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James E. Rauh/South Beach Heights, LLCm MIAMIBEACH 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 mod cation of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or arty 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 "Lobbylsffi" has specMc exclusions. Please refer to Ordinance 2004-3436. RAUH, JAMES E. NAME OF LOBBYIST: (Last) (First) (M.I) 2700 S.W. 37 AVE. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-4g45pp2 305-q4g-5566 JRAUH~TERMINELLO.COM TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: SOUTH BEACH HEIGHTS I, LLC NAME OF PRINCIPAUCLIENT: 2200 BISCAYNE BLVD. MIAMI, FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-3745700 305-847-3354 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section 'If principal is a Corporation, Partnership or Trust [Section 2482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: RUSSELL W. GALBUT • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SEE ATTACHED. II.SPECIFIC LOBBY ISSUE: CONDITIONAL USE PERMIT TO OPERATE PARKING LOT 24 HOURS PER DAY AT 630 ALTON ROAD. Issue to be lobbied (Describe in detail): lll. CITY AGENCIESJINDIVIDUALS TO BE LOBBIED: (Pursuant to city code section 2-482(g) include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an appearance of an impropriety, with-any City personnel sought to be lobbied; further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 72 months preceding the commencement of service of City personnel to be lobbied.) A Full Name of Individual Title B) Any Financial, Familial or Professional Relationship PLANNING BOARD NO ---~- IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $300/ HOURLY B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $300/ HOURLY (Required). The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Prg~curement Issues": 2) 3) present or pending award for goods. eguiament or service? to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On ite Development Issues": application for chance of zoning map designation or chanste to the Citv's Future Land Use Maa? reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEA STATEMENT UNDER OATH. LISTIN IN THE CITY OF MIAMI BEACH FOI EVEN IF THERE HAVE BEEN NO E) I do solemnly swear that all o provisions contained in S on 2-482 Signature of Lobbyist: Signature of Principal/C' nt: VI. LOBBYIST IDENTIFICATIO ^ Produced ID Form of Id ,Personally known (Lobbyist) VII. SIGNATURE AND STAMP C State of Florida, County of Miami-Dade Swom tubscribe efor me This dp'y 20 of Signature of Lobbyist doing facts re a and correct and that I have read or am familiar with the the Miami ch City Code and all reporting requirements. PRINCIPAL IDENTIFICATION: ^ ProducedlD o F Form of Identification $~~ ~. ~ ~ Personally known (Principal) ~a ~i ~+ ~ State of Florida, County of Miami-Dade ~ Swom and subscri ed efo DAYAMIAGUTAR ,y~.~,,,• i day Of ~ i1 ,. °~,•.• Notary PuDllc -State of Florida ~~ -~`' _~ r' ~ ~ hly COmiNstion EXpiroS Mar 16, 2011 ~~ da ~ ~ mission # DO 644032 ~„~r`~ S n e of Pu is otary S ,, ~~~ nThraghNationalNotaryAssn. Notari tion of Princi I's TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid S _ MCR # Date Paid ~ Lobbyist Registration Form received and verified by: F:\CLER\LOBBYIST\Lobbyist Registration Form 32708.doc ReYised 03/27/2008 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 snot-for-profit corporation or entity without speaal 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. m MI,~MIi~E~~H City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.7411 ,Fax: 305.673.7254 CilyClerk(~miamibeachfl.gov LOBBYIST NAME: I understand that no later than October 1st of each year, I must file the following forms, pursuant to Section 2-485 of the Miami Beach Ciry Code, with the City Clerk's Office for all active lobbying issues. 1 J Lobbyist Expenditure Form 2j Disclosure Form Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediatyly-rrs~tify the Ciry~Clefk~s Office of lobbyist withdrawal in writing. Sign~t(ture: ~ 21 rog D te: F:\CLERILOBBYIS11Lobbyist Registration Form 32708.doc 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) having the ultimate ownership interest in the entity.* SOUTH BEACH HEIGHTS I LLC . LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE SBH HOLDINGS 1, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member SBH MANAGEMENT COMPANY, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager OFFICERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Chairman RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 President BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Sr. Vice President SHARON CHRISTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Florida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Asst. Treasurer OF MEMERSHIP INTEREST 99% 1% 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. NOTE; Notarized signature required on page 8 6 CITY OF MfAMI 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) having the ultimate ownership interest in the entity.* SBH MANAGEMENT COMPANY LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE CH INVESTMENT HOLDINGS, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager OFFICERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Chairman RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 President BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Sr. Vice President SHARON CHRISTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Florida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Asst. Treasurer OF MEMERSHIP INTEREST 100% 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. NOTE: Notarized signature required on page & 6 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), trustees}, 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." SBH HOLDINGS I, LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE CH INVESTMENT HOLDINGS, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager DAVID GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 Member OFFfCERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Chairman RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 President BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Sr. Vice President SHARON CHRISTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Florida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Assi. Treasurer % OF MEMERSHIP INTEREST 89.89% 10.11% IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH /ND/VIDUAL'S NAME, ADDRESS, OFF/CE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE. NOTE: Notarized signature required on page 8 6 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) having the ultimate ownership interest in the entity.* CH INVESTMENT HOLDINGS LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST SK BUSINESS TRUST 37% 2200 Biscayne Boulevard Miami, Florida 33137 Member RF BUSINESS TRUST 37% 2200 Biscayne Boulevard Miami, Florida 33137 Member MENlN 1998 FAMILY TRUST 26% 2200 Biscayne Boulevard Miami, Florida 33137 Member MANAGERS: SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Manager RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 Manager BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Manager IF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAME(S) AND EACH IND/V/DUAL'S NAME, ADDRESS, OFFICE AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE. NOTE: Notarized signature required on page 8 6 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held by each. Where the beneficiarieslbeneficiary 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.* SK BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE SONNY KAHN 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary OF INTEREST 100% NOTE: Notarized signature required on page 8 _7 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held by each. Where the beneficiaries/beneficiary consist 'of corporation(s), another trust(s), partnerships} 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.* RF BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Fiorida 33137 Beneficiary % OF INTEREST 100% NOTE: Notarized signature required on page 8 7 CITY OF M1AM1 BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage of interest held 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." MENIN 1998 FAMILY TRUST TRUST NAME NAME, ADDRESS, AND OFFICE % OF INTEREST BRUCE A. MENIN 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary 100% NOTE: Notarized signature required on page 8 7