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James Rauh/Southpointe Heights, LLC (2)m ',I%,~lhIBEA.CN City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM PtiJ- EN p ~+~- E N Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or moditicailon 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 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 LOBBYIST: (Last) (First) (M.I) 2700 S.W. 37 AVE. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-444-5002 305-448-5566 JRAUH@TERMINELLO.COM TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: SOUTHPOINTE HEIGHTS, LLC NAME OF PRINCIPAUCLIENT: 2200 BISCAYNE BLVD. MIAMI, FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5700 305-847-3354 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) FiII out this section If principal is a Corporation, Partnership or Trust (Section 2-482 (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: DESIGN REVIEW APPROVAL FOR THE PARTIAL DEMOLITION, RENOVATION AND FACADE MODIFICATIONS TO AN EXISTING BUILDING AT 42 COLLINS AVENUE. Issue to be lobbied (Describe in detail): ill. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to city code section 2-482(8) 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 Gity 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 12 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 DESIGN REVIEW BOARD NO h0 ~£ N~ +~- ~~~ BOQZ - IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $5 , 000 FLAT FEE THROUGH FIRST, PUBLIC HEARING; $300 PER HOUR THEREAFTER. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $5 , 000 FLAT FEE THROUGH FIRST PUBLIC HEARING: (Required). $300 PER HOUR THEREAFTER. 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": ^ Yes LrJ No• Are you lobbvinst on a aresent or aendins~ bid for goods ecuipment or services. or on a present or pending award for goods, eauiament or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^ Yes ~NO' Are you lobbyina on a aendina aaalication for a Develooment Agreement with the City or aaalication for chance of zoninc mau designation or chantae to tfie Citv's Future Land Use Maa? 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 anot-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 ,s~ec~tion but, shall not be required to pay any registration fees. ^ Yes L~ No• Are you rearesentina anot-for-arofit corporation or entity without saecisi comuensation or reimbursement. . V. S{GNATURE UNDER OATH: .... ............-.. . ST ..~ r ..... ..~ of I do solemnly swear that all of the foregoing facts provisions contained in Section~y48i~aFtia~Miami correct and that I have read or am familiar with the ,ode and all reporting requirements. Signature of Lobbyist: Signature of Principal/Ciient~~l~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Nottty PubNc • State of Florida ~`n~r~ mmissivrr iexoiras iNar 16, 2011 - 6ikbiAit~dileald~ 644032 Notary Assn. ^ Produced ID aN~ OAYAWAtiNl1AR Form of ide f ~ Nolan Public ' 8hN d Flom - NAp ©ormissioe Eirpk~ IAar t6, 201i ' =~. s~ Comn>laalon N OD &N032 Personally known (Princip )~"%,,,o~~t~.•+ ~~TMsuphNaMonMNovryAan, ,~OtpfeV PVS,, OAYAMIAGUTAR State of Florida, County of Miami-Da + `~;; Notary PubNc -State of FI Swom nd subsc ed afore me • I~ bly ~ ~ ~ tt i day of 2008 "+,~ ~,aL B Commission # pp ~~p; '''~°~ ~ ;~'`~~ ondad Through National Nom, Si atu f Publ'c N ry -State of Florida No ariz ion of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee:.[ -] Yes [•~:_ ] No ~Amount`Paid; `~~ MCR # ~'~~ ~~~`~ ~~Date~Paid'~= Lobbyist Registration. Form received and veriftad by ' F:\CLER\LOBBYIST\Lobbvist Registration Form 32708.doc ~ 'Revised 03/27/2008 ~` i = . 5 ~ ~ ~r~ , , f ,~ - ~ i ~ ~ ~ - I _~ _~ _ City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 ~ 12 ~. LOBBYIST NAME: /4M~'S J ~ 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 City Code, with the City Clerk's Office for all active lobbying issues. 1) lobbyist Expenditure Form 2) 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 immediately notify the City Clerk's Office of lobbyist withdrawal in writing. ~ Z/ ZvOg Signature: Date: F:\CLERILOBBYISTILobbyist Registration Form 32708.doc CITY Ot= MIAMI BEACH DEVELOPMENT REVfEW 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. SOUTHPOINTE HEIGHTS LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST SOUTHPOINTE HEIGHTS HOLDINGS, LLC 100% 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 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 MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST ~ . 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 corporations}, 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." SOUTHPOINTE HEIGHTS HOLDINGS LLC LIMITED LIABILITY COMPANY NAME NAME, ADDRESS, AND OFFICE % OF MEMERSHIP INTEREST CH INVESTMENT HOLDINGS, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager 100% 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 CHRtSTENBURY 2200 Biscayne Boulevard Miami, Florida 33137 Vice President SHLOMO DACHOH 2200 Biscayne Boulevard Miami, Fbrida 33137 Secretary JOSEPH ZDON 2200 Biscayne Boulevard Miami, Florida 33137 Treasurer PABLO DE ALMAGRO 2200 Biscayne Boulevard Miami, Florida 33137 Asst. Treasurer IF THERE ARE ADI?ITIONAL 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 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 2200 Biscayne Boulevard Miami, Florida 33137 Member 37% RF BUSINESS TRUST 2200 Biscayne Boulevard Miami, Florida 33137 Member MENIN 1998 FAMILY TRUST 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 37% 26% lF THERE ARE ADDITIONAL CORPORATIONS, LIST OTHERS, INCLUDING CORP. NAMES} 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 MIAMI BEACH DEVELOPMENT REVIEVII 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.* 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 trusts}, 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.* RF BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE RUSSELL W. GALBUT 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), 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