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Alexander Tachmes - 1100 West Properties, LLC ' MIAMI BEACH � P r- P City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL M OR _3 AH 10' 56 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a principal who see erQdbSra�-& Va�s�6' , 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. Tachmes Alexander I. NAME OF LOBBYIST: (Last) (First) (M.I) Shutts&Bowen LLP 201 S.Biscayne Blvd.,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: Please notify this office if your contact information changes: address,phone, or e-mail address. I. LOBBYIST RETAINED BY: 1100 West Properties,LLC NAME OF PRINCIPAL/CLIENT: c/o Morgans Hotel Group 475 10th Avenue NY NY 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 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 OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached. II.SPECIFIC LOBBY ISSUE: Proposed legislation affecting West Avenue 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 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 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 Committees and Boards None ✓ City of Miami Beach Attorneys Office and Administration None ✓ City of Miami Beach Mayors/Commissioners None ✓ 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. Sec 2-482 Any Financial, Familial or Professional Relationship None V MIADOCS:74122560 �� IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) SSJ B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement I sues": _Yesjo: 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 Section 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate evelopment Issues": _Yes Jo: Are You lobbying on a pendin-g 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 Section 2-482(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 Yes)item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. 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 EYEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signa re of Lo byist 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 Beacnity Code and all re orfingkequirements. Signature of Lobbyist: — (XA4W(� — Signature of Principal/Client: —0j ON"i 021 VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: CY _Produced ID .3 o _Produced ID ° Form of Identifigtion W N�, Form of Identification Uj t 152 z e `/4 _Personal) known(Principal)_ ersonally known(Lobbyist) 3 Z VII. SIGNATURE AND STAMP OF NOTARY: o� a State of Florida, County of Miami-Dade LU State of Florida, County of Miami-Dade Sworn to and subscribed before me �� * �o, Sworn and subscribe before me 11 All y'� This ? day of AZ\ 2011 a This 31 day of d- 2013 s r7 Signature of Public Notary—State of Florida Signature of Public Notary—State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED PY CIZ CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes( No Amount P id$ MCR# Date Paid Lobbyist Registration Form receive and verified by: E&II bell/4 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc IM MIAM BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachf.gov CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 LOBBYIST NAME: Alexander I. Tachmes 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, 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 of 3 I Signature: Date: MIADOCS:7412256v3 1100 WEST PROPERTIES, LLC OWNERSHIP STRUCTURE 1100 WEST PROPERTIES, LLC 1100 West Holdings, LLC 100% (Sole Member of 1100 West Properties, LLC) 475 10`h Avenue c/o Morgans Hotel Group New York, New York 10018 1100 WEST HOLDINGS,LLC Mondrian Miami Investment, LLC 50% 475 10"'Avenue c/o Morgans Group, LLC New York, New York 10018 Sanctuary West Avenue, LLC . 50% c/o Hudson Capital 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 AIONDRIAN MIAMI INVESTMENT,LLC Morgans Group, LLC 100% 475 10`h Avenue New York, New York 10018 MORGANS GROUP LLC Morgans Hotel Group Co. 97.1% 475 10"'Avenue New York, New York 10018 Residual Hotel Interest LLC 2.9% (See attached c/o 475 10"'Avenue flow chart) New York, New York 10018 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation MIADOCS 2884089 1 SANCTUARY WEST AVENUE,LLC Sanctuary West Holdings, LLC 100% (Sole Owner of Sanctuary West Avenue, LLC) 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 SANCTUARY WEST HOLDINGS,LLC Sanctuary West Management, LLC 95% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Gladys Brownstein 2.5% Honey Waldman 2.5% SANCTUARY WEST MANAGEMENT, LLC Abraham Galbut&Nancy K. Galbut,his wife 28% 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 Keith Menin 18% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut 16% c/o 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 Seth Frohlich&Kimberly Frohlich, his wife 8% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Robert N. Galbut and Rita Galbut, his wife 10% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 David Galbut and Geta Galbut,his wife 10% c/o 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 Joan Brent 10% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MIADOCS 2884089 1 o m X o m' D W v G) m Z D N p °� n c ;:I' -a CL zr v � m -z n � _ GD ^-• a Z �. m W n C-Ds N n G C1 �- coo m N 7' - rn :3 m O CC1 r C) m -' 4 1 Z T O X D Cn z CD o `'�'� oo v Q.. 7 /� CD W -U N C v P- o D CD o O o CL N DO r v v CD (n o _ oCD �- 0 o r D -�' CD m z cn O \ n '{ �- c D cn CD _° r w o 0 -S rn 3 � cci (0(0 �- CD CD n D `DCD � (n d 9 2 -n co co n 3 — co r o � D � n 3. 3 � CL .� 0 C/) a) Q co ro D o CD � � � ^ o cn m co .lP C7 N o r Q m cn n co 1 r � C) `- Fn r -- -n cn rd m 3. 3 0 c �� w CL 0" @ (a O "O O C L`� CD CL cv -I -n 0- ((0 0 a \ CD N co r co r ca n