David H. Nevel,, ~~ ,-r, . X26 ,~oi~( - ~/a~ h.~c~'r ~~~~
m '~11A~'V~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.
Nevel David H.
NAME OF LOBBYIST: (Last) (First) (M.I.)
David H. Nevel, P.A 6741 Orange Dr. Davie, FI 33314
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
954-321-7701 877-791-3024 dhnevel@yahoo.com _
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
South Beach Heights 1, LLC
NAME OF PRINCIPAL/CLIENT:
South Beach Heights I 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
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:
Appeal of Expansion of historic district.
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 Planning Board None
City of Miami Beach Design Review Board None ~ ~ ~ ~ ; n C s
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~ ~ ~
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City of Miami Beach Planning Staff None - -~
-
City of Miami Beach Mayor/Commissioners
City of Miami Beach Land Use & Development None
None
~ ~ • ~ ~~ 9 - a3~ ~~~z
Committee
City of Miami Beach Committees None ~ "'"~ A . ,, ~ ~
1 y~
IV. ~ DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) $275-$300 per hour.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $275-$300 er hour.
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 lobbyina on a present or pending bid for goods equipment or services, or on a
present or pendina 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 pendina application for a Development Agreement with the City or_
application for change of zonina map desianation or chanae to the Clty'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.
V. SIGNATURE UNDER OATH:
ON OCTOBER 15t OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
. __.....~ ~--~~..~.~...w~w w w •~.~. , w [~ AAw~IIC\IC ATIALI
PERIOD.
I do solemnly swear that all of the foregoin
provisions contained in Section 2-482 of a Miami
Signature of Lobbyist:
Signature of Principal/Client:
Russell W. Galbu
VI. LOBBYIST IDENTIFICATION:
~ In .-~ ct ^ Produced ID
O ~ ~ N
^U
Form of Identification
o ~ A ~. ~ Personally known (Lobbyist)
w~~~o
H ~.~ . ~- NATURE AND STAMP OF NOTARY:
~ ~' ~ tate of n of Miami-Dade
~ a ~wor nd sub 'bed befor
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~ ,,,,W ~fhis day of ~i 009
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z '•~~~~~~°~~ gn ur of Public No to of Florida
Notarization of L,oiSbari~t's signature
Signature of Lob~t"--"avid H. Nevel
and correct and that I have read or am familiar with the
t ode and all reporting requirements.
Beach Heights I, LLC
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Principal)
State of Florida, County of Miami-Dade _ _ _ _ _
Sworn to and subs ribed before me "~'~' DAyAMIAGUTAR
Thi day of ~ , 200 ~''PF~~°~e :,,
=r~+ ~~,, Notary PuDNe - State of FbrWa
.= hly CAnM1~1/i011 Expires Mar /6, 2011
Si na re of Publi Notary - St e' : Commksion * DD 614092
.,,,,,, bonded 1'hrauph NsOonsl Notary /wn,
Notarization of Principal's si
TO BE COMPLETED BY CITY CLERK'S. ONL
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ Date Paid
Lobbyist Registration Form received and verified by: o
F:\CLER\LOBBYISTLobb ist Re istration Form 32708.doc Revised 03/ 7/2008
m I~IAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.pov
CITY CLERK office CityClerkCa~miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
David H. Nevel
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 Offic 1abb.~[ist withdrawal in writing.
2 ~~~
Signature: David H. Nevel Da
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