Jennifer McConney-Gayoso - Russell W. Galbut - 300 17th St. Investment, LLC E
P n; f t_.. REC-I
Office of the City Clerk 2018 UR I I AH 9: 03
1700 Convention Center Drive
Miami Beach, FL 33139 (.R,/ i--- fi ACit
305.673.7411 I r
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 City Code Chapter 2, Article VII, Division 3. entitled"Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form, with the applicable fee,to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "n/a° in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period That the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
McConney - Gayoso Jennifer
NAME OF LOBBYIST (Last) (First) (Middle Name)
McG Arcitecture + Planning 7580 NE 4th Court, Studio 100, Miami FL 33138
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 573-2728 Jennifer-cm-Leg-architecture corn
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Galbut Russell
NAME OF PRINCIPAL (Last) (First) (Middle Name)
300 17•h Street Investment, LLC, 3050 Biscayne Boulevard, PH 41, Miami Reach, FL 33137
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (Slate) (Zip Code)
305-573-4127 RGalbut(oiCrescentHeights.corn
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER, OR BENEFICIARY(if none,write N/A): Russell Galbut
• NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write WA): See Attached.
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development Approvals and Permitting Issues, including, but not limited to the Historic Preservation
Board, Design Review Board, Planning Board, Board of Adjustment, Land Use Development
Committee, City Commission, and any City Workshops or Committees, if necessary, relating to the
property located at 300 1 7h Street, Miami Beach, Florida.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship(If yes,explain) YES NO
Title of Person to be Lobbied _
Staff for the Planning Department, Building None X
Department, Public Works, and City None X
Administration, PB, HPB, BOA, DRB, City None X
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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
None
None
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
Z5o /hr.
Page 2 of 5
The following six(6)questions MUST be answered:
1) Pursuant to 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 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 City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist as set forth in
Section 2-481)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 city clerk as required by this section,but shall not be required to pay any registration fees.
Yes X No: Are you represGomezq a not-for-profit corporation or entity without special compensation or
reimbursement?
4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who
provide only scientific,technical or other specialized information or testimony in public meetings, any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item, and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
_Yes X No: Are you providing only scientific, technical or other specialized information; appearing as a
representative of a neighborhood association without special compensation or reimbursement or
represGomezq a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2391(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services
within the past election cycle. See Section 2-491 for more information.
_Yes X No: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
_Yes_No: If yes, has it been less than 12 months since the elected officlagsl whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
_Yes X No: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
Yes No: If yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
f ( )-
Annual Registration fee: [ I Yes[�No Amount Paid E 5c) MCR# R I�,U J, Date Paid
Lobbyist Registration Form received and verified by: — `10`) f711"L' -.cLG.
F:\CLER\BALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 01-01-18 REG.doc Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
• EXPENDITURE OR COMPENSATION DURINGNTHE�� REPORTING PERIOD.'
\3 a
Signature of Lobbyist: etcmed Date
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: Date
,
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Signature of Principal.: Date M r� 1 O
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
�A
State of %k 4, athchaf State of f �aY
County of: County of: 1 qat,- 1QLf LJ
Sworn to(or affirmed) and subscribed before me Swor to(or affix ) artd subscribed before me
this day of 20_, by 3-day of fel/ 20J by
tk?(ISS2,t i�l. Q (11(1-
NAME
(,1-
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known V rj rsonally Kn. n
tit �4S
Signature of Notary Public . atur. of Notary-ublic
t ills
Name of Notary, Typed, Printed or Stamped Name of otary, Type., Printed or Stamped
MIAMI AGUTAR
(NOTARY SEAL) (NOTARY SEAL ,y`� I/?ca Notary Public•State of Florida
Commission M FF 196144
My Comm.Expires Mar 16,2019
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Bondedikou9h National Notary Assn.
I The term"lobbyist"specifically excludes the following persons.
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.'
Signature of Lobbyist Date �//3/ /Co
I do solemnly swear or affirm that all of the foreg. : facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and all
rTreporting requirements. t� 111
Signature of Lobbyist: tcc--nn �y ��� Date //3 /{�
Signature of Principal: _ __42. CL 4_C1 'dt( Date /
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of c-' ko f i AO, State of L"1' 'cc
County of: Q r O LJ-_.C)1 \ County of:
Sworn to(or affirmed)anid subscribed before me Sworn to(or affirmed)and subscribed before me
this S day of Pr' 1 2003, by this day of 20_, by
vIvi,pc' McConell
NAME OF LOBBYIST NAME OF PRINCIPAL
/Produced ID Flo, 'L. ,Y:: Lc_.,,ss _Produced ID
FORM OF IDENTIFICATION LAT 51Wioiy FORM OF IDENTIFICATION
_Persona y Known Personally Known
Signature of Notary Public Signature of Notary Public
Lu_o. vC- l. -' . 1‘.1 1.0
Name of Notary,Typed, Printe4p1818rrtiod Name of Notary, Typed, Printed or Stamped
(NOTARY SEAL) (NOTARY SEAL)
My comm.Wire?:
Novembers 2021 1 _
.• No.GG 158830 !
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'The term"lobbyist specifically ex,..
xp��19.4K zutlb tst\ersons.
'4; OF ?,..\-‘0.
Expert witnesses who provide only scieeIpbral or other specialized information or testimony in public meetings; any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether
direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
City of Miami Beach. 1700 Convention Center Drive, Miami Beam, Florida 33139, www.miarnineacMLgor
Office of the Cily Clerk
Rafael E. Grenade, Cay Clerk
CityC lerkr miamibeach0.gov
Tel: 305.623.2911, Fax: 305.673.7254
NAME OF LOBBYIST: Jennifer McConneu
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 301h of each year, 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
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Signature Of Lobbyist 2 Date 1 l
CLEgsnuaroRMsroeeVPST FDRMsmmyal Regisiaaon rutin Remsed 0141.18 REC doc
Page 5 of 5
DISCLOSURE OF INTEREST
Interests in 300—17 Investments, LLC.
Percentage of Interest
Ronruss Partners, Ltd. 100%
2200 Biscayne Blvd.
Miami FL 33137
Interests in Ronruss Partners. Ltd.
Percentage of Interest
Ronruss Corporation 1%
2200 Biscayne Blvd.
Miami FL 33137
Russell Galbut 44.1%
2200 Biscayne Blvd.
Miami FL 33137
Ronalee Galbut 44.1%
2200 Biscayne Blvd.
Miami FL 33137
Marisa Galbut 5.52%
2200 Biscayne Blvd.
Miami FL 33137
Jenna Galbut 5.52%
2200 Biscayne Blvd.
Miami FL 33137
Interests in Ronruss Corporation
Percentage of Interest
Russell Galbut 49.5%
2200 Biscayne Blvd.
Miami FL 33137
Ronalee Galbut 49.5%
2200 Biscayne Blvd.
Miami FL 33137
Abraham and Nancy Galbut 1%
2200 Biscayne Blvd.
Miami FL 33137
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