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James Rauh - 1747-1759 Bay Road DRB I o f + MIAMIBEACH Dp-B 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 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. Rauh James E. NAME OF LOBBYIST: (Last) (First) (M.I.) c/o Terminello & Terminello P.A. 1111 Lincoln Road Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 276 -2343 (305) 673 -5505 jrauh @terminello.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: 1747 Bay Road Properties, LLC NAME OF PRINCIPAL /CLIENT: 1747 Bay Road Properties, LLC 2200 Biscayne Blvd. Miami Mak 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: Sharon Mirmelli • 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): I11. 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 Design Review Board None City of Miami Beach Planning Staff -11.11 - 11 -j -jr , t i City of Miami Beach Mayor /Commissioners None City of Miami Beach Committees None OS :£ iWd 1 - AON 0101 j.lj �al�� "7//". IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $ 375 per hour. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 375 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 ": flYes Fi 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 ": [lYes 6a 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.. 11 Yes NI 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. 41. c- S'� - - of Lobbyist — James Rauh 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 ' ' each City C de and all reporting requirements. Signature of Lobbyist: �� Signature of Principal /Client: , rt., i. Sharon Mirmelli, Ma ging Member, 1747 Bay Road Properties, LLC VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: I ❑ Produced ID ❑ Produced ID g u, g N = Form of Identification Form of Identification 2 ¢ 2 t4 Personally known (Lobbyist) ., Personally known (Principal) � ,, ,��• N •� `" -- X $ VII. SIGNATURE AND STAMP OF NOTARY: : "'!'!f'1 L I. R * I v State of Florida, County of Miami -Dade State of Florida, County of Miami - Dade ,/ J �� m q Sworn : subscri•e• •efore me Sworn to and sub cribed before me w T d of ' � % 2010 Th is 21 day of ' , /C2010 � 't r i a , e of '•lic Notary — tate of FI• %:a S ignature of ublic Notary — State of Florida 1 0 /' o • r • ion of Lobbyist' signatur:✓ Notarization of Principal's signature Z Az V; N 01� Go TO BE COMPLETED BY CITY CLERK'S SE ONLY Z i Annual Registration fee: ] Yes [ ] No Amount Paid $ :1 c0 MCR # $ (1///i Date Paid _ (J `} o o S Lobbyist Registration Form received and verified by: / - i � ' o ° � F: \CLER \LOBBYIST\Lobbyist Registration Form 32708.doc � ,� Revised 03/27/2008 tA tv\AMiBEACH 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: — 1 , 4 " 5 c : . - 7 - - C R . ``'"' 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. ',IN/ 1p -29 , co 0 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 747 INVESTMENTS, LLC Ronruss Partners, Ltd., a Florida Limited Partnership 100 % 2200 Biscayne Boulevard Miami, Florida 33137 Managing Member :ONRUSS 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 Page 2 of 2 - - w SI) R z z : & c 17 p ¢t 0 ❑ y ep t e 3 n 3 G ; \ - - -',... 0 '--. Ilk■ ,,--- , 1 __ a oo N 1 .. y -� a = =' 1 -. cs, m .-L ,. _ n =HIM 4 4 ^ °~- D ' 1 , -s .„ —.d •»: r ,....,...., ' ''''''‘ i 0 -.,,, \. O ..,, r A, ........., E; .: .