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Maria Gralia/Alton Sobe LLC ...iOO.ti BCiJth bad V 101l3- m - City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 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 w.ell as any employee engaged in lobbying activities. The term "LobbyistsR has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: Gralia, (Last) Maria (First) A. (M.!) Shutts & Bowen LLP BUSINESS NAME AND ADDRESS 201 S. Biscayne Boulevard Miami (Number and Street) (City) Florida (State) 33131 (Zip Code) 305-347-7328 TELEPHONE NUMBER: 305-347-7701 FAX NUMBER: mgralia@shutts-law.com EMAIL: I. LOBBYIST RETAINED BY: Alton Sobe, LLC, a limited liability company NAME OF PRINCIPAL/CLIENT: Alton Sobe, LLC, a limited liability company 7301 Belle Meade Island Drive Miami BUSINESS NAME AND ADDRESS (Number and Street) (City) Florida (State) 33138 (Zip Code) 305-347-7328 TELEPHONE NUMBER: 305-347-7701 FAX NUMBER: (Optional) mgralLa@shutts-law.com 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 Exhibit "A". . IDENTIFY 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: Obtain Design Review Board approval for project to be located at 929-939 Alton Road. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Design Review Board None. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RATE OR OTHER):. A) LOBBYIST DISCLOSURE: (Required) $230.00 hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $230.00 hourly 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": D Yes ~ No: Are YOU lobbyina on a Dresent or Dendina bid for aoods. eauiDment or services. or on a Dresent or oendina award for aoods. eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes ~ No: Are YOU lobbyina on a oendina aDDlication for a DeyeloDment Aareement with the City or aDDlication for chanae of zonina maD desianation or chanae to the City's Future Land Use MaD? 3) Pursuant to Miami Beach City Code 2-484 (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.. D Yes ~ No: Are YOU reDresentina a not-for-Drofit corDOration or entity without sDecial comoensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST 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 BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF "THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ~ (l ~ ~ 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 Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client. VI. FORCLER!MiJBNLY~ -z:; Q Annual Registration fee: [ Yes [ ] No Amount Paid MC. / I I ' Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc o Produced ID / Form of Identification ~ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: PRINCIPAL IDENTIFICATION: o Produced ID Form of Identification ~nallY known (Principal) :,OOl .~ J8qweldas S9JldX3 ,....~, !-€9vlZOO UOISSIWWO~ ^V1I :' 'I\. · Stat f Fl' C ty f M" . D d znJ~-oueqlJ::>S3 ~ eu\, '\!;' e 0 on a, oun 0 lam 1- a e Sworn and s scribed b e me This 2~ da f 20~ Revised 12/08/04 SEP-30-2005 FRI 11:22 AM Shutts and Bowen FAX NO, 3053819982 P. 02 I~XH:TBIT "A" Disclosure of] ntercst O\VNERSHIP STRUCTURE Entity Name Ownership ALTON SOBE, LLC 100(Yo Evergreen Overseas I-Ioldings, Inc. EVERGREEN OVERSEAS I-IOLDINGS, INC. 1000/0 Victor Uzan ALTON SORE, LLC Managing Member (sole melnher) . Evergreen Overseas Holdings, Inc. EVERGREEN OVERSEAS 1~10LDINGS, INC. President Sole Dire~tor Sole Shareholder Victor UZ~ln MIADOCS 839605 l SEP-30-2005 FRI 11:22 AM Shutts and Bowen FAX NO. 3053819982 P, 01 .......____._..._.'.tl..\\..."., SHq;TTS -__.-.yl.!rlT..............''''''''..'''''.. BO\~EN ----------.".,.' LLP ATTOR.NI?YS AND COUNS~UWS ",,'l L/\W FAX TRANSMISSION To: Company: Liz Gibson City ofl\1im.l1i Beach - City Clerk's Office Phone:: 305-673-7411 305-673-7254 .Fnx: From: Phone: Maria A. Gra1ia (305) 347-7328 User ID: Fax: 5813 (305) 347-7701 Date: Pages: Septelnber 30, 2005 2 (including cover shoet) Client/lVlatter No.: 23523-0002 Subject: Disclosure of Ownership for Lobbyist Registration F01111 for tv[aria A. Gralia to represent Alton Sobe, LLC NOTE: PLEASE CALL ANA ESCRlnANo-CRUZ AT 305-415-9008 IM1V1EDIATELY IF ALL PAGES ARE NOT RI~CI~lVED. Message: This facsin1ile contains privileged and confidential infonllation intended only for the use of the addressee nan1ed above. If you are not the intended recipient of this facsimile, or the employee or agent responsible for de.livering it to the. intended recipient, you are hereby noti fied that any disselnination or copy of this facsimile is strictly prohibited. If yOLl have received this facsimile in error, please notify us imrnediately by telephone and retuo1 the original facsin1ilc to LIS at the above address via the U.S. Postal Service. 'I'hank you. 1511/1 M lAM I CENTER. 2[)t SOUTH UISCA YN II, I-iOULEVARD . ML\.~n, FLOl~ID" ~)DI . r..H AMI (305) 3S:;l.(i3lltJ · lIM';::;II'd r 1.1 ': (3i!5}.'\SI.\Jf)h2 · WELl$ITI;:; \\I\V\v.HI'~l((n.I;''.V.m'' Mr!\MI F01\T T.:\un[!n.O.'\l.l! \"(,1E~" PAl..M UEACI'! Olll...\N1JCI TAl.J..:\1 r.ASS[:I~ 1\ 1\ 1~'1I~ J( J '" r.j 1.()ND()t-.; SHUTTS & BOWEN LLP ATTORNEYS AND COUNSELLORS AT LAW ANA C. ESCRIBANO-CRUZ (305) 415-9008 Direct Telephone E-MAIL ADDRESS: aescri ban o-cruz@shutts-law.com September 29, 2005 VIA FEDERAL EXPRESS Bob Parcher, City Clerk City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 Re: Lobbyist Registration Form Dear Mr. Parcher: Enclosed please find a check in the amount of $125.00 representing the City of Miami Beach annual lobbyist registration fee for Maria A. Gralia, Esq. of Shutts & Bowen LLP. Also enclosed is a Lobbyist Registration Fonn together with a check in the amount of $25.00 to register Maria A. Gralia as a lobbyist on behalf of Alton Sobe, LLC. Please confirm receipt of this letter by sending me your receipt in the enclosed self-addressed envelope. If you have any questions regarding this matter, please do not hesitate to contact me at 305-415-9008. /aec Enclosure M1ADOCS 840021 I 1500 MIAMI CENTER. 201 SOUTH BISCA YNE BOULEVARD. MIAMI, FLORIDA 33131 · TELEPHONE (305) 358-6300 · FACSIMILE (305) 381-9982 · WEBSITE: www.shutts-law.com MIAMI FORT LAUDERDALE WEST PALM BEACH ORLANDO TALLAHASSEE AMSTERDAM LONDON