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James Rauh - The Italian Job Miami, LLC 1 1��eaSe, \rl1(l 1� add T�!'Lia, �� "N'p 46e. 60o;e6 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) Terminello&Terminello, P.A.,1111 Lincoln Road, Suite 400, 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: The Italian Job Miami, LLC NAME OF PRINCIPAUCLIENT: c/o Dineamic Group,432 North Wells Street,2nd Floor, Chicago, Illinois 60654 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (312)527-1065 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: Lucas Stoioff,as Manager of Dineamic Group LLC, Manager of The Italian Job Miami, LLC • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached. II.SPECIFIC LOBBY ISSUE: Conditional Use Permit for Neighborhood Impact Establishment and any other land use and development issues relating to the property located at 404 Washington Avenue, Miami Beach, Florida 33139. Issue to be lobbied(Describe in detail): III.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 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 Baord 1 X Planning/Parking Director and Staff j 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(g)Any Financial,Familial or Professional Relationship 1 Wtt n t S 1A1 Y C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\ConteptOutlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 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.1) Terminello&Terminello,P.A. 1111 Lincoln Road,#400 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)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: Fairfax Hotel Partnership,Ltd. NAME OF PRINCIPAUCLIENT: Fairfax Hotel Partnership,Ltd. 1776 Collins Ave. Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (312)267-4191 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: Steven C.Florsheim • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Attached Exhibit ii.SPECIFIC LOBBY ISSUE: Special Event Permit,Certificate of Appropriateness,and any other land use and zoning issues relating to the property located at 1776 Collins Avenue,Miami Beach,Florida 33139. Issue to be lobbied(Describe in detail): III.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(late,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and contractual Relationship(Explain) W YES NO title of person to be lobbied _ City of Miami Beach Historic Preservation Board None X ................ ....._..... _.._...--- City Manager and Staff None X _..._.. ...... Planning Director and Staff 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 fonts filed. Sec.2-482 Any Financial,Familial or Professional Relationship None _:t _t J_ ,' r -; .J I u1 UG- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $375-hourly B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $375-hourly (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 IN No: Are you lobbying on a present or pending bid for goods,equipment or services,or on a present or pendinq 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 ® 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 ®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. A STATEMENT SHALL-BE44LED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of bb ist I do solemnly swear that all of the foregoing facts are true an corr ct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami ac *ty Code and all reporti quirements. Signature of Lobbyist: Signature of Principal/Clie VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification /Personally known(Lobbyist) ❑ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade zo�OaY P41ei,� BRAD STEVEN FLEET State of Florida, County of Miami-Dade Sworn to and subscrib d bef re me * * MY COMMISSION#EE 223709 Sworn and subscribed before me This_ 4n day of c Mfkr 201/ P EXPIRES:August 21,2016 This day of , 20 AT t l�rFOF Fl��\o Bonded Thru Budget Notary Services Sign ture of Public Notary—State of Florida Signature of Public Notary—State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY a Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# S Z- D Lobbyist Registration Form received and verified by: «t~.\r-LER\$ALL\aFORMS\LO�,�;;IS FO;�6?�S�,�_��bhyiSt Aw.da l Re is"k-r�,��.�e:�- �°��a.