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Keith Menin - 1100 West Properties LLCm 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. Menin Keith NAME OF LOBBYIST: (Last) (First) (M.L) 2200 Biscayne Boulevard Miami FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5700 (305) 847-3354 kmenin _crescentheights.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: 1100 West Properties, LLC ~ c.'~'', NAME OF PRINCIPAUCLIENT~ Mondrian South Beach c/o Morgans Hotel Group, 475 10~" Avenue New York, New York 10018 rte' ~ '~ / t .~. BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Cod~j _. :`~ ~_ . __ (305)_ 674-4848 (786) 258-2870 agalbut hudcap com ~'tr -~- TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) ~, ~ "~ -.-, ~ i k' out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] r-;_ ~ °- • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Abraham Galbut, as Pretl ent of 1100 West Holdings, LLC, Manager of 1100 West Properties, LLC IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached Disclosures of Interest. II. SPECIFIC LOBBY ISSUE: Request for modifications to conditions of the Final Order, and any other Order, for a previously issued Design Review Approval for a new landscape plan for the entire site, as well as for alterations to the existing exterior elevations, including modifications to the windows, doors, and porte-cochere, and the construction of new 2-story cabanas at the rear of the site.. Specifically, a proposal to modify the conditions of the Final Order, and any other Order, relating to the completion of the public baywalk under DRB File No. 20181, for the property located at 1100 West Avenue, Miami Beach, Florida 33139. 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 said City personnel' commencement of service with the City to the present date, stating the general nature of the subject contractual relation. A Full Name of Individual/Title B An Financial, Familial or Professional Relationshi City of Miami Beach Design Review Board None City of Miami Beach Planning Director/Staff None City of Miami Beach Mayor/Commissioners None Cit of Miami Beach Cit Mana er/Asst.. Cit Mana ers None , ~' IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $0. No compensation for lobbying. B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $0. No compensation for lobbying. 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 '6~ No: Are you lobbvina on a present or pendina 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 ba No: Are you lobbvina on a pendina application for a Development Agreement with the Citv~or application for change of zoning map designation or change 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 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 section but, shall not be.required to pay any registration fees. ^Yes 6d No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 18~ 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 IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 'Signature of Lobbyist -Keith Menin I do solemnly swear that all of the foregoing facts are true and correct and t at I have read or am familiar with the provisions contained in Section 2-482 of 'Bea ity Code an p in re uirements. Signature of Lobbyist: Signature of Principal/Client:. ~ , ~ l Personally known (Lobbyist) Signature of Public Notarization of Lo Personally known (Principal) State of Flgrida, County of Abraham Galbut. as President of 1100-West Holdings, LLC, Manager of 1100 West Properties, LLC VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: i ~ ~~~- Produced ID ~ 55b--S~3 ~~ ~~ ~ ~ roduced ID Form of Identification Form of Identification _.,,.... T. , 4 m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov CITY CLERK office Tel: 305.673.7411, Fax: 305.673.7254 CityClerk .miamibeachfl.gov Acknowledgement of fines/suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: Russell W. Galbut I understand that no later than October 1st of each vear, lobbyists subject to lobbyist registration requirements shall submit to the city clerk a signed statement under oath listing 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 shall be filed even if there have been no expenditures or compensation during the reporting period. The statement shall list, in detail, each expenditure by category, including food and beverage, entertainment, research, communication, media advertising, publications, travel, lodging and special events. Failure to timely 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 1, 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 for lobbyist withdrawal in writing. ~.. -~ -•~.. G, ~~ " natur eit Menin Date. P - _ CITY OF MLAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1144 WEST P120PERTIES,_LLC 1100 West Holdings, LLC 100% (Sole Member of 1100 West 1?roperties, LLC) 47S 10th Avenue c/o Morgans Hotel Group New York, New York 10018 1104 WEST HOLDINC~S..L.LC 1100 West Holduigs .lI, I,T~C 100% (Sole Member of 1100 West 1-lol.dings, LI,C) 47510th Avenue c/o Morgans Hotel Group: ' New York. New York 10018 i 1144 WEST .HOLDINGS II, LLC Mondrian Miami Investment, L1,C {}/ 50 - ~~ 475 10`" Avenue ~, clo .Morgans Group; LLC' Ne~v York, New York 10018 Sanctuary Vilest Avenue, LLC ~0% c/o Hudson Capital 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MONDRL4N MIAlYTI .INVESTMENT. LI.C Morgans Group, LLC 100% 475 loth Avenue '' New York, New York 10018 MORGANS GROUP. LLC Morgans Hotel Group Co, 97.1 475 10th Avenue New York, New York 10018 Residual Hotel Interest LLC 2.9% (See c/o Northstar Reality Finance Corp. attached flow 399 Park Avenue, 18th Floor chart) New York, New York 10022 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation. SANCTUARY WEST AVENUE, LLC Sanctuary West Holdings, LLC 100% (Sole Owner of Sanctuary West Avenue, LLC) 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 24% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Keith Menin 17% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut o 13 /o c/o 4770 Biscayne Blvd., Suite 400 , Miami, Florida 33137 2 t ~ ... Seth Frolich & Kimberly Frohlich, his r~rifc c1o X1770 Biscayne Blvd., Suite 400 Miami. Florida 33 137 Robert N. Galbut and Rita Galbut, his wife c/o 4770 Biscayne F31vd., Suite 400 Miami. Florida 33137 David Galbut and Gita Galbut. his wife clo 4770 Biscayne Blvd., Suite 400 IV17at111, Florida 331.37 Joan Brent c/a 4770 Biscayne Blvd., Suite 400 ivliarni, Florida 3.3137 SEAM Hoidir~gs, LLG c;o 2200 13isc;ayne Blvd. Ivliam.i, Florida 33137 S:C+lA1!'I .HQLDINQS, LLC Sonny Ka(rrr c/a 2200 13iscay~r.e Blvd Miami, Florida 33137 Erica Kahn cr'o 2200. Biscayne Blvd. Miami, Flarida 33137 A.brahartr Haven c;o 2200 Biscayne Blvd. Miami, Flarida 33137 Mord.i Bitton c/o 2200 Biscavrle .131vd. Miami, Florida 33137 3 7% 7% 7% 5 °.~o 20°10 , 25°!° 2S°io 25% 25% Z7 mz~_ S.i~ W Q V ~f~ •V ~_ N O ~_ ~ ^ ''mo't 1./ VJ ~ =' .Q n ~ ,_.- z O w~ ~~.. ^~ lei. t° r ~~ c~ m .~ ~. to `i~pp p1 m~ r~ ~ ~. .... m r ;o ~~ ~~ ~h b V ~ .ti ~ ~ ~ ~ ~ ~~ O q "m+ ~, a to _z i y ~' d V ~ ~' O ~~ v r v J . 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