2024 Lobbyist Registration Form - 1600-1624 Alton RD - (Marisa Galbut) Itoo - �6�ti A��oh eJ
� Dow5lgn Envelope ID:CB04DiDF62EE-44C8-A142-28AEAAD6B10A
- .. . . �.:.-..'/i_�i_.
M � ��� ✓��� � OfAceoftheCiryClerk ��/��( U� Z�L;
1700 Convention Center Drive
Miami Beach, FL 33139 . . . . -
305.6737411 �� � �� . .. .
LOBBYIST REGISTRATION FORM
Lobbyisl means all persons employetl or retained, whether paid or not, by a pnncipal who ueks to encourage ihe passage, tlefeat or
moGifiration of any ortlinance, resoWtion, action ar tledsion of any commissioner; any action, tlecision, recommendation of the City
Manager or any City boaN or wmmittee;or any action,tledsion or recommentlation of any Ciry personnel dunng the time penotl of the
enti2 decision-making process on such adion, deasion or recommendalion Iha� foreseeably will be heard or reviewed by Ihe City
commission, or a Ciry board or committee. The tertn specifically includes the principal as well as any employee engaged in lobbying
activities. The term'Lobbyisis'�as spacific exclusions. Please refer lo City Code Chapter 2,ARicle Vll, Division 3, entitled"Lobbyisls,"
for atl0itional information.
InsVuctlona: Please compkte all sections of lhis fortn antl submit lhe completed fortn,wiM l�e applinble ke, to the O(fice of the City
Clerk. I(you need more space lo camplete an answer, use a sepa2te s�eel(s)of paper If you have nothing lo report in a particular
section, you must wnte "none or "Na" in lhat section. Any change ro any infortnalion on9inally filed, or any atltlitional City
Commissioner ar personnel who a2 also sought to be lobbietl shall require Ihat ihe lobbyist file an amentlment to ihe iegistration form.
The lobbyist has a continuing tluly to supply information and amend the fortns fletl lhmug�out ihe period ihat the lobbying accurs.
Separale regisirdtion Po�ms shall Oe requiretl for each pnndpal 2presenled on each speafc issue.
I. LOBBYIST INFORMATION:
Herrera Wilson
NAME OF LOBBVIST (LasQ (Firs�) (Mitltlk Name�
Built Form 935v Chestnut Street, #520 Chicago IL 60642
LOBBYISTBUSINESSNAMEANDADDRESS (Numberend5heel) (City) (Sta�e) (ZipCotle)
312-7383835 wherrera��:Uuilt-form.net
LOBBYISTBUSWESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILA�ORESS
11. PRINCIPAL INFORMATION:
Galbut Marisa
NAME OF PRINCIPAL (Lesp (Firsp (MiGtlle Name)
1212 Lincoln LLC/1600 ARRP LLC 2200 Biscayne Blvd.,Miami Florida 33137
PRINCIPALBUSMESSNAMEANDADDRESS (NumEeranEStreet) (Ciry) (State) (ZipCOGe)
� 305-374-5700 mgalbut@crescentheights.com
' PRINCIPALBUSMESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILADDRESS
Pursuant to Ciry Catle Section 2i82(M1�(1)(a): A pnntlpal of any corporetiory paMersM1lp, or other eMdy who appears as a IODDyIst on Eehalf of t�at
enliry,without speaal compensatlon or reimEursemen�(or iM1e appearence,wheRrer Eirect,inEireG,w wMingen�,to express supPotl W or opposition to
an i�em s�all regis�¢r wi01M1e qeA as mqui�etl Ey�M1is subsedi0n bul s�all nM De mquiretl�a pay a�ry regislre�i0n kes.
� 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�: M Gdlbut
• NAME OF ALL PERSONS HOLDING,DIRECTLV OR INOIRECTLY,A 6%OR MORE OWNERSHIP INTERE3T IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(i!none,write N/Aj: Please Se2 t}12 attached.
_ Page 1 of 5 �
I
oo�v:�n ine>zseras-osw�a�cnaene�eoreie � v.�ime neen.uaovrie {�. Q�
,III B:S�F4f1��I I
, �ocuSignEnvelopel�:CB04D1DF62EE-E4C8-A142-28AEAAD4B10A
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is prectical, 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 PreservaHon
Board,Design Review Board,Planning Board, Board of Adjustrnent,Land Use Development,City
Commission, and any City Workshops or Committees,if necessary, relating to the property located
at 1600-1624 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 72 months preceding such commencemeM of service
with the City to the present date, sWting the general nature of the subject conUactual relatlonship.