���; vised 1/1 /2011 1 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR i OTHER): A) LOBBYIST DISCLOSURE:(Required) $375-hourly B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $375-hourly (Required). The following Infonnatlon must be answered: 1) Pursuant to Miami Beach City Code Section 2.488 Entitled°Prohibited Campaign Contributions By Lobbyists On Procurement Issues,: Q Yes IN No; Are you lobbying on a present or pending bid for goods,equipment or services.or on a urosent or pending award for goods,eaulnment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled°Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues°: p Yes ® No: Are you lobbyincl on a pending application for a Development Agreement with the City or application for channo of zonlnn map designation or change to the City's Future Land Use Man? 3) Pursuant to Miami Beach Clty Code 2-484 (h)Any person(except those exempt from the definition of'lobbyist'as set forth in Section 2481 above) who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for(lie 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. Q Yes IN 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 HE PRECEDING CALENDAR YEAR. A STATEMENT SHALL E-Ft ED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. —L, -- Signature of-6b st I do solemnly swear that all of the foregoing facts are true an corr nd t hat I have read or am familiar with the provisions contained in Secllon 2-482 of the Miamf.ae 'cTi' 'ty Code and all repo rll uirements. Signature of Lobbyist: - Signature of PrincipalICllede-- VI. LOBBYIST IDENTIFIC ON: PRINCIPAL IDENTIFICATION: Q Produced ID Q Produced iD Form of Identification Form of Identification MPersonall known(Lobbyist) Personally known(Principal) ) V . D STAMP OF NOTARY: II SIGN AN SIGNATURE A R Illinois Cook �pAY P�. State ot ,Count of ef#e State of Florida,County of Miami-Dade �o ,,..,�ir BRAD STEVEN FLEET Y Sworn to and subscrib befoQre me * Ift COMMISSION iEEM1'09 Sworn subscribed before me a This �� day of :ids 'J' ,201�� EXf IRES:August21,2016 This 1"5 day of Po,��n+t�r 201 a 1, �' ( i I_ Scow Tw 801Al ti t$�l4$4�___. t /J Slgn Lure of Public Notary—State of Florida Signature of Public Notary—State of Pie oid 111 i n o i s ~ . Notarization of Lobbylst's signature Notarization of Principal's signaturo TO BE COMPLETED BY CiTY CLERK'S STAFF ONLY Annual Registration fo©: [ ]Yes[ j No Amount Paid$ MCR# Date Maid Lobbyist Registration Form received and verified by: V:`1.lff"VI—A Ii fill!isa r.:li.:ri:•.r.i.,i':.�.r.:,�..,•. Revised 1/11/2011 I� City of Miami Reach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel:305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: James E. Rauh, Esq. 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. I) 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. l -i �402®� Siognare: Date: DISCLOSURE OF INTEREST 3. PARTNERSHIP/LIMITED PARTNERSHIP If the property which is the subject of the application is owned or leased by a PARTNERSHIP or LIMITED PARTNERSHIP, list the principals of the partnership, including general and limited partners. Where the partner(s) consist of another partnership(s), corporation(s), trust(s) or other similar entity, further disclosure shall be required which discloses the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity.* Fairfax Hotel Partnership, Ltd. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME AND ADDRESS %OF STOCK FAIRFAX HOTEL PARTNERSHIP,LTD. LEVY FAIRFAX,LLC 97% Lawrence F. Levy 3% LEVY FAIRFAX,LLC LEVY FAMILY PARTNERS,LLC 100% LEVY FAMILY PARTNERS, LLC LFL HOLDINGS, INC. 1% LEVY FAMILY 1997 SPECIAL TRUST 5% LAWRENCE F. LEVY 2003 FAMILY TRUST 20% LEVY FAMILY 1997 SPECIAL TRUST NO.2 34% ARI LEVY 2012 IRREVOCABLE TRUST 10% ANDREW FLORSHEIM 2012 IRREVOCABLE TRUST 10% ROBERT FLORSHEIM 2012 IRREVOCABLE TRUST 10% STEVEN FLORSHEIM 2012 IRREVOCABLE TRUST 5% FLORSHEIM LFP GIFT TRUST 5% LFL HOLDINGS, INC. Lawrence F. Levy 100% LEVY FAMILY 1997 SPECIAL TRUST Ad Levy 25% Steven Florsheim 25% Andrew Florsheim 25% Robert Florsheim 25% LAWRENCE F.LEVY 2003 FAMILY TRUST Ari Levy 25% Steven Florsheim 25% Andrew Florsheim 25% Robert Florsheim 25% LEVY FAMILY 1997 SPECIAL TRUST NO. 2 Ari Levy 25% Steven Florsheim 25% Andrew Florsheim 25% Robert Florsheim 25% ARI LEVY 2012 IRREVOCABLE TRUST AN Levy 100% ANDREW FLORSHEIM 2012 IRREVOCABLE TRUST Andrew Florsheim 100% ROBERT FLORSHEIM 2012 IRREVOCABLE TRUST Robert Florsheim 100% STEVEN FLORSHEIM 2012 IRREVOCABLE TRUST Steven Florsheim 100% FLORSHEIM LFP GIFT TRUST Riley Florsheim 16 2/3% Kaden Florsheim 162/3% Bodie Florsheim 162/3% Logan Florsheim 16 213% Saige Florsheim 16 2/3% Griffin Florsheim 16 2/3% 14, JAI �� J'I, , � Y �` � �'L E-4� �.