James Rauh/Heafey/Bentley Hotel, LLC~'~~~,~~~
~ l~/11 AM I B~AC H `-.
~. 1~~, ~C C a__ :`~
City of Miami Beach Office of the Ciry Clerk ~~ d~{ S; 30
1700 Convention Center Drive, Miami Beach, FL 33139 ~~~ Y~;~.tr;~i' ,
~ (jj'; ~~•r.
LOBBYIST RLCISTRATION FOR114
Lobbyist means alI 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 dedsion 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 Ordinance 2004-3435.
Rauh James E_
NAME OF LOBBYISf: (Last) (First) (M.I)
'~erminelJ.o & Terminello P A 2700 SW 37th Avenue, Miami, Florida 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305.444.5002 305.448.55b6 ~rauh@terminello.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Heafey / Bentley Hotel, LLC
NAME OF PRINCIPAL/CLIENT:
1717 North Bayshore Drive, Suite 102, Miami, Florida 33132
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
305 523 3344 -
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this sedion if principal is a Corporation, Partnership or Trust lSection 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: See attached .
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIPORTRUST: See attached.
II. SPECIFIC LOBBY ISSUE:
Application for Conditional Use Approval for Restaurant at 101 Qcean Drive
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
Planning Board No
Planning Director No
N. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) -~ 7/ 4J b~ (~L~ ~ Z q T~ /
B) PRINCIPAL'S DISCLOSURE (OF LOBBYISTCOMPENSATION): (Required). ~~~`1 v0 (Fc-~r (2f} i~
The following information must be answered:
i) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yes L~ No• Are you lobbvinq on a present or pendinq bid for qoods equipment or services, or on a
present or nendinu award for qoods, eQUiament or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled °Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
~Yes L~'No• Are vou lobbvinq on a pendinq application for a Development Aqreement with the Citv or
application for chanqe of zoninq map desiqnation or chanqe to the City's Future Land Use
Map?
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..
^ Yes t~ No• Are vou representinq a not-for-arofit corporation or entitv without special compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTIN6 LOBBYING EXPENDTTURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PREC NG CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EX ITU ES OR COMPENSATION DURING THE
REPORTING PERIOD.
Lobbyist
I do solemnly swear that all forE
familiar with the provisio contai d in
requirements.
Signature of Lobbyist:
Signature of Principal/Client: ~G
VI. LOBBYIST IDENTIFICATION:
0 Produced ID
Form of Identification
6V Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to ~a,[ ~subscrib d befo m
This 1: ~ _ day of ~Q~' ,~20Q~7
~icjnat~lre of Public Notary - State of Florida
Notarization of Lobbyist's signature
~are true and correct and that I have read or am
2-482 of the Miami Beach Citu cs!~ aari~a~~rP~n~rL
PRINCIPALIDENTIFICATION
^ Produced iD
Form of Ider~
Personally known (Principal)
Notary Public - State o( Flotida
r Commission Expires Jan 31, 2010
Commissio~ ~t DD 5126M
ondod flv National Notan Assn.
~AMUEL A. RUBERT
Notary Publie - Slale o( Fbrida
~' ~~°^ ExPKes Jan 3 t, 2010
~~"TM~~ * DD 51264q
Bonded 8y National Notary Assn.
State of Florida, County of Miami-Dade
Sworn and subscribed bef re rne
This '~day of G~ 7,,~~
Signature of ~fiblic Notary - State of Florida
Notarization of Principal's signature
FOR CLERK'S ~F ONLY ~
Annual Registration fee: [ ] Yes [ ~No Amount P ~' ~- MCR # ~~~Date Paid ~:~ ~ ~~
Lobbyist Registration Form received and verified by: ~-1~5lJ~~-r~- :. ~ i ~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATIOIV
DISCLOSURE OF INTEREST
1. LIMITED LIABILITY COMPANY
If the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
HEAFEY/BENTLEY HOTEL LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
Ocean Once Investments, LLC
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Member
°/a OF STOCK
20%
Nathalie Heafey
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Member
PH Bentley Bay Inc.
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Managing Member
Julie Grimes
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Member
14%
52%
14%
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
PH BENTLEY BAY, INC.
CORPORATION NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
Heafey Grand, Inc. 80%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Pierre Heafey Family Trust 20%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATIOIV
DISCLOSURE OF INTEREST
1. CORPORATION
if the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
HEAFEY GRAND, INC.
CORPORATION NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
Heagrand, Inc. 100%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership{s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
HEAGRAND, INC.
CORPORATION NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
Pierre Heafey 100%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MtAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. LIMITED LIABILITY COMPANY
If the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) havingthe ultimate ownership interest in the entity.*
OCEAN ONE INVESTMENTS LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
Aries Development Group, LLC
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Managing Member
% OF STOCK
SO%
Bentley Holdings Group, Inc.
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Member
50°/a
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(5) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. LIMITED LIABILITY COMPANY
If the property which is the subject of an application is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) havingthe ultimate ownership interest in the entity.*
ARIES DEVELOPMENT GROUP, LLC
LIMITED LIABILITY COMPANY NAME
NAME, ADDRESS, AND OFFICE
Gino Falsetto
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Managing Member
% OF STOCK
70%
Rajesh Kalwani
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
Member
30%
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of an appiication is owned or leased by a CORPORATION, list
the principal stockholders and the percentage of stock owned by each. Where the principal
officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
BENTLEY HOLDINGS GROUP, INC.
CORPORATION NAME
NAME, ADDRESS, AND OFFICE % OF STOCK
Andrea Alberghini 100%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.
CITY OF MIAMI BEACH
DEVELOPMENT REVIEW BOARD APPLICATION
DISCLOSURE OF INTEREST
h=~4~W.p ' .:
*~.~
~'~ Y
~ . 1'~y, ... ~
:~~ .~~ .~._
2. TRUSTEE
If the property which is the subject of an application is owned or leased by a TRUSTEE, list the
principal stockholders and the percentage of interest owned by each. Where the
beneficiaries/beneficiary consist of corporation(s), another trust(s), partnership(s) or other
similar entity, further disclosure shall be required which discloses the identity of the
individual(s) (natural persons) having the ultimate ownership interest in the entity.*
PIERRE HEAFEY FAMILY TRUST
CORPORATION NAME
NAME, ADDRESS, AND OFFICE % OF INTEREST
Pierre Heafey 100%
1717 North Bayshore Drive
Suite 102
Miami, Florida 33132
IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH
INDIVIDUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE.