James E. Rauh - Twice Around 1775 LLC Lei �
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City f Miami Beach Office of the City Clerk ®�?0C
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1700 Convention Center Drive, Miami Beach, FL 33139x1 T;.
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, de�fea#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)
Terminello&Terminello, P.A., 1111 Lincoln Road, 4th Floor, Miami Beach, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786)276-2343 (305)448-5566 jrauh @terminello.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
`Please notify this office if your contact information changes:address,phone,or e-mail address.
I. LOBBYIST RETAINED BY:
Twice Around 1775 LLC
NAME OF PRINCIPAUCLIENT:
c/o:Olshan Frome Wolosky, LLP, Park Avenue Tower,65 East 55th Street, New York, New York, 10022
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
212 451-2292 (212)451-2222 EGoldberg c'bolshanlaw.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:
Sam Nazarien and David Edelstein
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Attached Exhibit"A"
II SPECIFIC L® Y ISSUE:,
Modification of Modified Conditional Use Permit under Planning Board File No.1647 to change the name of owner/operator and appearance by subsequent owner/
operator to affirm understanding of conditions for the Raleigh Hotel at 1775 Collins Avenue.
Issue to be lobbied(Describe in detail):
nl CITY AG_EiVCIES/IIV;DIVLDIJALS TO �E 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 eneral 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
Planning Board X
Planning Director/Department X
Mayor and Commissioners X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent 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( Any Financial,Familial or Professional Relationship
i
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $375.00 Per Hour
I
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $375.00 Per Hour
(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 Section 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 Section 2-482(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 -.)r entity without special compensation or reimbursement
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 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 EVfA4FLZHERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Si ature obbyist
do solemnly swear that all of the foregoing facts are t ue d correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Be ty Co all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Clie .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID N Produced ID
Form of Identification g N Form of Identification
2_
Co
Personally known(Lobbyist) Personally known(Principal)
g U 2
VII. SIGNATURE AND STAMP OF NOTARY: x$
u.,
State of Florida, County of Miami-Dade dog State of Florida, County of Miami-Dade
Sworn t d-subse4b fore me n�:• 2. Sworn and subscribed before me
Th' da e ,20 2 This day of '2012
roy PEv
Sign re of 6blic Notary— tate orida Signature of Public Notary—State of Florida
ation of Lobbyist's signdrure Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual.Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified.by:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
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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) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $375.00 Per Hour
(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 Section 2490 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 may designation or change to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2482(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 yr entity without special compensation or reimbursement
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 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
SS, ature obbyist
1 do solemnly swear that all of the foregoing facts are tfu 'arid correct g 9 L� o ect and that 1 have read or am familiar with the provisions contained
In Section 2-482 of the Miami Be ty Ca e�7t all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Clio -
VI. LOBBYIST iDENTIFf N: PRINCIPAL IDENTIFICATION:
NNA1
Produced ID v Produced ID Q cl 2 o
Form of Identification .,; Form of Identification o 01 o N CN
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Personally known(Lobbyist) y I Personally known(Principal)
of co c o n
Vii. SIGNATURE AND STAMP OF NOTARY:
� w Q Ha ou'
�3 a
State of Florida, County of Miami-Dade ` ~� a E E
Sworn t d subscrib Afore me Q��. '0, State of Ref4a, County of MjmTt_B�
`� Sworn ansl subscribed before me a
Th da :o ,20 2 o This day ofd,2012
-Sign t re of ubiic Notary-- tat orida f Public Notary—State of-Flo�a
No at on of Lobbyist's slgn ure Notarization of Principal's signature ®�
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY IdNN
Annual Registratlon fee. [ ]Yes[ ]—No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verifled by.
C:IUserslclerhatllAppData\Local\Microsoft\Wjndows\Temporary Internet FileslContent.Outlook183LGQDDHILobbyist Registration
Formrevised 5-30-2012.doc
State of California )
)ss.
County of Los Angeles )
On October 25, 2012, before me, Asally Adib-Sarnadian, Notary Public,
personally appeared Sara Nazarian who proved to me on the basis of
satisfactory evidence to be the person whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his authorized
capacity and that by his signature on the instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California
that the foregoing paragraph is true and correct.
......
ASALLY ADIB-SAMADiAN Witness my hand and official seal.
Commission# 1904060
Z ®� Notary Public-California D
Los Angeles County
My Comm.Expires Oct 12,2014
(Seal above)
jistration Form.doc
Revised,04/27/2012
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: James E. Rauh, Esquire
I understand that no later than February 28 of each ear, 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, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist(or principal)who
fails to timely file a Statement and In addition to any other penalties which may be
Imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically susp"ed from lobbying until all fines are paid,, unless the fine has been
appealed to the I I m -D de County Commission on Ethics and Public Trust.
10 2,6 / 2-
Signa Date:
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EXHIBIT"B"
DISCLOSURE OF INTEREST
TWICE AROUND 1775 LLC
Name and Address %of Ownership
Twice Around 1775 LLC
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
Twice Around Holding LLC 100%
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
Twice Around Holding LLC
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
Twice Around Manger LLC 9.3%
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
Sam Nazarian 45.35%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
David Edelstein 45.35%
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
Twice Around Manger LLC
c/o Olshan Frome WoloskyLLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
1775 Collinstar LLC 16.67%
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
YDS 1775 Collins,LLC 83.32%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
YDS 1775 Collins SN Member,LLC 0.01 %
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
EXHIBIT"B" (PAGE 2)
DISCLOSURE OF INTEREST
TWICE AROUND 1775 LLC
Name and Address %of Ownership
YDS 1775 Collins,LLC
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
YDS 1775 Collins SN Member,LLC 20%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
Abington Raleigh South Beach,LLC 80%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
YDS 1775 Collins SN Member,LLC
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
Sam Nazarian 100%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
Abington Raleigh South Beach,LLC
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
Sam Nazarian 100%
c/o Brandt Mori,Senior Counsel
8000 Beverly Boulevard
Los Angeles,CA 90048
1775 Collinstar LLC
c/o 01shan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022
David Edelstein 100%
c/o Olshan Frome Wolosky LLP
Park Avenue Tower
65 East 55th Street
New York,NY 10022