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James E. Rauh - 1111 Gluttony Box Co., LLC 6/0knerV. Wit/00 al 04. sik;ii k RECEIVED l- � ete tti4 /\'\IA/V\ DEACH 2011 SAP 30 Mill: 49 City of Miami Beach c O , )f y cIe ICE 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 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. Rauh James E. NAME OF LOBBYIST: (Last) (First) (M.I) Terminello & Terminello, P.A 1111 Lincoln Road Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 276 - 2343 (305) 448 - 5566 jrauh @termineilo.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, ore -mail address. 1. LOBBYIST RETAINED BY: 1111 Gluttony Box Co., LLC NAME OF PRINCIPAL/CLiENT: 1111 Gluttony Box Co., LLC 81 Washington Avenue Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)607 - 6229 gloutonnerie1 @me.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section If principal Is a Corporation, Partnership or Trust LSection 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Marco Cooley, Manager • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached Exhibit u.SPECIFIC=LOBBY ISSUE: Modification of an existing HPB Order (File No. 4876) to increase the number of allowable restaurant seats permitted on the property located at 81 Washington Avenue (a/k/a 210 1st Street), Miami Beach, Florida 33139. Issue to be lobbied (Describe in detail): ---- -- ill. CITY .AGENCIES /INDIVIDUALS *TO BE LOBBIED: Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date, stating the 9enerai nature of the subject contractual relationship. Sec 2.482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied City of Miami Beach Historic Preservation' Board None X City of Miami Beach Planning Director /Staff None X City of Miami Beach Mayor and Commissioners None X Pursuant to City Code Section 2-482(g) Every registrant shall be required to sta the exte of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2- 482(g) Any Financial, Familial or Professional Relationship None fL/ • IV. DISCLOSURE OF TERMS AND AiIIOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $375.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $375.00 per hour (Required) 1 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 N1 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? 1 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues" CI Yes No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning mapidesignation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City C h y � ode 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. CI Yes [A No: Are you representing a n ot- for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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. — eallihird....._ ' Sign f Lobbyist 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 Cod- - id all reporting requirements Signature of Lobbyist: 1111 dr Signature of Principal /Clie . ' VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ' ' � . 0 Produced ID Form of Identification : Form of I dentification Eersonally known (Lobbyist) o d 0 Personally known (Principal) , i .. ` --3 VII. SIGNATURE AND STAMP OF NOTARY: , i ni State of Florida, County of Miami -Dade v tin y State of Florida, County of Miami -Dade Sworn • a • ubscribe _ befo - me - a. 4 r, ril Sworn and subscribed before me Thi day of _ !r , 2011 � $ -i This day of 2011 ,--4 ,Irrk. .; 4 # dr,. : Signature of Public Notary — State of Florida Signature of Public Notary — State of Florida dZ� Notarization of Lobbyist's signature Notarization of Principal's signature, TO BE COMPLETED BY TY CLERK'S STAFF 0 Y Annual Registration fee: [ s [' No Amount Paid $ : •t !# , i/ /y � � �i/� �Ijr�rw Date Paid . Lobbyist Registration F cei d and verified by: F:\ LFR \$ALL\aFO MS \LOBBYIST FORMS \Lobb ist Annual Registration For .d • 1 ,_ Revised 1/11/2011 / ■ 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $375.00 per hour B)) DISCLOSURE (OF LOBBYIST COMPENSATION): $375.00 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': El Yes NI 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 El No: Are you iobbvinp 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 (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. El Yes IA No: Are you representing a not - for -profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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. I A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 4111 —earh&i&..._ Sign:.f Lobbyist I do solemnly swear that all of the foreg ,ing facts are true and correct a Kd that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Cod = • d all reporting requirer -eats. r Signature of Lobbyist: 41111 - . �e�_� Signature of Principal/Clie . { Vi. LOBBYIST IDENTIFICATION: PRINCIP ENTI ATION: ❑ Produced ID � `+` Produced ID NitC5P0 4 qatel Form of Identification $ _ Form of Ideritification Iersonally known (Lobbyist) Il k ❑ Personally known Princi al I * VIi. SIGNATURE AND STAMP OF NOTARY: 1121 = ,, = GONSTAiZA ABADiA "' State of Flor k V - State of Florida, County of Miami -Dade State of Flori .. . NOla Pubic ' Sworn • : ubscribe • befo me ,' :k`f ? '' ' expires Jul 8, 2012 =bs , .. ; o = T day of . , 2011 P I This Swor ; - d • s y M " �� `ol ?it .2011 No. DD '33E481 _ --,-00 frit ; ,' / 1 - • a d , A .0 "4, ilty#* , de *I7 Signature of Public Notary — State of Florida Signature o* � : -- ate of Florida Notarization of Lobbyists signature Notarizat - ,, al's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: C I Yes [ j No Amount Paid $ MCR # / Da Paid Lobbyist Registration Form received and verified by: assamr F : \CLER�$ALLAaFORMS\ LOBBYIST FORMS‘Loblfylst Annual Registration Form.doc .� ��,� � Revised x/11/2011 _ EXHIBIT "B" DISCLOSURE OF INTEREST 1111 GLUTTONY BOX CO., LLC Name and Address % of Ownership Miguel Angel Gutierrez, Manager 32.5% 2875 NE 191 Street Turnberry Plaza Suite 801 Aventura, Florida 33180 Marco Antonio Gutierrez c ooley, Manager 32.5% 2875 NE 191 Street Turnberry Plaza Suite 801 Aventura, Florida 33180 Christian Cooley, Member 25% 81 Washington Avenue Miami Beach, Florida 33139 Carlo Bicaci, Member 81 Washington Avenue Miami Beach, Florida 33139 10% x s City of Miami Beach, 1700 Co wention Center Drive, Miami Beach, Florida 33139, www miamibeachfl gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel 305.673.7411 , Fax: 305.673.7254 James E. Rauh, Esq. LOBBYIST NAME: 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 form: on a timely basis will result in my name being transmitted to the Miami -Dade County Coy= emission 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. Signal" Date: