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Lyle Stern - Russell Galbut MIAMI BEACH r. _= City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 3313§013 APP -3 [1111 11: 04 LOBBYIST REGISTRATION FORM C I T ('L F_I1 r1'S OF F 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. Stern Lyle NAME OF LOBBYIST: (Last) (First) (M.I) Koniver Stern Group 1665 Washington Avenue ' ::V Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 532-6100 (305) 532-6101 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please.notify this.office if your contact information,changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: Russell Galbut NAME OF PRINCIPAUCLIENT: Crescent Heights 2200 Biscayne Blvd. Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5700 (305) 573-8489 raalbutta'�.crescentheiahts.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: u:SPECIFIC LOBBY'ISSUE:: IDevelooment Board Approvals for 600 Alton Road Issue to be lobbied(Describe in detail): III. CITY AGENCIESIINDIVIDUALS 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 arson's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO title of person to be lobbied Planning Department and Building Department Staff None X PB, HPB, BOA, City Commission, as necessary* None 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 2482 Any Financial,Familial or Professional Relationship C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration / Formrevised 5-30-2012.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) ^ $ µ'ic ti c T Av r X B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $ a-c� C i. T T f'/ `I` / /7 Ir- The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes X No: Are you lobbvina on a present or pending bid for goods.equipment or services.or on a present or Sgadipa 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 lobbvina on a pendina application for a Development Agreement with the City or application fQC change of zoning map 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-far-profit corporation or 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 EM THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signat of Lab I do solemnly swear that all of the foregoing facts are true and ecl and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all report' g requirements. Signature of Lobbyist: Signature of Principal/Cl' n VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: —Produced ID Produced ID Form of Identification Form of Identification V Personally known(Lobbyist) p `� Personally k �' �• �,.+o :11: 11 M.JONES VII. SIGNATURE AND STAMP OF NOTARY: .¢ 3, •¢: Notary Public.State of Florida �r y� •'=My Cortlm.Expires may 1 ' Y? 2015 Slate of Florida,County of Miami-Dade State of Florida, o i miRg8ftSfon #EF 591P3 Sworn to subscribed before me Sworn and sub ed through National Nora v Assn This day 20113 �v��.-�`-"'Thi y day of c -, 0 Signature f Public No a -State of Flor' Signature of Pu ary-State of Florida Notarizati n of Lobbyist's signature Notarization of signature TED BY CITY CLERK'S STAFF ONLY rr1 [Annual,Registration fee: 06 es[ ]No Am P $b5o •ou MCR# Date Paid �V LobbylSt Registration FomY received and verified y: C:\Users\clerhatMppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outiook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc F:,GLF istration Foriwdoc Revised 04/27/2012 MIAMIBEACH City of Miami Bench, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeach0.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk«miamibeachfl.gov Tel: 305.673.7411 . Far: 305,673.7254 LOBBYIST NAME Lyle Stern I understand that no later than February 28 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, 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 suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. 3 - � 6 - /__7 Signa Date: C:\Users\clerhatlWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGODDH\Lobbyist Registration Formrevised 5-30-2012.doc SUPPLEMENTARY DISCLOSURE OF INTEREST Interests in South Beach Heights I, LLC Percentage of Interest SBH Holdings I, LLC 99% 2200 Biscayne Blvd. Miami FL 33137 SBH Management Company, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 Interests in SBH Holdings I, LLC Percentage of Interest CH Investment Holdings, LLC 89.89% 2200 Biscayne Blvd. Miami FL 33137 David Galbut and Gita Galbut 10.11% 2200 Biscayne Blvd. Miami FL 33137 Interests in SBH Management Company, LLC Percentage of Interest CH Investment Holdings, LLC 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in 500 Alton Road Ventures, LLC Percentage of Interest 500 Alton Road Holdings, LLC 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in 500 Alton Road Holdings, LLC Percentage of Interest CH Investment Holdings, LLC 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in 1220 Sixth, LLC Percentage of Interest 500 Alton Road Holdings, LLC 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in CH Investment Holdings, LLC Percentage of Interest S Kahn CH Investments, LLLP 18.685% 2200 Biscayne Blvd. Miami FL 33137 S Kahn CH Holdings, LLLP 18.351% 2200 Biscayne Blvd. Miami FL 33137 Galbut CH Investments, LLLP 18.685% 2200 Biscayne Blvd. Miami FL 33137 Galbut CH Holdings, LLLP 18.351% 2200 Biscayne Blvd. Miami FL 33137 Menin CH-BT Co, LLLP 19.56% 2200 Biscayne Blvd. Miami FL 33137 Menin CH Holdings, LLLP 6.435% 2200 Biscayne Blvd. Miami FL 33137 Interests in S Kahn CH Investments, LLLP Percentage of Interest S Kahn CH Investments 1, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 SK Business Trust 99% 2200 Biscayne Blvd. Miami FL 33137 Interests in S Kahn CH Investments 1, LLC Percentage of Interest SK Business Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in SK Business Trust Percentage of Interest Sonny Kahn 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in S Kahn CH Holdings, LLLP Percentage of Interest S Kahn CH Management, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 Kahn 2009 Investments Irrevocable Trust 99% 2200 Biscayne Blvd. Miami FL 33137 Interests in S Kahn (Management, LLC Percentage of Interest Kahn Management Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Kahn (Management Trust Percentage of Interest Sonny Kahn 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Kahn 2009 Investments Irrevocable Trust Percentage of Interest Sonny Kahn 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Galbut CH Investments, LLLP Percentage of Interest Galbut CH Investments 1, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 RF Business Trust 99% 2200 Biscayne Blvd. Miami FL 33137 Interests in Galbut CH Investments 1, LLC Percentage of Interest RF Business Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in RF Business Trust Percentage of Interest Russell W. Galbut 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Galbut CH Holdings, LLLP Percentage of Interest Galbut CH Management, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 Galbut 2009 Investments Irrevocable Trust 99% 2200 Biscayne Blvd. Miami FL 33137 Interests.in Galbut CH Management, LLC Percentage of Interest Galbut Management Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Galbut Management Trust Percentage of Interest Russell W. Galbut 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Galbut 2009 Investments Irrevocable Trust Percentage of Interest Russell W. Galbut 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin CH-BT Co., LLLP Percentage of Interest Menin CH-BT Co., LLC 1% 2200 Biscayne Blvd. Miami FL 33137 Menin 1998 Business Trust 99% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin CH-BT Co., LLC Percentage of Interest Menin 1998 Business Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin 1998 Business Trust Percentage of Interest Bruce Menin 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin CH Holdings, LLLP Percentage of Interest Menin CH Management, LLC 1% 2200 Biscayne Blvd. Miami FL 33137 Menin CH Holdings, LLC 99% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin CH Management, LLC Percentage of Interest Menin Management Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin Management Trust Percentage of Interest Bruce Menin 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin CH Holdings, LLC Percentage of Interest Menin 2009 Investments Irrevocable Trust 100% 2200 Biscayne Blvd. Miami FL 33137 Interests in Menin 2009 Investments Irrevocable Trust Percentage of Interest Bruce Menin 100% 2200 Biscayne Blvd. Miami FL 33137