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Jonathan W. Cardello - Russell W. Galbut r ' MIAMI BEACH City of Miami Beach Office of the City Clerk '` r' 1700 Convention Center Drive, Miami Beach, FL 33139 1012FEB _Z LOBBYIST REGISTRATION FORM "/ P��2' S� Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, t�efeat 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. Cardello Jonathan W. NAME OF LOBBYIST: (Last) (First) (M.I) ADD, Inc. 2 South Biscayne Boulevard, Suite 1670 Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)482-8700 (305)482-8770 icardelloCabaddinc.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Russell W.Galbut NAME OF PRINCIPAL/CLIENT: Crescent Heights 2200 Biscayne Boulevard Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)573-4127 (305)573-8489 rgalbutCa 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: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: J II. SPECIFIC LOBBY ISSUE: Development Approvals for Gale Hotel 16 .7 0 (?p pil'1V S Alt-- Issue to be lobbied(Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A)Full Name of Individual/Title B)Any Financial, Familial or Professional Relationship Staff, HPB,BOA,PB None *Unless an issue is legislative in nature,HPB,BOA,Planning Board,and City Commission members are not lobbied outside of a public hearing setting. n IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $ 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 X 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 X 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.. ❑Yes X No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIST MIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING XPENDITU ES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR HE PRECEDI G CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN N EXPENDITUR S OR COMPENSATION DURING THE REPORTING PERIOD. nature of Lobbyist I do solemnly swear ev going facts are true d correct and that I have read or am familiar with the provSection 2-482 of the iami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATIO PRINCIPAL IDENTIFICATION: ���•No� Produced ID Produced ID �,• ° Form of Identification Form of Identification K•'`Z 2; personally known (Lobbyist) /Personally known (Principal) o a I. SIGNATURE AND STAMP OF NOTARY: c y y to of Florida, County of Miami-Dade State of Florida, County of Miami-Dade o 0 orn to and subscribed efore me Sworn d sub scrVFlk� e N is day o , 20 This day of 201 m nature of Public Notary tate of Florida Signature o Public Notary ate of Florida tarization of Lobbyists signature Notarization of Principal's signature FOR CLERK'S USE ONLY Annual Registration fee: [ ]Y/dand Amount Paid 00 MCR# 3 Date Paid D� Lobbyist Registration Form receiv verified b : Entered B : Y 9 Y Y F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04 r T City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeochfi.gov CITY CLERK Office CityClerk@rniomibeachfl.gov Tel:305.673.741 1 ,Fax:305.673.7254 LOBBYIST NAME: \2)V JW ajfd Gw 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, ce an issue I have registered to lobby on has been resolved, I am required to immediat y notify the City Clerk's Office of lobbyist withdrawal in writing. t ?y a or oo- Signature: Date: