Allan Shulman - 1346 Alton, LLC 1346 41-0 te-octel
I\A ! AMIBEACH
City of Miami Beach Office of the City Clerk x ;
1700 Convention Center Drive, Miami Beach, FLuali39 .
LOBBYIST REGISTRATION FORM �/
:."1 J l '" 1,2 z''9•
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to endourage: 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.
Shulman Allan
NAME OF LOBBYIST: (Last) (First) (M.I)
Shulman &Associates 100 NE 38th Street Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 438-0609 (305) 438-0170 Allan(4shulman-desian.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:
James A. Cavanagh, Jr.
NAME OF PRINCIPAL/CLIENT:
1346 Alton, LLC 35 N. Hibiscus Drive Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-528-8000 c/o lance(abeachre.ntals-ntia.corn
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: See Attached.
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: 5'C•C-. r
II.SPECIFIC LOBBY ISSUE:
[Development Approvals and Permitting Issues,'including, but not limited to the Historic Preservation Board, Design Review
Board;Planning Board,—Board-ofAdjustrnent,TL-and Use Development Committee, City Commission, and any City Workshops or
Committees, if necessary, relating to the property located ati-17346 Alton Road, Miami Beach;Florida?
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
Staff for the Planning Department, Building Department, None. X
Public Works and City administration, PB, HPB, BOA, None. X
DRB, City Commission, and Mayor 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 2-482(g)Any Financial, Familial or Professional Relationship
None.
None.
None.
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):
�25/17176k A) LOBBYIST DISCLOSURE:(Required)$
a
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $ -S
(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 XNo: Are you lobbvina on a present or sending bid for aoods.eauiament or services.or on a present or pending
award for aoods.eauiament 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 lobbvina on a oendina application for a Development Aareement with the City or application for
change of zonina map designation or chanae 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 aC 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 BEACK
MB THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORT! G PERIOD.
C c,1 ;
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Bea h City Code an all reporting requirements.
Signature of Lobbyist: c--/
Signature of Principal/Client: -� �. s _ _ _ _ / 1,3
' •0 yr ' 1
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: 'o' 9<= '
o. E
:Uq 7�`
Produced ID Al o Produced ID
Form of Identification 4, ►° : I Form of Identificati._n o .`
x o c � o c> a
/ o 0
ap
Personally known (Lobbyist) �, ` Personally known (Principal) • H _, Q m
` % —1
2,. ' 'n g o x ci -c
VII. SIGNATURE AND STAMP OF NOTAR i! Q W c r y
si W � E .E E nCto m 3
State of Florida, County of Miami-Dade Z. 8 o ` State of Florida, County of Miami-Dad ° d a m
Sworn to a d subscribed before me z° Sworn an subscrib before me . N
This r.- a i,.a'ff f115 This day of L ,..243-1-5 . o
Alt—Mil&V
Signature o Public N. ary—State of Florida t, p.. .; Si•nattij f Public Notary—State of Florida
Notarization of_•■•.■' signature 1 `''" , Notari n on of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual /�
Annual Registration fee: �1]Yes[ ]No Amount Paidi.'S°0 �c() MCR# t og17M7 /qo`t ill Date Paid 0341' )47
Lobbyist Registration Forrr�received and verified by: R� 5b�
MIAAA BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachtl.gov
CITY CLERK Office
•
Rafael E. Granado, City Clerk CityClerkrrmiamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LO B B Y IS T NAME Allan Shulman
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 C.ounty 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.
slaS 1 ( 0
Signature: Date:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
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CITY OF MIAMI BEACH
• DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
•
1. 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.*
1334 Alton, LLC. -35 N. Hibiscus Drive, Miami Beach, FL 33139
CORPORATION NAME
NAME AND ADDRESS %OF STOCK
JAC Holdings, LLC 100%
16885 Dallas Parkway
Dallas, Texas 75001
JAC Holdings, LLC. 16885 Dallas Parkway, Dallas, TX 75001
CORPORATION NAME
NAME AND ADDRESS %OF STOCK
James A. Cavanagh, Jr. 100%
16885 Dallas Parkway
Dallas, Texas 75001
1346 Alton, LLC. - 1330 Collins Ave., #1, Miami Beach, FL 33139
CORPORATION NAME
NAME AND ADDRESS %OF STOCK
JAC Holdings, LLC 100%
CT Corporation Sustem
1999 Bryan Street, Suite 900
Dallas, Texas 75201
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S)AND EACH INDIVIDUAL
STOCKHOLDER'S NAME,ADDRESS, OFFICE AND PERCENTAGE OF STOCK ON A SEPARATE PAGE.
NOTE:Notarized signature required on page 8
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