Full Name of Intlividual and Contrectual Ralationship(If yes,explain) YES NO
7itle of Person to be Lobbietl
Staff for the Planning&Building Department None X
PubHc Works &City Administration, PB,HPB, BO None X
DRB, City Commission,and Mayor as necessary None X
Land Use&Sustainabili CommiHee None X
Pursuant W City Code Section 2dffi�g), every regisVant shall be required to sWte the extent of any
busfness, financial, familial or professional relationship, or other relationship giving rise to an
appearence of an impropriery, with any current City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyist regisVation form filed.
List any Busineas, Financial, Familial or ProTessional Relationship, or othar relationship giving risa to an
a earance of im ro rie if none write N/A :
None
_ V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
_ conZingency fee is prohibited pursuant to City Code Sec. 2-485.3�:
$ .00 per hour
�, Page 2 of 5
ocVetlfylO�.EF39BF>SD6]NElldIDG19EP6MOFFIE ppppqB f1BEP508DFRE ,Ill�p'�RqyQ'llll
9oweTy mm <HyP6fYe
, Dow5lgn Envelope 10:CB04D10FE1EE-44C&A142-28AEAAOABIOA
The(ollowing aiz(8)questiona MUST be answered:
i) Pursuanl lo Ciry Cotle Sedion 2I88,entitled"Pro�ibitetl Campaign Contributions By Lobbyists On Procuremenl Issues":
Ves xNa: Are vou IobEvino on a oreaent or cendina bitl Tor 000ds. eauioment or services. or on a oresent or
pendinu award for aoods.eaulomene or aervice?
2) Pursuant to City Code Section 2d90, entitled"Prohibited Campaign Coniributions By Lobbyi54s On Real Estale �evalopment
Issues":
Vas X No: A I bb ' 0 8 ce dl n o 1' ll f D eloD 1 Au t 'ih th C'N a DI' ll
Tor chanae of zon'na mao dasianation or chanae to Me Ciri's Future Lantl Uae Mao?
3) Pursuant to City Cotle Section 4d8R�h�, any person (except lhose exempt from t�e tlefinition of 'IobCyisP as set foM in
Section 2-0Bi�who only appears as a rep2sentative of a nobbr-profit corporetion or entity withoul spedal mmpenution or
reimburument kr t�e appearance,whether dired or indirect to express support otor opposNon to any item,shall regisler with
the city clerk as 2quired by this section,but shall not be required to pay any regisUation kes.
YeaxNo: Are vou reoreaentlna a nobfor-orofit corooratlon or entiN without acecial comoeneation or
reimbursemenli
4) Pursuant to City Cotle Section 2181, Ihe term "IOEbyisC'specifically exGudes Ihe following persons: Ezpert witnesses who
provitle only scientifq lechnical or other specialized inhrmation or testimony in puElic meetings; any person w�o only appears
as a representative of a neighborhootl association without mmpensation or reimbursement forthe appearance,whether direcl,
intlirect or contingent,lo express support of or opposition to any item;antl any person who only appears as a represenGtive of
not-/or-proft mmmunity base0 organization for t�e puryose of requesting a grant without special compensa6on or
reimbursement forthe appeaance.
YenXNo: Are vou orovitlina onlv acient'fc lachniwl or other scecial{zed iniortnation: aooearina as a
o �fative ot a nelahbaMoatl associat'on w'Nout soeelal comcensation or reimbunement or
o tl e oW0 -o Flt b tl ' 860 !o M o ro f t' e annt wiMout
soeclal comoensation o�refmbunement?
5) PursuaM to Ciry Cotle Section 2-497(1�, no campaign consuHanl shall lobby ihe Ciry Commission for a period o( 12 mon�hs
follovnng ihe sweanng in of any elecletl officiaps)for whom Ihe campaign consuHanl provided campaign consulling services
wiNin Ihe past election cyGe.See Section 2-091 for more infortnalion.