��'� 'jo 40D ftt57*9 c c ,Q&>eSf1tG+r(4!-� a- 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) Terminello&Terminello, P.A.,1111 Lincoln Road, Suite 400, 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: Chef Fox, LLC NAME OF PRINCIPAUCLIENT: Chef Fox, LLC 157 Collins Avenue,2nd Floor, Miami Beach, Florida 33139 _ BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)785-4455 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: Nelson Fox, Managing Member • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Nelson Fox(50%)and Myles Chefetz(50%) II.SPECIFIC LOBBY ISSUE: Legally non-conforming restaurant use and other zoning issues relating to the property located at 150 Ocean Drive. Issue to be lobbied(Describe in detail): III.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 general 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 Director and Staff; Historic Preservation Board X Building Official and Director and Building Staff X City Manager,Mayor and City Commissioners c-) ,�, X C= Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial ot:Profes onal relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or c ty per13 nel who is sought to be lobbied as identified on the lobbyist registration form filed. r.., Sec 2-482(g)Any Financial,Familial or Professional Relationship CD r-1 Cda? 5T] C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc k i1/€ _ `' I BE Vi- n City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 3 SFP e 1 LOBBYIST REGISTRATION FORM !• ,�: �.� L;` F, '- L: 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) Terminello&Terminello, P.A.,1111 Lincoln Road,Suite 400, 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: The Italian Job Miami, LLC NAME OF PRINCIPAUCLIENT: c/o Dineamic Group,432 North Wells Street,2nd Floor, Chicago, Illinois 60654 _ BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (312)527-1065 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: Lucas Stoioff,as Manager of Dineamic Group LLC, Manager of the Italian Job Miami, LLC • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached. II.SPECIFIC LOBBY ISSUE: Conditional Use Permit for Neighborhood Impact Establishment and any other land use and development issues relating to the property located at 404 Washington Avenue, Miami Beach, Florida 33139. Issue to be lobbied(Describe in detail): lll.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 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 Baord X Planning Director and Staff 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(g)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) $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 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 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 FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL—BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Si2ng Lobbyist I do solemnly swear that all of the foregoing facts are true ect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all rep uirements. Signa ture of Lobbyist: i Signature of Principal/Client: Lucas Stoioff, Manager of Dineam'` up LLC, Manager of The Italian Job LLC VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: _Produced ID Produced ID Form of Identification Form of Identification ZPersonally known(Lobbyist) Personally known(Principal) VII. SIGNATURE AND STAMP OF NOT Y: OFFICIAL SEAL MICHAEL A ZALAY e J -o State of Florida, County of Miami-Dade NOTARY PUBLIC-STATE OF ILUNOI 0 a of Elo4da,County - e Sworn d subscribe of re me MY COMMISSION EXPIRES:11104113 rn d subscrib before me This day of , 2013 his ��day of T 2013 �,`Plkr•a('&% BRAD STEVEN FLEET Sig ature of Public rTotary—St5te of Florida* * MY COMMISSION#EE Ire of Public Notary—State o lorida Notarization of Lobbyist's signature s,� or EXPIRES:August 21, OF F1,0 Bonded Thru Budget t*l Servieft 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 a istration Formrevised 5-30-2012.doc Revised 04/27/2012 A City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk@miamibeachfi.gov Tel:305.673.7411 ,Fax:305.673.7254 James E. Rauh, Esq. LOBBYIST NAME: 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. Signature: Date: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 3.CORPORATION If the property which is the subject of the application is owned or leased by a CORPORATION, list ALL of the stockholders, and the percentage of stock owned by each. Where the stockholders consist of another corporation(s), trustee(s), partnership(s)or other similar entity, further disclosure shall be required which discloses the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity.