Allan Shulman/GG Realty, Inc.
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRA nON 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
Oty Manager or any city board or committee; or any action, dedsion or recommendation of any dty 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 dty board or committee. The term spedficaily indudes the prindpal as well as any employee engaged
in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Shulman -Allan
NAME OF LOBBYIST: (Last) (First)
Allan T. Shulman Architect, PA 100 NE 38th
BUSINESS NAME AND ADDRESS (Number and Street) (oty) (State)
3q5-438-0170 305-438-0170
(M.I)
Street Miami,FL 33137
(Zip Code)
TELEPHONE NUMBER:
FAX NUMBER:
EMAlL:
L LOBBYIST RETAINED BY:
GG Realty, Inc.
NAME OF PRINCPAL./CUENT:
GG Realty,
BUSINESS NAME AND ADDRESS
Inc. 16711 Collins Ave.,
(Number and Street) (Oty)
305-945-2838
FAX NUMBER: (Optional)
suite 2501 Mia Bch, FL 33160
(State) (Zip Code)
305-778-4428
TELEPHONE NUMBER:
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:
Gregory Gerasimov and Omitriy Vernitskiy
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUO!
CORPORATION, PARTNERSHIP OR TRUST:
XL
SPECIFIC LOBBY ISSUE: ^pplication for variances
with regard tp property located at 354 Washinqton Ave.
Issue to be lobbied (Describe in detail):
m. CITY AGENOES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or professional Relationship
Jorge Gomez none
.
Richard Lorber none
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $1 80 . 00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
$180.00 per hour
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":
o Yes ~No: Are YOU lobbvina on a ore~ent or oendina bid for aoods, eauioment or services, or on a
oresent 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:41 No: Are yOU lobbv;na on a Dendina aoolication for a Develooment AQreement with the City or
~oDlication for chanae of zonina maD desianation or chanae to the City's Future Land Use
Mao?
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..
DYes
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. A-I( <;::'/_
( ) l ?-v; UVJ<-,II/I7?--j
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that r have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements. ~ I ~
Signature of Lobbyist: "J7~ ~
if Signatu,. of Principal/alent: ~ -- _ . -. -e:L,.- ---;;J / (<<lo.&o~ C-c-elt-Ag; I MY -
I ~ i!..~ t/ LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
~ &~~~ ProducedID ~ucedID 'lA-J>l. G-0d.-f,UO J4-9~~ttl-u
~ ~ Q rY' cJ
~ qj.{} r:v eo Form of Identification
,;~' ~ :;..' ,<;-" ,if /
./~,~~.~::; $[,f' 'IJI' Personally known (Lobbyist)
.ty ....:.; ~ ':.'
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Form of Identification
o Personally known (Principal)
SIGNATURE AND STAMP OF NOTARY:
1)10
State of Florida, County of Miami-Dade
Sworf\,Qnd subscri before oI:
This ~day
te
S. MERCADO
. -; . . Slate of Florida
m. expo es May 5, 2009
426145
Signature of Public Notary State of Florida
Notarization of Lobbyist's signature
FOR CL~~~NL Y /JQ-1 1'1~
Annual Registration fee: [ Yes [ ] No Amo~t Paid ~ ,', MCR # ~\ "'CJ
Lobbyist Registration Form received and verified b~ O~6
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