Jim Gran TGNC Development
~
RECEIVED
03 M'R I 6 AM /0: 58
CITY CLERK'S OFF ICE
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Bach, FL 33139
Email: cityclerk@ci.miami-beach.f1.us
LOBBYIST REGISTRATION FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
o 15 Check Box If an Amendment
NAME OF LOBBYIST:
Gran
(Last)
Jim
(First)
(M.I.) DATE QUALIFIED AS LOBBYIST
10NW 42"" Avenue #200
BUSINESS ADDRESS: (Number and Street)
Miami
(City)
Florida
(State)
33126
(Zip Code)
(305\ 448-5076
TELEPHONE NUMBER:
(305\ 448-5466
FAX NUMBER:
EMAIL:
I.
LOBBYIST RETAINED BY:
TGNC Develooment. LLC
NAME OF PRINCIPAUCLlENT:
60 Cutler Mill Road #308
BUSINESS ADDRESS: (Number and Street)
(305\ 674-0600
TELEPHONE NUMBER:
Great Neck
(City)
New York
(State)
11559
(Zip Code)
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section If principal Is a Corporation, Partnership, or Trust [Section 2-482 (ell
? NAME OF CHIEF OFFICER, PARTNER OF BENEFICIARY: See Exhibit A
? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST
IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Exhibit A
II. SPECIFIC LOBBY ISSUE:
Substantial Amendment to Conditional Use Pennit Aoolication
Issue to be lobbied (Describe in detail):
III. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED: \
A) Full Name of Indlvldualmtle B) Relationship
Joroe Gomez None
Mercv Lamazares None
o
.
\ ,
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATRION (DISCLOSE WHETHER
HOURL Y, FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE:
1sJ,f)()D, or-
FI(A K~ 1'(
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIEST COMPENSATION): fJ~ K U~ ($ /tllP.!!!1
V. SIGNATURE UNDER OATH:
ON OCTOBER 1"T OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE
PRESEDING CALENDAR YEAR.
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 Beach City Code as
amended, and all reportin irements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
~ .IS Produced ID Fl>~ C..,.{"So- y6'1-<<>...... 01 t']-O - '"}A1-\e's .~~ Cc-tA('l
Form of Identification
o .IS Personally Kn&.~Lt~ AS 36- b ~o - 52.- 01;r;-- 0 - Rrv L tlm,,J
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn tq and SU~rd before me
This lh.-f'"day of . , ~ .3
V'_' NOfARysEAL
UWAN BEAUCHAMP
NarARY PUBUC STATE OF FLORIDA
COMMISSION NO. DDlO!l'289
MY COMMISSION EXP. APR. 29~
FOR CLERK'S USE ONLY
Registration:
M. ACCEPTED
4~\~...OJ
DATE:
[ ] REJECTED
If rejected, state reason:
.....-..,.." t>tV_ []N' ?S~~
:.JlstvtJ,. Check MeR # ,
pATA ENTRY DATE: 2.6.:Jii ENTERED BY:
1 First Revision - 05-17-02
ExmBIT A
DISCLOSURE OF INTEREST INFORMATION
Lots 2 and 4 and east 25.5 feet of Lot 6: TGNC Development, LLC:
Irrevocable Trust for the Benefit of David Craig Brodsky,
Jeffrey Holden Brodsky, Jessica Brodsky Miller, Lee Jared Brodsky.
Each of the beneficiaries holds an equal share in the trust.
Muriel Brodsky is the guardian ofthe trust.
26 Harbor Park Drive, Port Washington, NY 11050
Paul Anton, 60 Cutter Mill Road, Suite 308, Great Neck, NY 11201
GSB Holdings Corp. (100% owned by Steven A. Boughner)
60 Cutter Mill Road, Suite 308, Great Neck, NY 11201
Michael Groothius
60 Cutter Mill Road, Suite 308, Great Neck, NY 11201
Lots 1 and 3: POP Development, LLC:
Irrevocable Trust for the Benefit of David Craig Brodsky,
Jeffrey Holden Brodsky, Jessica Brodsky Miller, Lee Jared Brodsky.