* THE ITALIAN JOB MIAMI,LLC CORPORATION NAME Name and Address %of Ownership The Italian Job Miami, LLC Lucarex Miami, LLC 60.00% c/o Lucas Stoioff 900 N.Kingsbury St. Unit 1172 Chicago, IL 60610 Roman Sanchez 5.00% 786 Greenleaf Ave. Glencoe, IL 60022 Ajay Desai Revocable Trust 4.00% c/o Ajay Desai 1204 Heatherton Dr. Naperville, IL 60563 John C.Leonard 4.00% 201 W.Grand PH2 Chicago, IL 60614 IJ I, LLC 5.00% c/o Ralph Gesualdo 2300 Lehigh Ave. Ste.#245 Glenview, IL 60026 L&F Restaurants, LLC 3.00% 18723 Peralta Hill Lane Tomball,TX.77377 Hunter Master Holding Series LLC 2.00% c/o Christopher E. Hunter 1449 N. Mohawk Chicago, IL 60610 EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC Page 2of6 Wright Master Holding Series H LLC 2.00% c/o Jeff Wright 13260 N.83rd Place Scottsdale,AZ 85260 Scott Hoyt 2.00% 2650 N.Lakeview Ave. Apt.#3005 Chicago, IL 60614 Ashley Lauren Barrish 1.25% 1451 N.Astor St. Chicago, IL 60610 Burton Barrish 1.25% 1451 N.Astor St. Chicago, IL 60610 Darcy Ann Barrish 1.25% 530 N. Lake Shore Dr. Apt.#2702 Chicago, IL 60611 Kirsten Joy Barrish 1.25% 21 E. Huron St. Apt.#3102 Chicago, IL 60611 Sean Lannan 1.00% 415 9th St. Wilmette, IL 60091 Freeman Master Holding Series LLC 1.00% c/o Jaisen R. Freeman 611 S.Wells St. Unit#3002 Chicago, IL 60607 John A.Svoboda 1.00% 2037 Seminary Ave. Chicago, IL 60614 Balkin Family LP 1.00% c/o:Michael Balkin, Managing Member 1145 Green Bay Rd. Glencoe, IL 60022 Eason Family LTD 1.00% c/o:William Easom, President 227 W.Monroe St. Suite 3400 Chicago, IL 60606 EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC Page 3 of 6 Christian Meyer 1.00% 26384 320th St. Bellevue,LA 52031 Dan Hoffman 1.00% 227 W. Monroe Ste.3400 Chicago, IL 60606 Sheth Investments,LLC 1.00% c/o Sager Sheth 330 W.Grand Ave. Chicago, IL 60654 Lucarex Miami,LLC Dineamic Group,LLC 53.89% 900 N.Kingsbury St. Unit 1172 Chicago, IL 60610 Fabio Viviani Hospitality, LLC 26.94% 4714 Elderberry Ave. Moorpark,CA.93021 IJ I,LLC 8.34% 2300 Lehigh Ave. Ste.#245 Glenview, IL 60026 Ashley Lauren Barrish 2.08% 1451 N.Astor St. Chicago, IL 60610 Burton Barrish 2.08% 1451 N.Astor St. Chicago, IL 60610 Darcey Ann Barrish 2.08% 530 N.Lake Shore Dr. Apt.#2702 Chicago, IL 60611 Kirsten Joy Barrish 2.08% 21 E.Huron St. Apt.#3102 Chicago, IL 60611 Hunter Master Holding Series, LLC 1.50% 1449 N. Mohawk Chicago, IL 60610 • EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC Page 4 of 6 Wright Master Holding Series H, LLC 0.67% 13260 N.83rd Place Scottsdale,AZ 85260 Freeman Master Holding Series, LLC 0.34% 611 S.Wells St. Unit#3002 Chicago, IL 60607 Dineamic Group, LLC David Rekhson 50% 900 N. Kingsbury St. Unit 1172 Chicago, IL 60610 Lucas Stoioff 50% 900 N. Kingsbury St. Unit 1172 Chicago, IL 60610 Fabio Viviani Hospitality,LLC Fabio Viviani 100% 4714 Elderberry Ave. Moorpark,CA.93021 IJ I, LLC Ralph Gesualdo 100% 2300 Lehigh Ave. Ste.#245 Glenview, IL 60026 L&F Restaurants, LLC Johnathan Lynch 50% 18723 Peralta Hill Ln. Tomball,TX.77377 Gary Fehrmann 25% 18723 Peralta Hill Ln. Tomball,TX.77377 Linda Fehrmann 25% 18723 Peralta Hill Ln. Tomball,TX.77377 Jay Desai Revocable Trust Ajay Desai 100% 1204 Heatherton Dr. Naperville, IL 60563 EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC Page 5 of 6 Hunter Master Holding Series,LLC Christopher E. Hunter 100% 1449 N. Mohawk Chicago, IL 60610 Wright Master Holding Series H, LLC Jeff Wright 100% 13260 N.83rd Place Scottsdale,AZ 85260 Freeman Master Holding Series, LLC Jaisen R. Freeman 100% 611 S.Wells St. Unit#3002 Chicago, IL 60607 Balkin Family LP Michael P. Balkin 25% 1145 Green Bay Rd. Glencoe, IL 60022 Bonnie L.Balkin 25% 1145 Green Bay Rd. Glencoe, IL 60022 Tyler R. Balkin 25% 1145 Green Bay Rd. Glencoe, IL 60022 Jamie L. Balkin 25% 1145 Green Bay Rd. Glencoe, IL 60022 Eason Family LTD William Easom 49% 227 W. Monroe St. Suite 3400 Chicago, IL 60606 Stephanie Easom 49% 227 W.Monroe St. Suite 3400 Chicago, IL 60606 Lindsay Easom 1 % 227 W.Monroe St. Suite 3400 Chicago, IL 60606 • EXHIBIT"B" DISCLOSURE OF INTEREST THE ITALIAN JOB MIAMI,LLC Page 6 of 6 Hayden Easom 1 % 227 W. Monroe St. Suite 3400 Chicago, IL 60606 Sheth Investments,LLC Sager Sheth 100% 330 W.Grand Ave. Chicago,IL 60654 I