James Rauh/Mynt Holding Company, LLCMrnmi Hcatn
AIM II~fDfr
~
I
t
`~
2UU5 ~~~
~.
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGI5TRATIOiV FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourace the passaee, 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 aty personnel defined in any
manner in this section, during the time period of the entire decision-making process en such action, decision or recommendation
that foreseeabiy will be heard or reviewed by the city commission, or a city board or committee, The term spedfically inciuoes the
principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435. I-
1~~~Ch fa s/~~ rtt"~ l
NAME OF LOBBYISfT: {Last) {First) (h1.I)
E ~._ ~_, t/
G~~t~.~ ~,..,z; rr i<ty . - C`.~v ; ,.v ~ (, ~ i'"~(.J ~ LI.~: r'n i ~t r<_~.,. ,.r ~?i.}. G'~= r.'`!' . `^~ ~` -~ -~ y 3
BU~S.I-,.NESS NAME ANDd ADDRESS
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAI,iCLIENT:
BUSINESS NAME AND ADDRESS
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust (Section 2-482 (c)]
~, i
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: }' ~ ~ ~t..~-~ ~; ~ (.,x i
i
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH ~
CORPORATION, PARTNERSHIP OR TRUST: ~^ 1ji ~
i
II. SPECIFIC LOBIIY ISSUE:
~ ~ ~ ~~ ( / r - i /~
A t. I C •4 T t a !"' "rr~ ~" ~c+ iv ,J ~ n1 C. .,~ <- `"t / . ~-u / ~;' t C~ t ~ i L ~'7 '~( ~«~ -t7% l ^C!v~ ~ . "~[c..~ n ~ ~'1 ~.1' Y't= (Na t-~
issue to be lobbied (Describe in detail): ~ 1~ ~ `+ 3 ~ C e e `. -.a ; 4 v ~ ,~ iA E 1
III. CITY AGENCIESfINDIVIDUALS TO BE LOBBIED:
AYCC)~``\~~Fjulf Name of Individ~^u'a~l/Title
~r and Street)
r ~ ~
AX NUMBER:
(_!
~- ~s c~ I ~ ~~.. r ~ ~
(Number and Street)
(Gty) (Stale)
~~' S , /~ r , -~, ;
(~ih')
i ~~rc;r~z ~ ail y~
(Zip Code)
_1~,1 erne) i "~rH^FS s ~.t, ~.,
,~~;~i~,,~~.. ~s~3i
(State) (Zip Code)
B) Any Financial, Familial or Professional Relationship
~,f
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) ~ ~ ~ ~~ ~?~-' r k1 ~`~ T
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). -~ ~~ r' ~~ ~~'.~ ~ 4 ~~ !'
I
D Yes No: Are you representing a not-fo.r-arafit corporation or entity without special compensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1) Pursuant to Ordinance No. 2003-3393 Amending Miami Beach City Codes Chapter Z Article VII Div'sior
Thereof Entitled "Campaiar Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibi~ed
Campaign Contributions By Lobbyists On Procurement Issues":
Yes ~No• Are you labbvina on a present or sending bid for ooods eauipment or services or on a present
or sending award for goods, equipment or service?
2) Pursuant to Ordinance No. 2003-3345 Amending Miami Beach Citv Code Chapter 2 Article VII Division 5
thereof Entitled "Campaign Finance Reform", Via The Addition Or Code SPrtior [-490 Entitled "Prohibited
Campaign Contributions By i_obbYists On Real Estate Deveioomen~ ~=sues`'
Oyes ~No: ArE: you lobbying on a pending ap[siication for a Deveioament Agreement with the City or
application for chance of zoning man designation or chance to the City`s Future Land Use Maas
V. SIGNATURE UNDER OATH;
ON OCTOBER 1~ OF EACH YEAR, EACH L08BYIST 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 EXP~NtSITI~ES OMPEMSATION DU-RING THE
REPORTING PERIOD. % f
- ~~`
~/ 5igr~atura of Lobbyist
I do solemnly swear that all of the foregoing fa is are true and correct and that I .have read or am
familiar with the provisions contained in Se 482 of the Miami Beach City Code and all reporting
requirements, ,~~ "~
Signature of Lobbyist:
VI. LOBBYIST
PRINCIPAL IDENTIFICATION;
D Produced ID
Form of Identification
^ Produced ID
Form of Identification
Personally known (Lobbyist}
VII. SIGNATURE AND STAMP OF NOTARY:
State gf Florida, County of Miami-Dade
Sworn to and subscribed before me
This Z~ ~' of vnl F ,_ _ ~ 20 0 ~"~
Signature of ptary -State of Florida ~~
Notariza ' n of oM%byist's sa nature
:iao~, i,.t~Flgit[,` c~
~+. - • -
~_C~tt~~t~~to,r ~i)L~~',~ ~. ~~.
~•~ ~= Expu'es I+je~ 1I~, ~0)ii?
~~' ,011~0`~~
" •"' • ~ Bonded Ttuv
AtI30hC BOAd1IIg CO., IflC.
Annual Registration fee: {~i]'Yes [ J No
Lobbyis*. Registration Form received and verified
Revised 02;101OG
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This 2S day of J f , Zp o~
Signature of Public
Notarization of
-State of Florida
~ o ~ N'otary Public State of Fbrida
~' `F Alejandra Romero
o` My Commission DD663495
~ora°~ Exnirae(~i/15YIn11
MCR CCU Date Paid
FORM 04
DISCLOSURE OF INTEREST
MYNT HOLDING COMPANY, LLC
LIMITED LIABILITY COMPANY NAME
Name, Address, and Office
Alfred A. DeSimone
c/o Mynt Holding Company LLC
235 Lincoln Road, Suite 305
Miami Beach, Florida 33139
Komain Zago
c/o Mynt Holding Company LLC
235 Lincoln Road, Suite 305
Miami Beach, Florida 33139
Gary E. Brecka
cio Mynt Holding Company LLC
235 Lincoln Road, Suite 305
Miami Beach, Florida 33139
.Tustin B. Erilcsen
c/o Mynt Holding Company LLC
235 Lincoln Road., Suite 305
Miami Beach, Florida 33139
° ~ OF STOCK
304%
25 °/v
3 0%~
15 °/,