Joaquin E. Vargas(gZ(a Co ((Irv A-~~_ l~o~o~rC
m r,~.'~IBEACH
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.
Vargas Joaquin E.
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o Traf Tech Engineering, Inc. 400 North University Drive, Suite 202 Tamarac FL 33321
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(954) 582-0988 (954) 582-0989 Joaquin at7trafteck.biz
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
IC, LLC
NAME OF PRINCIPAL/CLIENT:
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 mkramer@crescentheights.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
II. SPECIFIC LOBBY ISSUE:
Certificate of Appropriateness for the construction of a new robotic parking garage at 1826 Collins Avenue,
including an accessory commercial space containing a restaurant, which will replace an exisfing surface parking
lot.
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) Any Financial, Familial or Professional Relationship
City of Miami Beach Historic Preservation Board None
City of Miami Beach Planning Staff None
City of Miami Beach MayorlCommissioners None
City of Miami Beach Committees None
/y,~
DIV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE• (Required) $5 000 Flat Rate.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $5,000 Flat Rate.
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 6a No• Are you lobbvina on a present or pending bid for goods equipment or services. or on a
present or pending award for goods, eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^Yes 6a No• Are you lobbvina 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 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 ®No• Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
PERIOD.
Signature of Lobbyist -Joaquin E. Vargas
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: /1J/f~i'GL'G1~f
RussellT W. Galbut, as
VI. LOBBYIST IDENTIFICATION:
ing Member of IC, LLC
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
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 Lobbyist's signature
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of
Swor to and su scnbed b
T,lZis ~,Q day of
re
of
signature
DAYAMIAGUTAR
Notary Public -State of Florida
MY Commission Expires Mar 16, 201 i ((
Commission # DD 644032
Bonded Through National Notary Assn. `
O BE COMPLETED BY CITY CLERK'S USE ONLY
Annual Registration fee: [ ]Yes No Amount Paid $ . Q C #~ Date Paid /.1
Lobbyist Registration Form received and verlfled by:
F:\CLER\LOBBYIS11Lobbyist Registration Form 32708.doc Revised 03/27/2008
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) $5,000 Flat Rate.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $5,000 Flat Rate.
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 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 6~ No: Are you lobbvinq on a pending application for a Development Agreement with the Citv 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 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 ®No: Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1St OF EACH YEAR, EACH. LOBBYIST___SH 1~LL SUBMIT _TO THE .CITY CLERK A SIGNED
STATEMENT UNDER OATH LISTING LOBBYING EXP NDITURES AS WE L AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC DING CALENDAR YE R.A STATEMENT SHALL
BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSA'GIO D NG THE REPORTING
PERIOD.
I do solemnly swear that all of the foregoing
provisions contained in Section 2-482 of the P
Signature of Lobbyist - Joaquin E. Vargas
are true ai
Beach City
Signature of Lobbyist:
Signature of PrincipallClient:
Russell
IDENTIFICATION:
i _
~Vpu~ss%t;~iced I D Flom ~ r
'_~ 2' ~~ Form of Iderr
~`p ~• ~ ~'~O°
g~. ~°s~~] ~~~rsa'F~ally known (Lobbyist)
~~n ~M_ ~ i
^ Produced ID
as Managing M ber of IC, LLC
PRI IPAL IDENTIFICATION:
NATURE AND STAMP OF NOTARY:
'/ipjgel~~'Florida, County of Miami-Dade/8,~,,~H,-c~
Sworn and subscribed before me
This ~ day of ~~,'nvct• , 200p'g
ature o ublic Notary -State of Florida
Notarization of Lobbyist's signature
read or am familiar with the
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
TO BE COMPLETED BY CITY CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\LOBBYISlILobbyist Registration Form 32708.doc Revised 03/27/2008
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
CITY CLERK office C~Clerk _miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
Joaquin E. Vargas
I understand that no later than October 1$` 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.
Ina ition, once an issue I ha registered to lobby on has been resolved, I am required to immediately notify the
City Jerk's Office for lobbyist thdrawal in writing.
~ Q
S' ure: Joaquin E. Var a Date: