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Alexander Tachmes - Phillips South Beach, LLC[~ • ~^~~~ 9 ~ li° ~_:. .y ~ o of ~~~ ~ ~ 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: Phillips South Beach, LLC d/b/a The Shore Club -- PRINCIPAUCLIENT: The Shore Club 1901 Collins Avenue Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 695-3236 (305) 695-3255 tim.nardi .morganshotel roup 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: II. SPECIFIC LOBBY ISSUE: Roof Top Ordinance issue in connection with The Shore Club -1901 Collins Avenue 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 IndividuaUTitle B) An Financial nfi r Rr? 'pn I R lationship City of Miami Beach Planning Board None ` •~ City of Miami Beach Mayor/Commissioners None QS : t City of Miami Beach Committees ~~ None ~- ~~~ ~odZ ~ ~~:) f~~1 i ~ ~.a r .~ ~~`~ S~ • ~. 11/. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly - $450.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly - $450.00 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': ^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°: ^Yes 6a No: Are you lobbying 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 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 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 snot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: Signature of Lobbyist: Signature of Principal/Client: Tim Nardi, VI. LOBBYIST IDENTIFICATION: IPAL IDENTIFICATION: ^ Prod1~~'jPUBLIC - STATE OF FLORIDA f ~~f''~~~{{i'' Co~~,~6514~~ ® Persof'tel •ithc~u6~~t~3, 2011 BOND D THRU C B ND G CO, INC. VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed pefore me This $ day of fi 4Q..,~, 2010 ~~at.C~TS~.~.. Sig attire of Public Notary -State of Florida rization of Lobbyist's signature ^ Produced ID Form of Identification Personally known (Principal) JENNIrcR WEINBERG State of Florida, County of Miami-D . ~, NOTARY PUBLIC STATE OF FL Swor to and subscribed before me DRIDq This ~ day of~~, 2010 G°r"rn'~ EEt)00743 FaWlrss 8!14/2014 Sig tune of'Publi._ ' State of Florida No arization of Principal's signature TO BE COMPLETED BY CITY CLERK'S US ON Y Annual Registration fee: ]Yes [ J No Amount Paid $ ~ MCR # $ Date Paid Lobbyist Registration Form received and verified by: F:\CLER\LOBBYIS71Lobbyist Registration Form 32708.doc _.vr~ _, Ro.,~ao,~ z~~~nnna I do solemnly swear that all of the foregoing facts are true and correct d that I have read or am familiar with the provisions contained in Section 2~2 of the Mi~rti ~ctt"G~ity Code arl reporting requirements. ~~ MIAMIBEACH City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, vrww.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1. ,Fax: 305.673.7254 Acknowledgement of fines/suspension from lobbying for failure to. comply with City of Miami Beach lobbying Laws LOBBYIST NAME: A~ pxanr3Pr T T~3.ChmpS I understand that no later than October 1st of each year, lobbyists subject to IQbbyist 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 of lobbyist withdrawal in writing. (~ ~0 0 Signature: Date: