE• (Required) $0.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $0.
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 ®No• 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
Real Estate Development Issues°:
^Yes ®No• Are you lobbying on a pending application for a Development Agreement with the City or
application for change 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 anot-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 ®No• Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement
Signature of Lobbyist -Jeffrey M. Hyde
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 Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to and subscribed before me
This _ day of , 2008
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
Annual
TO BE COMPLETED
Form received and verified by:
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and su scribe b fo e
Thi day of , ~~ ~ n' DAYAMIAGUTAR
•`'~`~ `~°~~•; Notary Public -Stale of Florida
Commission Expires Mar 16, 2011
Sig atu of Pu lic of ~d~ Flot7t+{~inission # OD 644032
Notarization of Princi I'~ urtabndedThrougANadonaiNotaryAssn.
Y CLERK'S USE ONLY ~ i _ r.
..~
Paid
V. SIGNATURE UNDER OATH:
IV.• DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE (Required) $0.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYtS7 COMPENSATION):
(Required). $0.
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 ~ No• Are you lobbying on a present or_pendinn bid for goods equipment or services or on a
Bresent 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":
f-lYes ~ No• Are you lobbying on a pendinn application for a Development Agreement with the City or
application for change of zoning map designation or change to the City's Future Land Use Maa?
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-profd
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..
j],Yes ~ No• Are you representing snot-for-profit coraoration or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
~ffrey M. Hyde
I do solemnly swear that alt of th
provisions contained in Section 2~
Signature of Lobbyist: .__.
Signature of Principal/Client: _
F
VI. LOBBYIST IDENTIFICA
W.
facts are true
and.. that have read or am familiar with the
all reporti g requirements.
^ Produced ID
Fonn of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND~STAMP OF NOTARY:
State of-W~~a, County of Mimi-~e
Sworn to and subscribed before me
This ~s' day of ~_, 2008
Si t re f Public Notary -State of Florida
Notarization of Lobbyist's signature
TO BE CO
Registration Form received and verified by: _,
.OBBYIS?1Lobbvist Registration Form 32708.doc
dAYLE MIEDINA
NOTARY PUBLIC-ARIZONA
MARICOfM COUNTY
My Gnmm £xp. AAarch 28, 2011
~g Member o~TC, LLC
PRINCIPAL IDENTIFICATION:
^ ProducedlD
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of ~, 2008
Signature of Public Notary -State of Florida
Notarization of Principal's signature
Y
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK office CityClerk miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
Jeffrey M. Hyde
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 for lobbyist withdrawal in writing.
M. Hyde !)ate: