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Alexander I. Tachmes (3)Lv ~- V ~ I2 u rJwar~s m 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 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 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 10th 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 OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ~ --~ See Exhibit "A" attached. ~-; r-- r•:-. MORE 0 ~c s~. =a~ t w ~„ -~ ~, II. SPECIFIC LOBBY ISSUE: ~ ~ ~`° Miami Beach Marine Authority Board Approval for Wave Runners ~ ~ ,~; r r Issue to be lobbied (Describe in detail): 7" ~ 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 IndividuallTitle B) An Financial, Familial or Professional Relationshi City of Miami Beach Planning Board None City of Miami Beach Mayor/Commissioners None City of Miami Beach Committees None MIADOCS 3366721 1 iV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLA T RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly - $400.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly - $400.00 The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "I~rohibited Campaign Contributions By Lobbyists On Procurement Issues": ^Yss 6a No: Are you lobbvina on a present or pendina bid for Goods. equipment or services, or on a present or pendina award for Goods. equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohik~ited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes 6a No: Are you lobbvina on a pendina application for a Development Agreement with the City or application for chance of zoning map designation or chance to this City's Future Land Use Mao? 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 ~~ppears 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 ®No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: Signature of Lobbyist: Signature of Principal/Client: ATraham7al. Galbut, 1 West Properties, LLC VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification NOTARY PUBLIC • STATE OF FLORIDA ® Personally known, Lb>~gyist~;~da Christian Vll. SIGNATURE A, ~~®~~~65141ti ,, „ ,,,, s, 3 2011 State of Florida, County bm>t;9lf~fiat~'~ ~oNptNG CA., ttiC, Swor o and• b ribs before me T ' day_o , 20 9 ~. IS~ ig atur of Public Notary -State of Florida tarization of Lobbvlst's signature Lobbyist Reelstraflon Form received and verified ~ c 11C•0 West Holdings, LLC, Manager of 1100 PRINCIPAL IDENTIFICATION: ^ Produced ID ,~'~~~~'~' ~ Form of Identification ,,,, ' 1 ~, ~'~~ l ~) Personally known (Principal) ~'••.,, .r .d ~ ~ o ~ \J c ~gB ~~ N St t nt of Mi i-Dade id Co f Fl ~ y or u am a e o a, and subs ribed before me S ; C n c ~ wo ~ _ f ~~ 2009 o ~ ~ "' Si t St t f "~•~~~o gN~ ~ c gna ary a ~ ~ 9 tariz~at[ Pri Ipal's signature fY CLERK'S USE DNLY_,~2 2 /!J ~., ~' Revised MIADOCS 3366721 1 I do solemnly swear that all of the f oing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-4 2 'tie MiamJ~a~y de and all reporting requirements. m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.pov CITY CLERK office CityClerk(a~miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 LOBBYIST NAME: Alexander I. Tachmes 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 for lobbyist withdrawal in writing. nature: 3 ~, ~ `~ Date: MIADOCS 3366721 1 1100 WEST PROPERTIES. LLC OWNERSHIP STRUCTURE 1100 WEST PROPERTIES, LLC i 104 West Holdings, LLC 100% (Sole Member of 1100 West Properties, LLC) 475 10th Avenue c/o Morgans Hotel Group New York, New York 10018 1100 WEST HOLDINGS. LLC Mondrian Miami Investment, LLC 50% 475 10`h Avenue c/o Morgans Group, LLC New York, New York 10018 Sanctuary West Avenue, LLC 50% c/o Hudson Capital 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MONDRIAN MIAMI INVESTMENT. LLC Morgans Group, LLC 100% 475 10`h Avenue New York, New York 10018 MORGANS GROUP LLC Morgans Hotel Group Co. 97.1 475 10`h Avenue New York, New York 10018 Residual Hotel Interest LLC 2.9% {See attached c/o 475 10t1i Avenue flow chart} New York, New York 10018 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation MIADQCS 2884Q89 I SANCTUARY WEST AVENUE, LLC Sanctuary West Holdings, LLC 100% (Sole Owner of Sanctuary West Avenue, L]~C) 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 SANCTUARY WEST HOLDINGS. LLC Sanctuary West Management, LLC 95% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Gladys Brownstein 2.5 Honey Waldman 2.5% SANCTUARY WEST MANAGEMENT, LLC Abraham Galbut & Nancy K. Galbut, his wife 28% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Keith Menin 18% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut 16% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Seth Frohlich & Kimberly Frohlich, his wife 8% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Robert N. Galbut and Rita Galbut, h.is wife 10% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 David Galbut and Geta Galbut, his wife 10% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Joan Brent 10% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 ti~inr~ocs zasaoa~~ ~ ,~ a ,~.. G} D _~ Z ~° ~ 0 n ~ 't] y f~D Q- CC rt ~ Q -o ~- m ~ = C? ~ cn ~ A o ~~ ~~ ~ ° Z r` o ~ C7 ~ a ~ D ~j Z ~ C~ 3 p V ~ ~. ~~ ~ a~ ~ y ~ ~ ~ ~ W ~ ~ y ~ o v 0 C ~ pp N ~ ~ r a O c n _ o ~ rn ~ ~ ~ G~~ ~ ~ ~= a 3z o ~ ~ o ~: ~~ ~ ~ r" ~ o ~ ~ ~ C7 .~ ~~ IV W J n ~~ K~ a~ °~ ~ ~ D _a ~ o r-. D o ° ~~ 0 N ~ r m~ r ~ r ~,' v N ~ ~ c~ ~ ~ ~ . ~' _ ~ ~ _ ° d a o o ~ ~~ .~.. 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