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Russell Galbut - Marisa Galbut DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C RECEIVED MAR 2 3 2023 MI AM I B EAC H' Office of the City Clerk I BEACH 1700 Convention Center Drive CITY OF IVIIAM Miami Beach, FL 33139 OFFICE OF THE CITY CLERK 305.673.7411 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: Galbut Russell NAME OF LOBBYIST (Last) (First) (Middle Name) 740 Alton Road, LLC 4770 Biscayne Blvd.,Suite 1100 Miami Florida 33137 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5700 mgalbut@crescentheights.com LOBBYIST BUSINESS TELEPHONE NUMBER "CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Galbut Marisa NAME OF PRINCIPAL (Last) (First) (Middle Name) 740 Alton Road,LLC 4770 Biscayne Blvd.,Suite 1100 Miami Florida 33137 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5700 mgalbut@crescentheights.com a N PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS pursuant to City code Section 2-482(h9(1)(4 a principal of any corporation, partnership o othe entity who appears as a lobbyist on behaf of hat anti dfilare s•-vial co pens.tier' •CSi' • = eft'appearance, indirec CO"contingent,Irj express support o oro.po ition to an i ern shal req" er with the C erk as required b/this subsection bu shall not be required to.a any eqigliTtion fees C\ If the principal is a Corporation, Partnership or Trust, the following information MUST be provided a pursuant to City Code Section 2-482(c): L') • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): M. Galbut • NAME OF ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A): Please see the attached. Page 1 of 5 __Docverlfy ID:1 E3F220A-832D-47A3-92A2-A7907956A18D l Page 15 of 35 T 15A7907956A18D� ,III 'I II I www docverify.com II DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C 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 &Permitting Issues,including but not limited to the Historic Preservation Board, Design Review Board,Planning Board,Board of Adjustment,Land Use Development, City Commission, and any City Workshops or Committees,if necessary,relating to the properties located at 710-720-740 Alton Road in 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&Building Department None X Public Works&City Administration,PB,HPB,BOA None X DRB,City Commission,and Mayor as necessary None X Land Use &Sustainability Committee 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 S rn a 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): $0.00 per hour LL Page 2 of 5 DocVerify ID: docver co nF220A-832D-47A3-92A2-A7907956A18D - Page 16 of 35 16A7907956A18D I 1111 R II III I DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C 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 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 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 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 representing 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 XNo: Are you providing only scientific, technical or other specialized information; appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(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 XNo: 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 XNo: If yes, has i been less th•n 12 mon hs since the elected official(s)whom you provided campaiq consul inq services was sworn inf - 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 N within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: C: N O n o Yes XNo: If yes, were you promised or did you receive economic consideration in exchange for campaign 10 consulting services, O 2 TO BE COMPLETED BY CITY CLERK'S STAFF ONLY a Annual Registration fee: [ ]Yes[ ,]No Amount Paid'$ MCR# Date Paid d N 2 Lobbyist Registration Form received and verified by: N F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018 R h Page 3 of 5 wwwDocVerify ID:1 E3F220A-832D-47A3-92A2•A7907956A18D r page 17 of 35 I 17A7907956A18D 1 ,III p(9�, 'I II I www docveriry.com CdfLT' • DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C 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 COMPOLSE 1TIOjN DURING THE REPORTING PERIOD.' Signature of Lobbyist: ��61.455 Date 03/22/2023 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 C . �- tP'Ireporting requirements. A., Signature of Lobbyist: cif Doeusignedby: Date 03/22/2023 ociS7921A9OG1J'.