Ves XNo: H V 'd d q oala t IB t en ' t be t b i M CN CommiBaion
ilh' lhe oastel 0 v I ?N I se Ihtfhe i b t 6eA 1 t tM C'N Commisalon�
Yes X No: If vas has 't been less than 12 monlhs since Me electetl ofFiciallal whom vou orovided camoaian
consultina servicea was sworn In9
6) Pursuant to City Code Section 2d83�aN<k�. a lobbyist who has within the past election cycle provitletl campaign wnsufling
services to an incumbent member of the City Canmiwion(which lobbying activity is not olheiwise prohibited by Catle section
= 2<91) shall disclose such partiwlar service on his/her lobbyist iegisiration fortn antl shall orallv disclose such oerticular
sery ce bekre lobbv'na the CiN Commission at a oublic meetino.
- Yes x No: Ha e v o 'ded camoalan conaultinn aerv'ces to an Incumbent memOer of Me CIN CommUsion
'th'n the oest ele ll v I 71t oleaae Il6tth ' b t membeAsl of M C'N C ' elon'
Ves x No: H are o i d d'd recelve eeonom e cons'derollon In exchanae for camoa'an
consultina senices7
' TO BE COMPLETE!D BY CRY CLERK'3 STAFF ONL)Y��a�� Z
- Annual Ra8lsUatlon he: I�I Ym I 1 No Amount Pa*ltl S■ `��J��MCR{� %�"�b paq PaIY �
' LOLbybt Registreffon Foim recelveE antl verifletl by:./ll"�
F:\CLE0.\{ALL\aFORMS\LOBBYISTFORMS\LabbyistRe9isba[ianFormRevisetl09-20-18REG.tloc Revlsetl09/10/2018
_ Page 3 ot 5
�,w.��o��va��rwmsa�os.oeas<ev.eroa�ae>meovs,e � . ,Ill�li'cYFl321IIII
a.o.ame aieens�eorFie
, Doa�SpnEnv�bpelD:CB01D1DF-02EEdAC&A1t2-2BAEMMBIOA
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 2! OF EACN YEAR. EACH LOBBVIBT SXALL SUBMIT TO THE OFFICE OF TNE CITY CLERK A
SIGNED STATEMENT UNDER OATH. LISTIN6 LOBBYING EXPENDRURES. AS WELL AS COMPENSATION
RECENED FOR THE PRECEDING CALENDAR YEAR WITN REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGA6ED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF TNERE HAS BEEN NO
EXPENqTURE OR C0�1 M TME REPORTIN6 PE '� '
Signaturo of Lobbyiat: ��� �r0. Dala ovwrzoz�
'C � M
I do solemnly swear a affirm ihet all of the fwagoing facls, statemeMs, end diaGosures in this fortn aro Ws and correcl,
and that I hav� read or am hmiliar with Me provisions contained in Chaptx 2, M. VII, Division 3, entitNd 'LobDyiats' oi
ihe Miemi Beach Ciry andWnsporting requiromsnta.
Sipnature of Lobbyisl ��'�"' �'m'r°" �� ..w. Date ovo�uzoza
Signffiun M Principal: � �� � Date avo�rm>a
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State W Florida Staro M Florida
Counry ot Miami-Dade Counry oC Miami-Dade
Swom ro(«affirmetl)entl subscnbed betore me, Swom m(w atfirmed)ana sunxribed betae me,
by means of O physical precence by means of 0 physical prea�nca
or qtonlins notarization, or 6p online rwtarizatbn,
Mis_day M mm�.nno. .20_, by Nia_day of aamanna� .20_,by
WiLson Herrera Marisa Galbut
NAME OF LOBBVIST �1E OF PRINCIPAL
ProEuced ID _ProOuced ID
FO F� (� - �
�Poisonelly K \IL � �Personally Know �
. Sipnatun of Noury u'bfic� SpneWr�o/Nofary Pu T��'�� ���
� Diena Ramos Diana Ramos
I. Nam�of Nofary,TypM,Pdnted or StampW N of N� t � T • , 'nls o m tl
pru Rano� OW�timo�
� CemmWbn�IM]�Mt7 C�mlubn�NN 7lN71
/blsry Pudic.31�M of i1wIW IbInY Pudic-Sb4 d FbM�
My Comm'sWon E�pM��Apr 16,202] MY�^�^^w��b^E'�1'�t�P 18.102�
'T� WRons: .........m.�..... .se_.
- Eap�rt wiNesws wlw proviM only sci�ntllk,techniul or olhx ap�cwl@etl in(ormetion or tatimony in puDlk meeti�ps;any penon wlq
�-� only�vV+an n a rp�unfativ�of a nNpnDorhooE nsod�tion xil�oul compsmalbn w roim Wrwm�nt!or�M appeerano.wlretMr
. Oiroc�, iMinct or continqsM,b eRpms wDOON of or oppo4tbn b�ny Xem;�ntl�ny p�non who oMy�ppe�n�s a roD���+tive of
not-for-profit canmunily bxaE orpmiratbn br Mm purym�ol rpws6np e 9����'�+��W��I compsnselion or roimDursemeM(or
ih�app�a�nw.
Peqs I of S
_ .._ -- .._-_ ._. .-___ . . . ._. {� Q�
� savosovcae� - - orrie � vy.�ae n�.uworr+e ,IIIPJ:O�F.L:1IIII �
, DaaSpnEnwbpslD:CB0I01DF82EEJ/C&A1�2-PBAEMD0810A
� F ' � i
. . E � l f �� �� � .
Ciy of Miami Beooh, 1]00 Convem�on Cenrer Drive,Miomi Beach,FloriM 33139,wwwmlamibeachN.gov
Office of rhe Ciry Clark
RafaelE. Granado,Ciy Clerk CiryClerkCmlomibeachfLgov
iel: 305.673741 7, Fox: 305 6737254
NAME OF LOBBYIST: Wilson Herrera
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant W City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
prindpal)who falls to file tlmely a Lobbyist Fee Expenditure and Compensation Statement
(Stalement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a flne of $50.00 a day shall be assessed for Sfatements flled after the
due date. The City Clerk shall notiy the Miami-Dade County Commission on Ethics and
Public Trust o/ the failure of a lobbyist (or principal) to file the SWtement or pay the
assessed fines after notlfication.
My lobbyist, who fails to file the required Statement by April 30'^ of each year, shall be
automatical�y suspended trom lobbying until all fines are paid, unless the fine has been
appealed to the Miaml-Dade Counry Commission on Ethics and Public Trust.
I hereby acknowledge that on February 28 of each year, I shall submit ro the City Clerk a
signed Statement under oath listlng all lobbyist expenditures, as weli 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 wfth the Office of the City Clerk.
' 3) ANNUAL LOBBYIST REGISTRATION FEE
_� I understand annual registration of all lobbyista shall be required for each 12-month period
canmencing October 1 of each year, and the fee fa such annual registretion shall be
$500.00 pursuant to Section 2-482 of the Miami Beach Ciry Code.
�' o..�.a..w:
��Sdti �LYn.Ya
l o3la/2aN
'.. Signature of Lobbyist Date
F1CLE0.WlLVFpYMCYV16TfOMISL��IMpYMmipmIMNG 4111.ARGtr<
Paps S of 5
1 . .-- — ..... . _.._ ....
o .yio ovs-+eve.ocieinsaeorr+e
vq.sae sie[wweorr�[ ,III���''IIII
, OacuSignEnvelopelD',GBO4O1DFG2EE-04C&A142-28AEAAD4B10A
EXHIBIT B
SUPPLEMENTARY DISCLOSURE OFINTEREST
Interests in ARRP 1800 Alton. LLC and 1212 Lincoln. LLC
Percentage of Interest
ARRP Miami Holdings, LLC 100%
2200 Biscayne Bivd.
Miami FL 33137
Interests in ARRP Miami Holdinas. LLC
Percentage of Interest
KGM Equities 2, LLC 95�0
2200 Biscayne Blvd.
Miami FL 33137
Beach R Holdings, LLC 5%
2200 Biscayne Blvd.
Miami FL 33137
Interests in KGM Eauities 2. LLC
Percentage otlnterest
Sonny Kahn 2004 Irrevocable Trust 45%
2200 Biscayne Bivd.
Miami FL 33137
Russell W. Galbut 2004 Irrevocable Trust 45%
2200 Biscayne Blvd.
Miami FL 33137
Bruce A. Menin 2004 Irrevocable Trust 10%
- 2200 Biscayne Blvd.
Miami FL 33137
oo�v.,rvio�.eczaer�e-osos<eu.e�ocieens.eorcie � r.e.eme T sieeaveorr�s
��s,� ������������
. OowSi9^Envelope ID'.C80401DF-62EEd4G8-A142-28AEAAD4B10A
Beneficiaries of Sonnv Kahn 2004 Irrevocable Trust
Percentage oflnterest
Elliott Kahn 20%
2200 Biscayne Blvd.
Miami FL 33�37
Joshua Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Naomi Kahn 20�0
2200 8iscayne Blvd.
Miami FL 33137
Rachel Kahn 20%
2200 Biscayne Blvd.
Miami FL 33137
Avigail Kahn 20%
2200 8iscayne Blvd.
Miami FL 33137
Beneficiaries of Russell W. Galbut 2004 Irrevocable Trust
Percentage of Interest
Marisa Galbut 50%
2200 Biscayne Blvd.
Miami FL 33137
� Jenna Galbut 50%
2200 Biscayne Blvd.
Miami FL 33137 .
� Beneficiaries of Bruce A. Menin 2004 Irrevocable Trust
Percentage of Interest
- Mauwell Menin 33.33°�
- 2200 Biscayne Blvd.
- Miami FL 33137
�-oe�veo�rrp�o�eozseras-oncneia.e�ocneensuovr+e v.w�me neenveorrie ,III��FAE1IIII
. OocuSign EnvelopelD:CB04D1DF-62EEi0C8-A142-26AEMD4B10A
Mason Menin 33.33%
2200 Biscayne Blvd.
Miami FL 33137
Lucas Menin 33.33°h
2200 Biscayne Blvd.
Miami FL33137
Interests in Beach R Holdinas. lLC
Percentage of Interest
Tomer Bitton 100�0
2200 Biscayne Blvd.
Miami FL 33137
�o�,�vccryeio=En^sensns�c<ei�a�ocnaen¢uorr�e vw.ene � eieehsaaorrie ,IIIB:$FT;E2t'llll
� P ( �
� doc�/erify y s °
{
�Ocvea�e
Lobbyist Registration Fortn -W. Herrera - 1212 LR RD - executsd.pdf
DocVerifylD: EA29BF3SD536-4E13-870C-1BEA548DFF1E
Created�. March 04. 2024 07_12.51 -8-00
Payes 8
Electronic Notary�. Yes � State- FL
,��. . . . . . ..� , . .. . . � . . .
, .. . . i i . , . .. . . .
,�... ,�. " .�.. .. . .;„.� .. �� i. .. �, . , .. . . .
... ... i . . �. . . ... i . , . . ,,,,,. .��., i ...�,�, . .. . .,
� __ __ __. . __
ESipn�[un Eumm�ry
E31pn�Wn NaYry:Dl�n�IYme�(On)
Al�icn W,2M�01:1a:53-0:00 f�B86B30C8Z61 D/P20.80.111�
tlramm�62dYrqlw'.mm
,
i �' �
. 1 , I � �, � �
I IIIIII IIIIII IIIII IIII IIIII IIIII IIIII IIIII IIIIII IIII IIIII IIIII IIII IIII
� -. ->._. ...... . _„—. - - . .
serasosasaeve.oc+aensaeorrre ,III�Fyy�,llll �
Crw�MCv.MPp� 1lEAWDiFtE �y.;
- �
. Miscella..eous Cash Receipt
� CITY OF MIAMI BEACH No. 433206
❑Cash ❑Credit Card�Check# ' � $ `
20
Received of � � �
Address
For
Cdy of Miami Beach
�. Miscellaneous-MCR-2D21
006797-0011 PhiGp �._ 03/afi/2024 09:i8AM
�� MCR OPEN(MCR) Office of Finance Director
. Paymen[AmowR: 85�.00
. (THIS INFORMATION MUST BE COMPLETED) By
'. Account number: � � � � �
�. Preparer: ' � Dept: � EXT: � '
a � oo � I o
a o °a
�r�i o z �. —_
. � ' � �� � ; � ¢ I
�� �c � �
� `m� � � N � ��� i �I y
m c � o ' � � z - — o
^c.°�i LL v � ¢ .� ,'{ �. ����
'� ,�^ � ,r o n � � _ �;i . . a ta
�y'_�� V � � _ � �j i � T m�
OU ��o3 E �� � � w � �� �F ' � ��
.�A. �d.-� m j^s ¢ o � _ ! � �
U 6 ^ f¢ c� ^ K � ' � f H
U p � N y UEO£ O � i�` k
OS N ^ O .—�i�+ OZ � L`1j � I � j � �j
W Nz�Yc]p w� � � � { � �
�� JNO �� � � � �`� T . � �F ]5/ � Ll
R Ll Y � � �� � i!(
�m yOSN � £ YT LYIL � S � � SEi
¢ � � a¢
0o i 'o � � �¢ t.�
