David Rothenberg - Tishman Hotel & Realty, LP. /\AIANAI 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-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.
ROTHENBERG DAVID
NAME OF LOBBYIST: (Last) (First) (M.1)
TISHMAN HOTEL&REALTY,LP, '100 Park Avenue,18th Floor New York,New York 10017
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212)708-6713 (212)262-0037 drothenberg @tishman.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:
Robert S.Wennett;Tishman Realty,L.P.and/or Affiliate and Entities to be Formed
NAME OF PRINCIPAL/CLIENT:
100 Park Avenue,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: David Rothenberg for Tishman Hotel&Realty LP and Robert S.Wennett
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE
RFQ#22-11/12 and related issues
Issue to be lobbied(Describe in detail):
Ill.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(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 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 Procurement Division staff;City Manager's �(
Office; Planning and Zoning Staff;City Commission;
Honorable Matti Herrera Bower,Mayor
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,fipap¢iah,,lamirra t, ,rofiessional
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 Any Financial, Familial or Professional Relationship
N/A s "°
d
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
Not Applicable
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required)) Not Applicable
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":
19 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 ❑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 ONO: 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 SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
X W, /O—-
David Rothenberg
I do solemnly swear that all of the foregoing facts are true nd correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beac ity Co 0e a I e rting requirements.
Signature of Lobbyist: X
Signature of Principal/Client: X TISHMAN HOTEL&REALTY LP BY:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID N� 'by'l V Vproduced ID 11�1� �Y tV t V
Form of Identification Fo
v P�e ADRIANA S.HELD
❑ Personally known(Lobbyist) ❑ Personally know Lp Notary Public.-State of Florida
a•. , My Comm.Expires Aug.4,�2014
Commission#E15,14560
VII. SIGNATURE AND STAMP ' O;`0% Bonded Through National Notary Assn.
P S.HELD
ORPNW
State of Florida, County of Miami-Dad = ': Notary Public State of Florida State of Florida, County of Miami-Dade
• •• My Comm:Expires Aug 4',201,4
Sworn t nd subscrib,�.d before me Sworn jMubscd�ed before me
Commission#EE,14560
This 2 -� day of`-1 ayluar , 20 "'•: o This day of ,n�a� ,2013
Bonded Through National Notary Assn.
Signa ure of Public Notary—State of Florida Signature of Public Notary—State of Florida
Notarization of Lobb ist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration.fee: [ ]Yes[ ]No-. Amount:Paid$ MCR Z/ 4 Z`. Date P id
Lobbyist Registration Form received and'verified by:
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I V 4
1: 1 No
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City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granada,City Cleric CityCleric miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME DAVID ROTHENBERG
I understand that no later than February 28 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, 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.
David Rothenberg Date:
MIAMI 3517336.1 76134/40305
I