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Alexander I. Tachmes Collins Hotel Associates~ ~ ~ , ~r~ ~., ' City of Miami ;Beach Office of the City Clerk. 1 1.700 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: 1. LOBBYIST RETAINED BY: ' Collins Hotel Associates, LLC .. .NAME OF PRINCIPAL/CLIENT: c/o Morgans Group LLC 475 10th Avenue New York, N.Y. 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (212).277-4130 N/A N/A TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust {Sectiori 2=482 (c)] • NAME OF, CHIEF OFFICER, PARTNER, OR. BENEFICIARY: ---~ r..~ .... ~~ ,.. ~ • IDENTIFY ALL PERSONS HOLDING,. .DIRECTLY CR INDIRECTLY, A 5~°lo ORS MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ~ ~ ~ , See Exhibit "A" attached. ~~ ~ ~ ~~ ~-~ . . ~ ~~,. . ~ l~ c-.> II. ~ SPECIFIC LOBBY ISSUE: `'~'` ~''`~ Roof Top Ordinance issue in connection with The Gale Hotel 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) FuIF Name of Individual/Title B) Any 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 IV. DISCLOSURE OF TERMS AND AMOUNTS OF~ LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): t ~~' t A) LOBBYIST DISCLOSURE: (Required) Hourly - $450.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly - $450.00 Thefollowing information must be answered:. 1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^Yes ~ No: Are you lobbvinq 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 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes ~ No: Are you lobbvinq on a pending application for a Development Agreement with the City or application for chance of zoning map designation or chance to the City's Future Land Use Maps 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, fo 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: ON OCTOBER 1St OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE. CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF.MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR A STATEMENT SHALL BE FILED EVEN LF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist= Alexander I. Tachmes I do solemnly swear that all of the foregoing facts are true and correct and that 1 have read or am familiar with the provisions contained in Section 2-4f the Miami ~~h~ity Code and al(reporting requirements. Signature of Lobbyist: U Alexander 1. Tachmes Signature of Principal/Client: VI. J.P. Oliver, Authorized Sigriatory LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ Produced ID ^ Produced ID Form of Identification ® Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to. ands scribed before me. This day of ~ , 2010 f_ _ ~ S µ-~-. ig . ~fP BII~t~pFl~~Af Florida No afi~~`Ci' ofTla~,f~1~y~~~g~;ture Commission ~DDG51416 '~. .= sires: MAR. 23 ~D~41BE COMPLETE Annug~ '~~~i~,~[~~j~~,IgptC.Amount Paid $_ Lobbyist Registration Form received and verified by: ' F:\CLER\LOBBYISIILobbyist Registration Form 32708.doc Form of Identification ^ Personally known (Principal) State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of , 2010 Signature of Nublic Notary -State of Florida Notarization of Principal's signature BY CITY CLERK'S SE ONLY MCR # $ Date Paid /") ~ ,~ ~ ~ '/2008 ~ - - ,~ ,A) LOBBYIST DISCLOSU'RE:.(Required) - s ~ `. - - +~v..1.- a., Hourly ._ $450.00 - - - ;,, 'B) PRINCLPAL'S DISCLOSURE (OF LOBBYIST COMPENSAT'ION): = ' .. (Required).. ' Hourly - $450.00 .. ~ , :, The following .information .must qe answered: ~ -~ - . - , ` ~ 1'.) Pursuant.to Miami Beach Cify Code Section 2=488 Entitled"Prohibited Campaign Contributions By Lobbyists .. _. On Procurement.lssues"; .. ; .. :. ~ . F .. .: . :. Yes ~ No: Are you lobbying 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 2-490 Entitled. "Prohibited Campaign Contributions By Lobbyists On - . Real Estate Development .Issues": y . ' - ~ Yes ~ No: Are you lobbying on a~pendinq application. for a Development Agreement 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 2-484 {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 entitywithout special compensation. or reimbursement for the appearance, whether direct, or indirect, ~fo 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 ~representinq a, not-for-profit corporation or entity without special compensation or . , reimbursement.:. ~ ~ Y ; • V. ~..: SIGNATURE UNDER OATH: ~_ . ' :. ON.;OCTOBER 1St OF EACH YEAR, .EACH LOBBYIST SHALL SUBMIT` TO THE CITY CLERK A SIGNED . , STATEMENT UNDER. OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION - ,' RECEIVED IN THE CITY OF MIAMLBEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL ~~' t .. BE FILED EVEN.IF THERE ..HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING- PERIOD: ~~ -~ ~. ~ ~ ~ ~ Signature of-Lobbyist=Alexander l: Tachmes ~I do solemnly swear that--all, of the foregoing facts. are true and correct and that.l Have read or am familiar with the . provisions contained in Section 2-482 of the` Miami.. Beach City Code and aII .reporting requirements:: - , Signature oftobbyist: ~-, .- . . .. ... , . lexand `: r I Tachmes _ ,. - .,~ Signature of:Principal/Client: _ . ' ~ .Oliver, Authorized Signatory .,. ~ , ° i ' VI. LOBBYIST'IDENTIFIC TION: PRINCIPAL IDENTIFICATION: - ~ ~ Produced:lp. ^ , Produced~lp ,. , ": ~ ' Form of Identification Form of Identification O ~ ~ ~ :~ ... o ' ~ ®, Personally known (Lobbyist) Personal) -known Princi al o N . O°~~ VII.. SIGNATURE AND STAMP OF NOTARY: ~ U N ~, ~ - . - ,~Nz State of Florida,"County of Miami-.Dade State of Florida, County of Miami-Dade ~ o a ~ . Sworn to and subscribed before me , ~. Sworn to and subscribed before me ~ U - . ' ~ . ~ - Thin. day of ~ . . , 2010 .~ This ~.~ day ofd, 2010... .. ~ '- .. - o .- ~ ~ , m Signature .of Public Notary;- State of Florida Signature of Public Notary -.State of Florida ~'` ~ - ` - Notarization of Lobbyist's signature Notarization of Principal's signature' # - - ~. . , - { ~'~ I ,. Ciiy of P7iarni Beach, 1700-'Convention Ceriter Drive;.Miami Beach; Florida 33139., www.rniamibeachi"i. ov - ~ CITY-CLERi< Office ~ Ci clerk rriiamieachfl. ov . . ..~ - ~ - . Tel,:' 305.673.7411,; .Fax:,. 30:5.673.7254. .~. ;Acknowledgement of fines/suspension from ~tobbying for failure to . comply~with City of Miami Beach lobbying Laws 4 LOBBYIST NAME: Alexander I. Tachmes ~ - I understand that no later :than -October ist of each -year, lobbyists subject to lobbyist . } -.registration requirements shall submit to the city clerk a signed statement under oath .~ . - ~ ~ lasting all lobbying expenditures; ~ as :well as compensation received, for .the preceding ~. - ., calendar year with regard to:~the specific issue on which .the lobbyist has been engaged to ~ lobby. A statement shalt be fired even if there have been no expenditures - or - ~ compensation during th:e reporting period. The statement .shall list, in. detail, each .. expenditure by category-, including food and beverage; entertainment, research,. . ~ communication, media advertising, publications, ravel, lodging and special events. . Failure to timer file the expenditure and fee disclosure report will result in : a fine of $50.00 per day. Any lobbyist who fails to file the required . . ., expenditure report by December shall automatically be suspended from lobbying until all fines are paid, unless the:fine has been appealed to the Miami-Dade County Commission on Ethics and ..Public Trust. In the -event a lobbyist fails to either- file the .report and/or pay the assessed fines, .the. Clerk-shall . notify the Miami Dade County Commission on Ethics and Public Trust. ~ . _. ~ - . .- - 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; E - Signature:: - Date:. - ~ ~ ~~ =t~. µ ..