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James E. Rauh - Tanuki, LLC iot7o-Ilse) A1.k 2-1- M, AM i BEACH 7 City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LG 15 SE ' -8 PH LI: 31 LOBBYIST REGISTRATION FORM I �,� _;;;, ,ti I l i'- 11:: 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. 1224 WASHINGTON AVENUE MIAMI BEACH FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 602-8245 (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: TANUKI , LLC - NAME OF PRINCIPAL/CLIENT: TANUKI, LLC 1070-1080 ALTON ROAD MIAMI BEACH FLORIDA 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 803-2286 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:TAGIR SAYDKUZHIN, MANAGER • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SEE ATTACHED EXHIBIT "B" II;SPECIFIC: LOBBY ISSUE:MODIFICATION OF CHANGE OF OWNER OR OPERATOR FOR THE VARIANCE PREVIOUSLY APPROVED UNDER BOA FILE NO. 2891 AND ANY AND ALL OTHER LAND USE, ZONING, AND LICENSING MATTERS RELATED TO THE PROPERTY AT 1070-1080 Issue to be lobbied(Describe in detail): ALTON ROAD 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 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 X BOARD OF ADJUSTMENT X MAYOR & 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 NONE F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc r 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): (REQUIRED). $3 7 5-HOURLY 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 XNo: 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 XNo: 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. • YesXNo: 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 B ED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. — Signature Lob.fist I do solemnly swear that all of_tlie foregoing facts are true an•,cor • t and that I have read or am familiar with the provisions contained in Section 2-482 of the Mi. i Beach ity Code and all reporting requirements. Signature of Lobbyist: —A' Signature of Principal/Client: VI. LOBBYIST IDENTIF`'�`= , , /v\ iAM City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granath), City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: JAMES E. RAUH 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 of each year, shall be autom- - suspended from lobbying until all fines are paid, unless the fine has been ap• =sled to t:,a Miami-Dade County Commission on Ethics and Public Trust. t/ q...- r ,9„),(5 Signature: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc EXHIBIT "B" DISCLOSURE OF INTEREST I. 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.* Tanuki, LLC CORPORATION NAME NAME AND ADDRESS %OF STOCK Tanuki, LLC Cactus, Ltd. 50% Withfield Tower, Third Floor 4792 Coney Drive P.O. Box 1777 Belize City, Belize Empinada Limited Corp. 50% East 53rd Street, Marbella Humboldt Tower, FL 2 Panama, Republic of Panama Miscellaneous Cash Receipt J 1.7;„- uo:r 9/0 /2015 COI 1 i CITY OF MIAMI BEACH i-.: -4: 1_x;5 C, .3-.: 40715'',:', '35 .QIJ NO. ."y ij i 1. 56 -:..: , . .,,,_ . , , . :,-;,,,,-;., ,,!,, . :,, ,40,,,,_::::. i.... .0 ,, ;. - ❑ Cash 1Credit Card ❑Check# $ , -4.../ . r ,--- .- 20 / Received of )a me 5 &( tV\ Address \22 L i lir-J 7. 1 - vim. Aki<E-#t4.e . ,41,,,,; 6- )) For D; 'r V4)Q4 10 -0 —10 9 0 . (THIS INFORMATION MUST BE COMPLETED) t Office of/Fi arrce Director By \ , i - Account Number:01 I gel 00" 1‘Cf _c1 Li r r• c)CIA.- CC I AA 1.'" - De t: d` "" EXT: i.Prepae . , p f , CITY HALL CASHIER OFFI :.:_ 1700 CONVENTION CNTR DR MIAMI BEACH, FL 33139 09/08/2015 16:34:43 - CREDIT CARD VISA SALE WOMWWOMMMMffiWWOW CARD# XXX "GKXX)(5682 '` Chip Card AID: A0000000031010 ATC: 0004 TC: 1766FOBC82766E3E City of Miami Beach-Florida INVOICE 0009 Finance Department SEQ#: 0009 Batch#: 1 City Hall 001623 1525113-2 09/08/2015 BR1 T113 hod 008522 Entry Me thod:: Tue Sep08,2015 04:34PM Trans#5-5 Entry Me Chip Read 5 $350.00 MCRCLERK - MCR-City Clerk Mode: Issuer * MCR#: 407156 Tax Amount: $0.00 1 ITEM(S): TOTAL: $350.00 SALE AMOUNT $350QU Credit Car PAID $350.00 Have a nice day! CUSTOMER COPY