Each of the beneficiaries holds an equal share in the trust.
Muriel Brodsky is the guardian of the trust.
26 Harbor Park Drive, Port Washington, NY 11050
Paul Anton
60 Cutter Mill Road, Suite 308, Great Neck, NY 11201
GSB Holdings Corp. (100% owned by Steven A. Boughner)
60 Cutter Mill Road, Suite 308, Great Neck, NY 11201
Michael Groothius
60 Cutter Mill Road, Suite 308, Great Neck, NY 11202
50%
16.667%
16.667%
16.665%
50%
16.667%
16.667%
16.665%
\ .
Lot 8 and west 50 feet of Lot 6: Just Around the Corner, LLC
Paul Anton
60 Cutter Mill Road, Suite 308, Great Neck, New York 11201
19.5%
Michael Groothius
60 Cutter Mill Road, Suite 308, Great Neck, NY 11202
26.5%
Lee Lazenus
60 Cutter Mill Road, Suite 308, Great Neck, NY 11202
9.5%
Dean Fierro
60 Cutter Mill Road, Suite 308, Great Neck, NY 11202
2.5%
Michael Meyers
60 Cutter Mill Road, Suite 308, Great Neck, NY 11202
2.0%
South Beach Garage, LLC
26 Harbor Place Drive, Port Washington, NY 11050
40%
(Ownership Breakdown of South Beach Garage, LLC)
Hugh Freund
26 Harbor Park Drive, Port Washington, NY 11050 3.0%
Irrevocable Trust FBO David Craig Brodsky (beneficiary)
26 Harbor Park Drive, Port Washington, NY 11050 5.625%
Irrevocable Trust FBO Jeffrey Holden Brodsky (beneficiary)
26 Harbor Park Drive, Port Washington, NY 11050 5.625%
Irrevocable Trust FBO Jessica Heather Brodsky Miller (beneficiary)
26 Harbor Park Drive, Port Washington, NY 11050 5.625%
Irrevocable Trust FBO Lee Jared Brodsky (beneficiary)
26 Harbor Park Drive, Port Washington, NY 11050 5.625%
(Each of the beneficiaries holds an equal share in the trust. Muriel Brodsky is the
guardian of the trust.)
Barnett Brown
P.O. Box 987, East Hampton, NY 11937
1.0%
Gerald Angowitz
37 Fieldstone Lane, Oyster Bay, NY 11771
2.5%
. "
#
.
David Gershen
26 Harbor Park Drive, Port Washington, NY 11050
0.5%
Adam Caslow
Old House Lane, Sands Point, NY 11050
1.25%
Emily Caslow
26 Harbor Park Drive, Port Washington, NY 11050
1.25%
Gerald Shapiro
26 Harbor Park Drive, Port Washington, NY 11050
4.0%
Joel Mair
83 Winthrop Road, Plainview, NY 11803
1.5%
Edward Miller
7 Sunset Lane, Garden City, NY 11530
2.5%
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER):
,,/. ~ ~ S::t.-47 fl..4 re..
A) LOBBYIST DISCLOSURE: . ~ L!.
...
?- /!Jot) ~ n..#r tfA7"-L
B) PRINOPAl'S DI5a.OSURE (OF LOBBYIST COMPENSATION):
V. SIGNATURE UNDER OATH:
ON OCTOBER lIT OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
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 Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
;:;;;j.~.,.~
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Signature of Prlndpal/Client:
VI. LOBBYIST IDENTIFICATION:
a Produced ID
o Personally Known
Form of Identification
YD. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of . 2003.
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Signature of Public Notary - State otiFlo~ m
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Print, stamp or type name of Notary:RubR'i m
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Registration: ~
FOR a.ERK'S USE ONLY
[ ] REJECTED
DATE:
If rejected, state reason:
Registration fee pa'd:11e5 [ ] No
DATA ENTRY DATE: 2-4
2nd RevIsion 1/27/03
.
[ ] Cash [ ] Oleck M~CR
. 2003 ENTERED BY:
F:' HAn \Lobbylstsl,reglstratfon03.doc
.