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James E. Rauh/South Beach Heights I, LLC (3) 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 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 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. MIAMI, FLORIDA 33133 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: SOUTH BEACH HEIGHTS I, LLC NAME OF PRINCIPAL/CLIENT: 2200 BISCAYNE BOULEVARD MIAMI, FLORIDA 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-374-5700 TELEPHONE NUMBER: FAX NUMBER: (Optional) 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: 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: LAND DEVELOPMENT REGULATION AMENDMENT TO CHANGE THE ACTUAL ZONING MAP DESIGNATION OF PARCEL(S) OF LAND FOR THE PROPERTY LOCATED AT 630 ALTON ROAD (SOMETIMES REFERRED TO AS 600 ALTON ROAD) Issue to be lobbied (Describe in detail): lll. CITY AGENCIES/INDIVIDUALS 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 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 PLANNING BOARD NO CITY COMMISSION NO G ~ ~~ FFp ~ ~ ~~16 i f p~~Z IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $15,000 FLAT FEE THROUGH FIRST PUBLIC HEARING. $300 PER HOUR THEREAFTER. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): $15,000 FLAT FEE THROUGH FIRST PUBLIC HEARING. (Required). $300 PER HOUR THEREAFTER. The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes L~No• Are you lobbving on a present or pendino bid for goods equipment or services or on a present or pending award for goods equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On ~ Real Estate Development Issues": application for chance of zoning map designation or chancre to the Citv's Future Land Use Map? 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of snot-for-profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this sect%bn but, shall not be required to pay any registration fees. reimbursement. . V. SIGNATURE UNDER OATH: of I do solemnly swear that all of the foregoing facts provisions contained in Sectiory~!~iS~oT~he Miami correct and that I have read or am familiar with the ode and all reporting requirements. Signature of Lobbyist: Signature of Principe VI. LOBBYIST PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Lobbyist} VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, Count of Mi mi- e Swornr and su ore me DAYAMIAGUTAR T, s d ~~" ~ t~I~$blic -State of Florida _~ _ ` * , My Commission Expires Mar 16, 2011 l~ / ~ '~`~. DD 644032 Si net a of Pub ~ `t~,~larionalNaaryASSn• ~o~~ 1a` Notariz tion of ^ Produced ID Form of Identification Personally known (Principal) f ,,,,,,,,,~ OAYAMIAGUTAR c`~~~`Y P~°ic ~ Notsry Public -State of Fbtida State of Florida, C unty of Mi ? ~ Commission Expires Mar 16, 20tt Sw rn dsubscri ed efore E ''_ ~'hi~day of ~`~ Commission # DD 644032 ,,, F F „.• Bonded Through National Notary Assr-. 'ublic Notary -State of Florida of Principal's signature Y Annual Registratior-'fee: [ ]Yes [ ] No Amount-Paid $ MCR # ~""'~ ~-~ Date Paid ~ ~' ~ Lobbyist Registration Form received and verified by: / F:\CLER\LOBBYIST\Lobbvist Registration Form 32708.doc ~ Revised 03/27/2008 m M,IAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florido 33139, www.miamibeachA.gov CITY CLERK Office Tel: 305.673.7411 ,Fax: 305.673.7254 CiyClerk@miamibeachfl.gov LOBBYIST NAME: `' °, ~~"1~S ~'~r 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 J Lobbyist Expenditure Form 2) Disclosure Form Failure to file these forms on a timely basis will result in fiy 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 CI~'s-Af~ce of lobbyist withdrawal in writing. Signature: ~/Zl(~X F:ICLERILOBBYISTILobbyist Registration Form 32708.doc o ~ m ~ G = m ~ N Z Z ~ ~ 3 O z 1 ~ ~~ c ~ y ~ m w n o .~ W ~ ~~ m ~ v o ,~ i~ ~. (1 m -1 I`~ ~ 1 ~v ~. o a o. s m n~ ~n 0 ~ ~ ~ tD 3 C W~ n =s t~ ®, -_ ;; ;= ~ ,~. :LL r....: :t, .; r; in ,°ii p.J p. _: [i ! n .` i f[ °-. Ih. ~ ~ _ -i ~,:. .: ; _ , 1 ~ ~ ` ~' ~~ ~ ~,. N ~I o ~, N C ,~, . CITY OE 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 corporations}, 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 I, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member SBH MANAGEMENT COMPANY, LLC 2200 Biscayne Boulevard Miami, Florida 33137 Member and Manager OFFICERS: SONNY KP,HN 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 5r. Vice President SHARON CHRlSTENBURY 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% lF 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 MIA11111 BEACH DEVELOPMENT REVIEW BOARD APPLICATION D6SS~QSURE OF INTEREST 'I. 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 stack 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, APHID 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 8 6 CITY OF MIAMI ~3EACH DEVELOPMENT REVIEI~U BOARD APPL1CATlON 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 ofi:fcers 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 HOLDINGS I, LLC LIMITED LIAB[L1TY 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 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 5r. 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 °Io OF MEMERSHIP INTEREST 89.89% 10.11% 1F 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 S 6 CITY OF MIAMI BEACH DEVELOPIIIIENT 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, ,4DDRESS, 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% IF THERE ARE ADDITIONAL CDRPORATIONS, LIST OTHERS, INCLUDING CORP. NAMES} AND EACH /NDIV/DUAL'S NAME, ADDRESS, OFFICE - AND PERCENTAGE OF STOCK, ON A SEPARATE PAGE. NOTE: Notarized signature required on page S 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 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.* SK BUSINESS TRUST TRUST NAME NAME, ADDRESS, AND OFFICE SONNY KAHN 220D Biscayne Boulevard Miami, Florida 33137 Beneficiary OF INTEREST 100% NOTF: Notarized signature required on page 8 7 CITY OF IVIIAIItII BEACH ®EVELOPNIENT REVIE1sV BOARD APPLICATION DISC~t~~URE OF INTEREST 2. TRUSTEE If the property which is the subject of an application is owned or Eeased by a TRUSTEE, fist 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 OF INTEREST RUSSELL W. GALBUT 2200 Biscayne Boulevard Miami, Florida 33137 Beneficiary 100% NOTE: Notarized signature required on page S 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 198 FAMiLYTRUST TRUST NAME NAME, ADDRESS, AND OFFICE % OF INTEREST BRUCE A. MENIN 220D Biscayne Boulevard Miami, Florida 33137 Beneficiary 100% NOTE: Notarized signature required on page 8 7