Alexander I. Tachmes - Brilla AJ RMB, LLC dba The Raleigh ei M Am BEACH
ity of Miami Beach Office of the City Clerk
1700 onvention 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 su h action, decision or recommendation that foreseeably will be heard or reviewed by the city
commission, or a city board or commi ee. The term specifically includes the principal as well as any employee engaged in lobbying
activities. The term "Lobbyists" has pecific exclusions. Please refer to Ordinance 2004 -3435.
Tachmes Alexander I.
NAME OF LOBBYIST: (Last) (First) (M.I)
c/o Shutts & Bowen LLP 20' S. Biscayne Boulevard, Suite 1500 Miami Florida 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:
Please notify this office if your contact information changes: address, phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Brilla AJ RMB, LLC d /b /a The Raleigh
NAME OF PRINCIPAL/CLIENT:
The Brilla Group 120 NE 27th Street, Suite 500 Miami Florida 33137
BUSINESS NAME AND ADDRESS l(Number and Street) (City) (State) (Zip Code)
(786) 375 -5601
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:
Adam Denmark Cohen, Chief Operating Officer
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See attached
II.SPECIFIC LOBBY ISSUE:
Proposed Parking Impact Fee Legislation
Issue to be lobbied (Describe in detail):
in. CITY AGENCIES /INDIVID ,ALS TO BE LOBBIED:
Pursuant to City Code Section 2- 482(a)( ) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered
Into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date, stating the general nature of the subject contractual relationship.
Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO
title of person to be lobbied
City of Miami Beach Planning Board /Committees
City of Miami Beach Mayor /Commissioners
City of Miami Beach Attorney /Administration Section
Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or profess'i`onal
relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is
sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2- 482(g) Any Financial, Familial or Professional Relationship _ C �}� hli0
None
None
6 � =1 i�d 7 f IOZ
None U 7 1 A i i J
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$495.00
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).$495.00
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 )M 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 ":
Q Yes I} No: Are you lobbying on a pending application for a Development Agreement with the City 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 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.
0 Yes El No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th 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 SHA E FILED EVEN IFE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
'S °r
Signature of Lobbyist I Alexander I. Tachmes
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 2-482 of the Miami Bea i Code and - re% •,. • - quirements.
Signature of Lobbyist: '� •
g ,�
Alexander I. Tech / r -
Signature of Principal /Client: A ie
Adam Denma • ' Director and Chief Operating Officer
VI. LOBBYIST IDENTIFICATI • PRINCIPAL IDENTIFICATION:
o p P14, STACY BAEZ
❑ Produced ID * MYCOMMISSION°EE004704❑ Produced ID
Form of Identification,,;' EXPIRES: dune 21, 2014 — Form of Identification
of c Bolded Thu Budget Nay SOWICOS
ersonally known (Lobbyist) 2 Personalty known (Principal)
VII. SIGNATURE AND STAMP OF NOT • • Y. , u.,,, ANAlIELp�AGAN
* Mourn - State Raids
a
State of Florida, County of Miami -Dade l*CommisionExpirockeigkiON lorida, County of Miami -Dade
Sworn to and subscribed before me ''., Ca�nlieeion 0 00 �lrtn - • before me
Thi day of VV\c r i , 2011 'A';a:' :, RiC.b , 2011
da
Sign ure of Public Notary – Stat- • Florida Signature of • bli Notary State of Florida
Notarization of Lobbyist's signature Notarization o Pr' - i • al's • • nature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY +
Annual Registration fee: [ ] Yes [ ] No Amount Paid $ ' ,r —M - # 1 • Date Paid
Lobbyist Registration Form received and verified by: • ,! " �wari
F: \CLER \$ALL \aFORMS \LOBBYIST FORMS \Lobbyist Annual Registration Form.. '.c .PIS � 0 Rev' 1/11 2011
1
M I AM' BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
Alexander I. Tachmes
LOBBYIST NAME:
I understand that no later than February 28th of each year, I must file the following
form, 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 and Compensation 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 of lobbyist withdrawal in writing.
Cc)L Gam- LT2 t
Signature: Date:
Alexander I. Tachmes
Ownership Disclosure
Brilla AJ RMB, LLC — 100% owner of Raleigh Hotel, 1775 Collins Avenue
88% owned by RMB Investment Holdings, Inc.
12% owned LB Brilla RMB, LLC
RMB Investment Holdings, Inc.
Only owner of more than 5% interest: Brilla Capital Investments B.V. (Netherland
Antilles), which is controlled by Brilla Group, Inc.
Only owners of more than 5% interest in Brilla Group, Inc.: David Brillembourg and
Adam Cohen
LB Brilla RMB, LLC
Only owners of more than 5% interest: Fundacion Privada Luben (Netherland Antilles)
(foundation) and Brilla Group, LLC
MIADOCS 5210321 1