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John Vickers - Robert S. Wennett:Tishman Realty LP i MIAMI BEACH 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-malting process on such action, decision or recommendation that foreseeabiy 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 tern"Lobbyists"has specific exclusions. Please refer to Ordinance 2004-3436. Vickers John NAME OF LOBBYIST: (Last) (First) (M.1) TISHMAN REALTY,L.P., 100 Park Avenue,18th Floor, New York,New York 10017 BUSINESS NAME AND ADDRESS (Number and Street) (CRY) (State) (Zip Code) (212)399-3600 (212)202-5058 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact Information changes:addmss,phone,or e-mail address. 1. LOBBYIST RETAINED BY: Robert S.Wennett;Tishman Realty LP and/or Affiliate and Entitles to be Formed NAME OF PRINCIPAUCLIENT: Ire Pork Aver a 18th Floor New York New York 10017 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (212)399.3600 (212)202.5058 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Fill out this section if principal Is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: John Vickers for Tishman Realty L.P.and Robert S.Wennett • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:Tishman Realty L.P.Is wholly-owned Indirectly by Tishman Hotel i Realty L.P. II.SPECI M LOBBY ISSUE RFQ X22-11/12 and related Issues Issue to be lobbied(Describe In detail): III.CITYAMENCIESIINDIVIWA TO.BE LOBBIED: IED: Pursuant to City Code Section 2482(a)(4)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 eneral nature of the subject contractual relationshl1 . 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 Procurement Division staff;City Manager's Office;Planning and Zoning Staff;City Commission; Honorable Matti Herrera Bower Mayor Pursuant to City Code Section 2-462(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. Sec 2.482 An Financial f=amilial or Professional Relationship N/A 110Z i IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHEM: A) LOBBYIST DISCLOSURE:(Required) NOT APPLICABLE B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION). (Required)) NOT AP-EU-CABLE ' The following Information must be answered: 1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues". Wes []No: Are you lobbying on a Present or Pending bid for goods eauinment or services or on a_Present or R2ndlnA award for goods.eguie;iment or service? 2) Pursuant to Miami Beach City Code 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues': Wes []No: Are you lobbying on a Pending aPPlicatlon for a Davelo®mant Aareem nt with the City or aaPlicationfor change of zoning Mai)designation or change to the City's Future Land Use-Man? 3) Pursuant to Miami Beach City Code 2484(h)Any person(except those exempt from the definition of"lobbyist"as set forth in Section 2481 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 Rem,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. ❑Yes®No:Are you regresentina a not-for-Profit car gratfo or entity with-ho eneclai comPensatlon or reimhursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT T®THE CITY CLERK A SIGNED STATE ENT UNDER OATH..LISTING LOBBYING EXPENDITUREES,AS WELL Al COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL 8E FILED EVEN IF THERE,HAVE BEEN NO EXPENDITURES OR COMPENSATION DU IN¢THE REPORTINQ PE_ RIOD. John Vickers I do solemnly swear that all of the foregoing facts are true correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City ode and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client )C H N REALTY -'B �5�o i- � otiATc%o� Wn A-JL- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID 0 Produced ID Forth of Identification Form of Identification ,e'a::`,'�.�, ALBERT E.DOTSON,JR. 9>4e,rsonally known(Lobbyist) personally known(Princl * MY COMMISSION#EE 021887 EXPIRES:August 30,2014 VII. SIGNATURE AND STAMP OF N0�4 y�.�, ALBERT E.DOTSON,JFL � OOFf�'oP sorbed"' N Servloes * * MY COMMISSION#EE 021887 State of Florida,County of Miami-Dade EXPIRES:August 30,2014 State of Florida,County of MiamaDade Sworn t and subscri d before me 44 "y" Bonded Thru Budget IV m Services Sworn and subscribed before me This_L�day of e u4 h�!2012 This��day of o u is Notary-State bfMorlds Signature of Public Notary-State of Florida Notarization of b s's gnature Notarization of Princiffil's signature TO BE COMPLM BY CITY CLERK'S STAFF ONLY �i Annual Registration fee: [14]Yes( ]No Amount Paid: j2 MCR 8 Date Pal Lobbyist Regletr4on Fore received and verified by: wised 1/11/2011 /\AIAMIBEACH X11 of Miami 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamlbeachfl.00v CITY CLERK Office Rafael E.Granada,City Cleric W[ark0 LLTlbeachil 8m Tel:305.673.7411 ,Fax:305.673.7254 LOWY=NME .QHN VQCERA I understand that no later than February 28 of each y r. I must file the following fern, 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, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2.485(d), the City Clerk shall notify any lobbyist(or principal)who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be automatically 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. 9 . 2o�z Jo ckers Date MIAMI 3458238.176134/40305