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Alexander I. Tachmes/1100 West Properties, LLC (2)m M.IAMIBEACH 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 bond 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. Tachmes Alexander I. NAME OF LOBBYIST: (Last) (First) (M.I.) c/o Shutts & Bowen LLP 201 South Biscayne Boulevard, Suite 1500, Miami, FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 347-7341 (305) 347-7754 atachmes@shutts.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: 1100 West Properties, LLC NAME OF PRINCIPAUCLIENT: c/o Morgans Hotel Group 475 10'h Avenue New York NY 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305-) 674-4848 N/A agalbut@hudcap.com 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: • IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Exhibit "A" attached. SPECIFIC LOBBY ISSUE: Amendment to DRB Order No. 20181 Issue to be lobbied (Describe in detail): III. 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 rise 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 An Financial, Familial or Professional Relationship City of Miami Beach Planning Board None City of Miami Beach Mayor/Commissioners None City of Miami Beach Committees None MIADOCS 3130374 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST GOMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER7: A) LOBBYIST DISCLOSURE: (Required) Hourl - $400.00 B} PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourl - $400.00 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": I_ZYes ~ No• Are you lobbving on a present or pending 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 2490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": [7Yes ~ No' Are you lobbyina on a p~ndina application for a Development Aareement with the City or application for chance of zoning map designation or chance to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code 2-084 (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 section but, shall not be required to pay any registration fees.. ^Yes 6a No• Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: Signature of Lobbyist: Signature of PrincipallClient: West Properties, LLC VI. LOBBYIST IDENTIFICATION: ^ Produced 1D Form of Ident' ti n NOTARY PLBI,IC • STA ~F ~LORIDA ® Personally ''~o'"' ,(Lo)itij~6t}Christian Commission #I7llb51416 VII. SIGNAT- -L~~~1JP~dtl~/~~: State of Florida, GsBu~ii ~ygoiam~i-~a~eND~66A,,txc, Sworn to ands scribed before me This .,3 day of , 2008 ' t O.R-~-~--~ Sig t re of Public Notary -State of Florida rization of Lobbyist's signature Manager of 1100 PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personail known Princi TARy rJL'LIC-S;~uE Op fL~~RIDA Y ( p~N,,..,,, JIiA,1IA b4. P,i1RTINE7, :Commission #pD3844:i9 ~''• ':••'~ ~P~~ AUG. 14, 2010 State of Florida, County of Miami-Dee~nt~nttr,uuxncaoxuuvcco.,nvc. o and subscribed b fore me his of II~/i~~8 Signature f u is tary - S to of lori a Notariz Principal's signature TO BE COMPLETED BY CITY CLERK'S USE NLY Annual Registration fee: j Yes [ ] Na Amount Paid S MCR # $ Date Paid Lobbyist Registration Form received and verlfled by: ' F:\CLERILOBBYI511Lobb st Re Istratlon Form 32708.doc Revised 03127 008 MIADOCS 3130374 1 I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-4f~the Miami B~Code and all reporting requirements. m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK office Tel: 305.673.7411, Fax: 305.673.7254 LOBBYIST NAME: Alexander I. Tachmes CityClerkCo)miamibeachfl.gov I understand that no later than October 1 g` 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 for lobbyist withdrawal in writing. Signatu << 3 0~ Date: MIADOCS 3130374 1 1100 WEST PROPERTIES, LLC 1100 West Holdings, LLC (Sole Member of 1100 West Properties, LLC) 475 10`h Avenue c/o Morgans Hotel Group New York, New York 10018 1100 WEST HOLDINGS. LLC Mondrian Miami Investment, LLC 475 10`h Avenue c/o Morgans Group, LLC New York, New York 10018 Sanctuary West Avenue, LLC c/o Hudson Capital 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MONDRIAN MIAMI INVESTMENT. LLC Morgans Group, LLC 475 10`h Avenue New York, New York 10018 MORGANS GROUP LLC Morgans Hotel Group Co. 475 10`h Avenue New York, New York 10018 Residual Hotel Interest LLC c/o 475 10`h Avenue New York, New York 10018 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation 100% 50% 50% 100% 97.1 2.9% (See attached flow chart) MIADOCS 2884089 I 3 .:~ SANCTUARY WEST AVENUE, LLC Sanctuary West Holdings, LLC (Sole Owner of Sanctuary West Avenue, LLC) 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 SANCTUARY WEST HOLDINGS, LLC Sanctuary West Management, LLC 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Gladys Brownstein Honey Waldman SANCTUARY WEST MANAGEMENT. LLC Abraham Galbut & Nancy K. Galbut, his wife 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Keith Mersin c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Seth Frohlich & Kimberly Frohlich, his wife c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Robert N. Galbut and Rita Galbut, his wife c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 David Galbut and Geta Galbut, his wife c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 _ Joan Brent c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 ~ ~, L~ 100% 95% 2.5% 2.5% 28% 18% 16% 8% 10% 10% 10% MIADOCS 2884089 I R; X a C a d w 0 N O ~ (~D y o a c co fl3 ~ 2 cn O O_ `^~' V. o ~, C ~ r n~ .~ ~ ' ~~_~ .?~ ~i _ ~ n c1D ~a ~ ~. 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