David Nevel - 1747 Bay Road Properties, LLC r m �
MIAMLBEACH
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 clty 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 foreseeabiy will be heard or reviewed by the
city commission, or a city board 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.
Neve! David H.
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o David H. Neve!, P.A. 950 S. Pine Island Road, Suite A -150 Plantation, Florida 33324
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(954) 423 -4348 (954) 727 -8250 law @dnevel.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
1747 Bay Road Properties, LLC
NAME OF PRINCIPAL/CLIENT:
1747 Bay Road Properties, LLC 2200 Biscayne Blvd. Miami Beach 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, as President
of Ronruss Corporation, General Partner of Ronruss Partners, Ltd., Managing Member of 1747
Investments, LLC, Managing Member of 1747 Bay Road Properties, LLC
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
See attached Disclosures of interest.
II. SPECIFIC LOBBY ISSUE:
Application for Design Review Approval for design modifications to an existing structure and the reconfiguration of
the surface parking lot for the property located at 1747 -1759 Bay Road.
Issue to be lobbied (Describe in detail):
III. CITY AGENCIESl1NDIVIDUALS 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 said City
Personnel' commencement of service with the City to the present date, stating the general nature of the subject
contractual relationship.
A) Full Name of IndivlduaUTttle B) Any Financial, Familial or Professional Relationship
City of Miami Beach Design Review Board None r
City of Miami Beach Planning Staff None l S. >a '� 1
City of Miami Beach Mayor /Commissioners None
City of Miami Beach Committees None ZZ :h 14d 1 - AON 01 12
/La .“7/ 5 ,e/7;k1
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
LOBBYIST DISCLOSURE: (Required) $ 275 per hour.
8) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $ 275 per 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 J 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 ":
f lYes l51 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 a not - 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..
F]Yes (5J No: Are you representing a not- for - profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL
BE FILED EVEN IF THERE HAVE BEEN NO EXPENDI - - _ - : - = • • RING THE REPORTING •
PERIOD.
Signature of Lobbyist — David Nevel
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 t - 1 :eac• .'ty Code and a re'. -'.. requirements.
Signature of Lobbyist: ��—
Signature of Principal/Client:
Russell W. Galbut, as President of Ronruss Corporation, General Partner of
Ronruss Partners, Ltd., Managing Member of 1747 Investments, LLC, Managing
- Member of 1747 Bay Road Properties, LLC
N N VI, LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
lf
z° °
' Produced ID ,FL._ L ❑ Produced ID
o 8 Form of Identification Form of Identification
Y r ¢ ❑ Personally known (Lobbyist) ❑ Personally known (Principal) I , VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami -Dade State of Florida, County of Miami -Dade
■:4 Sworn to and subscribed before me Sworn to and subscribed before me
'•
..7„„: /
This / day ,yin 2010 --- -•, This _ day of , 2010
Signature of Public Notary — State of Florida Signature of Public Notary — State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S USE ONLY
Annual Registration fee: 1 ] Yes [ ] No Amount Paid $ MCR # $ Date Pald
Lobbyist Registration Form received and verified by:
F:ICLERILOBBYISfLobbyist 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) $ 275 per hour.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $ 275 per 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 ":
j - l Yes 6a 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 ":
FIYes 61 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 a not- 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..
f Yes M No: Are you representing a not - for - profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH. LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL
BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING
PERIOD.
Signature of Lobbyist — David Nevel
1 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:
Russell W. a ut, as Pres •ent of Ronruss Corporation, General Partner of
Ronruss Partners, Ltd., Managing Member of 1747 Investments, LLC, Managing
Member of 1747 Bay Road Properties, LLC
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification
❑ Personally known (Lobbyist) Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami -Dade State of Florida, County of Mia ' -lid$ _ _ •
Sworn to and subscribed before me Sworn to and subsgqribed before a DAYAMIAGUTAR
This _ day of , 2010 T - _L day of N ^ , 201 = r
off" Pu g - - Notary Public - State of Florida
I
= , .: My Commission Expires Mar 16, 2011
4 _ �. .1 . f �-� %N � of Commission i DD 644032 '
Signature of Public Notary — State of Florida v n -t - of Pub is otary — Staff = Bonded Through National Notary Assn.
Notarization of Lobbyist's signature N 'tars tion of Principal's sig
' TO BE COMPLETED BY CITY CLERK'S SE ONLY /
Annual Registration fee: [ t 'es [ j No Amount Paid $ j sv MCR # $ • t r Da Paid 1/
Lobbyist Registration Form received and verified by: � / (((
F:ICLERILOBBYIS71Lobbyist Registration Form 32708.doc c' 1 ✓ �� Revised 03/27/2008
MIAMI BEACH
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 , Fox: 305.673.7254
LOBBYIST NAME: a V 1 / H, /
I understand that no later than February 28th of each year, I must file the following
form, 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 and Compensation 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.
1
//AA o / D
Signature: Date:
•
EXHIBIT "B"
DISCLOSURE OF INTEREST
NAME AND ADDRESS % OF INTEREST
1747 BAY ROAD PROPERTIES, LLC
1747 Investments, LLC 32 %
2200 Biscayne Boulevard
Miami, Florida 33137
Managing Member
MJK Group, LLC 18 %
2200 Biscayne Boulevard
Miami, Florida 33137
Member
Sharon Mirmelli 30 %
1210 Michigan Avenue
Miami Beach, Florida 33139
Managing Member
Philip Mirmelli 10 %
6500 North Bay Road
Miami Beach, Florida 33141
Member
Sean Mirmelli 10 %
1415 20th Street, #103
Miami Beach, Florida 33139
Member
i 747 INVESTMENTS, LLC
Ronruss Partners, Ltd., a Florida Limited Partnership 100 %
2200 Biscayne Boulevard
Miami, Florida 33137
Managing Member
RONRUSS PARTNERS, LTD,
Ronruss Corporation, as General Partner 1 %
2200 Biscayne Boulevard
Miami, Florida 33137
Russell Galbut, as a Limited Partner 43.72 %
2200 Biscayne Boulevard
Miami, Florida 33137
Ronalee Galbut, as a Limited Partner 43.72 %
2200 Biscayne Boulevard
Miami, Florida 33137
Jenna Beth Galbut, as a Limited Partner 5.65 %
2200 Biscayne Boulevard
Miami, Florida 33137
[CONTINUED TO NEXT PAGE]
Page 1 of 2
Marisa Ann Galbut, as a Limited Partner 5.91 %
2200 Biscayne Boulevard
Miami, Florida 33137
RONRUSS CORPORATION
Russell W. Galbut, as a Director, President and Shareholder 49.5 %
2200 Biscayne Boulevard
Miami, Florida 33137
Ronalee Galbut, as a Shareholder 49.5 %
2200 Biscayne Boulevard
Miami, Florida 33137
Abraham A. Galbut, as a Shareholder 1 %
4770 Biscayne Blvd., Suite 1400
Miami, Florida 33137
MJK GROUP, LLC
Keith Menin 33.33 %
2200 Biscayne Boulevard •
Miami, Florida 33137
Manager
Jenna Beth Galbut 33.33 %
2200 Biscayne Boulevard
Miami, Florida 33137
Member
Marisa Ann Galbut 33.34 %
2200 Biscayne Boulevard
Miami, Florida 33137
Member
Page2of2
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