- n, �.- ��r'��L Signature of Principal: 1VlSa (SAW Date 03/22/2023 7FAB78o80F9342A... VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida County of: Miami-Dade County of: Miami-Dade Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of❑ physical presence by means of❑ physical presence or 0 online notarization, or®online notarization, this day of 03/22/2023 , 20_, by this_day of nv4rmmr n ,20_, by Russell Galbut Marisa Galbut NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Kno _Personally Kno.? rt —• 1► N o'^ - m s6nmm�.mrrlem:moesw Signature of Notary Public Signature of Notary Public Diana Ramos Diana Ramos N N M O Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped N O ( to-r0oawr'tc4ri 4 e.e.,e,—w.e._s w,.a._s 4.. 4 Diana Ramos Diana Ramos n Commission#GG 308355 mmission#GG 308355 o 4 Votary Public-State of Florida l,�otary Public-State of Florida 4 1 l�y Commission Expires Apr 10,2023 Commission Expires Apr 10,2023 n Th o g persons: ay p p < - __ _..., __._..-.•.._, -- _al or others ecializef•A'� � ^"- t .-..h'r�^R^R^may 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 u_ the appearance. Page 4 of 5 DocVerify ID:1E3F220A-832D-47A3-92A2-A7907956A18D i , ,III p �iryp*�'I III www docverify.com I___Page 18 of 35 _ 18A7907956A18D_ Qg11;6��.%•p i r • DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C MIAMIBEACH AM City of Miami Beach,1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granado, City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Russell Galbut 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 30th 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 r, 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. cao DocuSigned by: rn ° ratr, 03/22/2023 0C157921AO4:r... Signature of Lobbyist Date F:\CLER4SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Lu LL Page 5 of 5 I t oc er Iy ID:E3F220A•832D•47A3.92A2•A7907956A18D W ID Page 19 of 35 19A7907956A18D� ,III p( ME7�T ,I III 1 • DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C SUPPLEMENTARY DISCLOSURE OF INTEREST Interests in 740 Alton RD, LLC Percentage Interest Ronruss Nobe Creek, LLC 22.5% Alton M and J Investments LLC 50.0% Brack-Tel Alton, LLC 27.5% Interests in Ronruss Nobe Creek, LLC Percentage Interest Ronruss Partners, Ltd. 100% Interests in Ronruss Partners, Ltd. Percentage Interest • Ronruss Corporation 1.0% Russell Galbut 44.1% Ronalee•Galbut 44.1% Marisa Galbut, LLLP 5.52% Jenna Galbut, LLLP 5.28% Interests in Ronruss Corporation Percentage Interest Russell Galbut 49.5% Ronalee Galbut 49.5% Abraham A. Galbut 1.0% and Nancy K Galbut Interests in Marisa Galbut, LLLP 8 Percentage Interest Russell Galbut 1.0% Marisa Galbut 99.0% LL N W Ir Dwww docver comF220A-832D-47A3-92A2-A7907956A18D Page 20 of 35 1 20A7907956A18D 1111 ,I 'I II I DocuSign Envelope ID:DBA5D3B5-F63B-4E59-A994-60FBFB8C7F3C Interests in Jenna Galbut, LLLP Percentage Interest Russell Galbut 1.0% Jenna Galbut • 99.0% Interests in Alton M and J Investments LLC Percentage Interest Marisa Galbut, LLLP 37.5% Jenna Galbut, LLLP 37.5% R& R Family Grandchildren's Investment Trust#1 25.0% Interests in R & R Family Grandchildren's Investment Trust#1 Percentage Interest The Children born and yet to be born of 100% Marisa A. Galbut, Jenna B. Galbut, and Keith M. Menin. Interests in Brack-Tel Alton, LLC Percentage Interest Jefferson Brackin 36.35% Donald Wayne Brackin 36.35% NKW-EBG Prop 1, LLC 27.3%. Interests in NKW-EBG Prop 1, LLC Percentage Interest Abraham A. Galbut& Nancy K. Galbut 33.3% Eric Galbut & Sarit Galbut 33.3% Daniel Galbut &Jillian Galbut 33.3% N 0C a QN CD W N 0 N M W DocVerify ID:1 E3F220A-832D-47A3-92A2-A7907956A18D I Page 21 of 35 L_21 A7907956A16D_j ,III EMU MU ill www docverify.com • MBF j City Wall 1700 Convention Center Or. Miami Beach , FL 33139 30 - 73-7420 N u . W= Welcome c `� 006013-0027 Ebani T. 03/22/2023 01:54PM `� ` c • MISCELLANEOUS o Reference 1: MCR_431421 z.. • �,� ;` NCR OPEN (NCR) 0 ...` 2023 Item: MCR "R 1 @ 1,200.00 MCR OPEN (MCR) 1,200.00 o Alt: 1,200.00 Subtotal 1,200.00 of t �, Total 1,20Q.OA a 3 CHECK 850.00 , "` 1 Check Number001205 �- s e •: CHECK 350.00 "" Y '- �° Check Number001209 OJ . W »J Q. ,a �Vs �, Sri„ � �Q � I—. � `+.� vy,. 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