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James P. Wurst - Nichols Brosch Wurst Wolfe & Associates, Inc. kda,A.Nt)q ns-4AA I MI BEACH aq o City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 E c / LOBBYIST REGISTRATION FORM 2011 FEB 1 8 Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the igeCre pt 9r, gnodification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manage b'r i 47-iotulFor 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 board 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. Wurst James P. NAME OF LOBBYIST: (Last) (First) (M.I) Nichols Brosch Wurst Wolfe & Associates, Inc. 161 Almeria Ave. Coral Gables Florida 33134 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 -443 -5206 305 - 443 -3168 TELEPHONE NUMBER: FAX NUMBER: EMAIL: P /ease notify this office if your contact information changes; address, phone, or e-mail address. I. LOBBYIST RETAINED BY: Seville Acquisition, LLC NAME OF PRINCIPAL /CLIENT: 10400 Fernwood Road Bethesda Maryland 20817 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (301) 380 -7972 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: Publicly traded on the NYSE under the symbol MAR. • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Publicly traded on the NYSE under the symbol MAR. II. SPECIFIC LOBBY ISSUE: Redevelopment of the properties located at 2901 Collins Avenue and 2901 -2912 Collins Ave., 201 -265 29 St., & 2901 -2911 Indian Creek Drive Issue to be lobbied (Describe in detail): III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2- 482(a)(4) include the commissioner of personnel sought to be lobbied, and whether the lobbyist has entered into 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 2482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied Planning Staff, Public Works Staff, Parking Dept. None X Staff HPB, BOA, Planning Board, City Commission None X Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional 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. 1/ Sec 2- 482(g) Any Financial, Familial or Professional Relationship None. 08111 r IV. ' DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER A) LOBBYIST DISCLOSURE: (Required) vhc C "'ft B) PRINCIPALS DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). i Z*044 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 X 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 X 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.. Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28 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 RE' ' G PERIOD.en 4411. G■—■l Signature of Lobbyist 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 th-. .ami Beach Ci ■ C'-de a .• - eporting requirements. Signature of Lobbyist: C..........." 1 • Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification ersonally known Lobbyist) Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami -Dade State of Florida, County of Miami -Dade Sworn to a subscribed before me Sworn and subscribed before me This 3' ` day of Fk'x' a) /, 20! 1 This day of , 20_ Signature of Public Notary — State o o da Signature of Public Notary — State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature FOR CLERK'S USE ONLY Annuala ` i FFF�AAN . t�l C, OFF No Amount Paid MCR # Date Paid 3 .. S . *_ - c, mmiSS ski I g , 11 -. , Lobbyist; ;.4 ;; .tEXpi�$rN0 1bti O i d by: Entered By: • OF F, Bonded Thru Tr oy Fain Durance 800385.7019 Revised 1/11/2011 , , IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) • A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 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 X 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 X 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.. Yes X No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28 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 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 Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal /Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification N Personally known (Lobbyist) Personally known (Principal) co N L VII. SIGNATURE AND STAMP OF NOTARY: cer E. MAPy`aAA M y C1 State of Florida, County of Miami -Dade State of �r; County of / Sworn to and subscribed before me Sworn arid subscribed before me This day of , 20_ This 3 day of Tcbncatt.y, 20 I I 2 co o, Signature of Public Notary — State of Florida Signature of blic Notary State of .+eridie Mawykao■A >_`• E Notarization of Lobbyist's signature Notarization of Principal's signature co 0 FOR CLE ' USE ONLY Q I / Annual Registration fee: [ /] Yes [ ] No Amount Paid MCR # Date Paid v Lobbyist Registration Form received and verified by: Entered By: Revised 1/11/2011 1 // / CA/