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John Paul Oliver - 1100 West Properties, LLC oaf 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-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. Oliver John Paul NAME OF LOBBYIST: (Last) (First) (M.I) Mondrian South Beach Hotel 1100 West Avenue Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-514-1900 305-514-1909 ip.oliver @mhgc.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 PRINCIPAUCLIENT: c/o Morqans Hotel Group 475 10th Avenue New York NY 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) C-) ry 212-277.4130 TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) __< w >. O Fill out this section if principal is a Corporation,Partnership or Trust[Section 2482(c)] F • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCW ORPC� ATION; PARTNERSHIP OR TRUST: ii.SPECIFIC LOBBY ISSUE: Conditional Use Permit Issue to be lobbied(Describe in detail): 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 Committees and Boards None City of Miami Beach Attorneys Office and Administration None City of Miami Beach Mayor/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 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGODDH\Lobbyist Registration / Formrevised 5-30-2012.doc VVV' MIADOCS:7647654vl ` IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHERJ: A) LOBBYIST DISCLOSURE:(Required) NO special compensation B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No special 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 ✓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 Section 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 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 item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. Yes✓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 gUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER, OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPffkSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMEALT SHALL BE FILEDTEVEN IF T ERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. I SI 6ature of Lobbyist I do solemnly swe r th all of the foregoin facts are tr and correct and that I have read or am familiar with the provisions contained in Section 2-482 o e iami Beach City C de and all r ing requirements. Signature of Lobbyist: I Signature of Principal/ i nt: VI. LOBBYIST I TIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID . .�_ Form of Identification Form of Identification Ypersonally 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 and-Isubscribed be re me Sworn and subscribed before me Tr,is ; ° day of�' ,g9 0 13 This day of ,2012 Si a — , JERRY BARTHELOW ure of Public Notary—State of Florida N tarization of Lobb is sign '~ My COMMISSIONS EE f zation of Principal's signature EXPIRES IdICWD-SY C�� S STAFF ONLY ' BE C P T Annual Registration fee: [ ]Yes _Date Paid Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual RegistrAton Form.doc Revised 04/27/2012 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc MIADOCS:7647654v1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) No Special compensation B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No special 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 ✓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 Section 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 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 item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. Yes✓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: ( V-4i 0LWyT11% Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) .2L_Personally known •'�►RY::; DEANNA TURPEN VII. SIGNATURE AND STAMP OF NOTARY: MY COMMISSION#EE 839483 • �o; EXPIRES:October 20,2016 State of Florida,County of Miami-Dade State of Florida,Coun �...A on Thru Notary Public Undervrriters Sworn to and subscribed before me S Ell su !bed before me This day of ,2012 T ay of S 1 ,2012 Signature of Public Notary—State of Florida Signa ure of Public Notary—State of Florida Notarization of Lobbyist's si nature Notarization of Principal's signature (� 2 TO BE COMPLETED BY CITY CLERK'S STAf F ONLY O Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# D e Paid Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Fonn.doc evised 04/27/2012 r C:\Users\clerhaU\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook183LGQ Registration Formrevised 5-30-2012.doc MIADOCS:7647654v1 /Vt I A M I B XIF_�A C Hi City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfi.gov CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel:305.673.741 1 ,Fax:305.673.7254 LOBBYIST NAME: John Paul Oliver 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 FORMA 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 app the Miami-Dade County Commission on Ethics and Public Trust. ignatu e: Date: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc MIADOCS:76476540 CV. . N IL Z - 4f} ® � ca Ld r= f V . U p • LL Z CL 1100 WEST PROPERTIES, LLC OWNERSHIP STRUCTURE 1100 WEST PROPERTIES,LLC 1100 West Holdings, LLC 100% (Sole Member of 1100 West Properties,LLC) 475 10"'Avenue c/o Morgans Hotel Group New York,New York 10018 1100 WEST HOLDINGS,LLC 1100 Nest Holdings II,LLC 100% (Sole Member of 1100 West Holdings,LLC) 475 10th Avenue c/o Morgans Hotel Group New York,New York 10018 1100 WEST HOLDINGS It LLC Mondrian Miami Investment,LLC 50% 475 10th 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 MONDRIAN MIAMI INVESTMENT,LLC Morgans Group, LLC 100% 475 10th Avenue New York,New York 10018 MORGANS GROUP LLC Morgans Hotel Group Co. 97.1% 475 l V1 Avenue New York,New York 10018 Residual Hotel Interest LLC 2.9%(See attached WADOCS 7573739 1 475 10`x'Avenue flow chart) New York, New York 10018 MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation 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 SEAM Holdings,LLC 20% 2200 Biscayne Blvd., 7th Floor Miami,FI 33137 Abraham Galbut&Nancy K. Galbut,his wife 24% 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 Keith Menin 17% c/o 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 Daniel Galbut 13% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Seth Frohlich& Kimberly Frohlich,his wife 7% c/o 4770 Biscayne Blvd,, Suite 400 Miami,Florida 33137 MIADOCS 7573739 1 � l Robert N. Galbut and Rita-Galbut,his wife 7% c/o 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 David Galbut and Geta Galbut,his wife 7% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Joan Brent 5% c/o 4770 Biscayne Blvd., Suite 400 Miami,Florida 33137 SEAM HOLDINGS,LLC Mordi Bitton 25% Abraham Hayun 25% Erica Kahn . 25% Sonny Kahn 25% MIADOCS 7573739 1 LL 2 c a- o V R Cl ai `o a 2 LO 0) co U) U- co � J •U J U ° W J m E J p Q o 2 �,c, o C C: ' _ ° co •E E tip a U0 � E 0) 00 u- 2 ca CD CD Ae ca tm I- }a 3CD o 'E .-, a) .t... o O cn _ r � L O (1) a = ca J (� Lm U O O a a= CD � N a OC Oo o E h CL z Q •- c b w zO EM t! CL N �--co co CL ~ N ° w Q C) cu v Q� 4 ,W a CL c ,C � � a Z CD 0 3