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Carter McDowell/2901 Beach Ventures LLP $f2~ 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. (First) N. (M.I) NAME OF LOBBYIST: McDowell (Last) Carter Bilzin Sumberq - 200 South Biscayne Boulevard, Suite 2500, Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code) 305-350-2355 TELEPHONE NUMBER: 305/351-2239 FAX NUMBER: cmcdowell@bilzin.com EMAIL: I. LOBBYIST RETAINED BY: 2901 Beach Ventures LLP NAME OF PRINCIPAL/CLIENT: 1300 Brickell Avenue, Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305/351-1000 TELEPHONE NUMBER: 305/371-6213 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: II. SPECIFIC LOBBY ISSUE: Flood plain variance Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Flood Plain Management Board and staff None IV.. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) Hourlv $455.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourlv $455.00 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 [R]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 [R]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.. DYes [R]No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1st OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, I THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL B FILED EVEN IF T ERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO . ~/ Produced ID u" I do solemnly swear that all of the foregoing contained in Section 2-482 of the Miami B Signature of Lobbyist: Signature of Principal/Client: Form of Identification Personally known (Lobbyist) ....."... MERCEDES PADRON VII. SIGNATURE AND STAMP ff.;D' .R~YCOMMISSION#DD608768 -*. .'*1 : :. .~i EXPIRES: November 9,2010 State of Florida, County of Mia ~ ~~ BondedThruPichardlnsurancoAgoncy sworrl1fR and subs r\bed before '.."" hi . 'g day of O\J ,20_ o ENTIFICA TION: diD fkt - V(\ \lee .~ ~l-C'E?n5e Form of Identification - Personally known {Princi al ,"r;i''MJ.:... MERCEDES PADRON ;.,' :~... MY COMMISSION # DD 608768 · . EXPIRES: NOVlmb.r 9, 2010 D~ f1'i1tJ PIChAra Iniurenoe ~g."cy VI. LOBBYIST IDENTIFICATION: tate of Florida, Count worn and subscribed This' day of.~ (' f) h{(' , 200Co e{ , {)(,wI- Signatur of Public Notary - State of Florida Notarization of Principal's signature Sig ature of Public Notary - State of Florida Notarization of Lobbyist's signature / FOR CLERK'S USE;, ONLY Annual Registration fee: [q--Yes [ ] No Amount'paid 2....~c:::>o MCR # .P82rl Lobbyist Registration Form received and verified bY:(-dct \(es' F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM 5.doc Date Paid rIjt.PIDh Revised 12/08/04 IAMI 121 e'-~ \1,/{, (0'" uc Enyred Disclosure of Ownership Interest for 2901 Beach Ventures, LLLP 2901 Beach Ventures, LLLP, a Florida Limited Partnership 1300 Brickell Avenue Miami, FL 33131 A. General Partners I. Lionstone Seville GP, LLC a, Ownership 100% Lionstone Group 2901 Collins Avenue Miami Beach, FL 33140 1. Ownership 100% Lionstone Holdings (Barbados), LId, (a) Ownership 100% Alfredo Lowenstein 2901 Collins A venue Miami Beach, FL 33140 2, Miami Beachfront GP, LLC a, Ownership 100% Edgardo Defortuna 1300 Brickell Avenue Miami, FL 33131 b. Managers Fortune International Management, Inc. 1300 Brickell Avenue Miami, FL 33131 1. Ownership 100% Edgardo Defortuna 1300 Brickell Avenue Miami, FL 33131 11. Officers/Directors Edgardo Defortuna 1300 Brickell Avenue Miami, FL 33131 SANCHEZ, MILAGROS 1300 Brickell Avenue Miami, FL 33131 IMERY, EDUARDO 1300 Brickell Avenue Miami, FL 33131 9 100% 1% 1% 1. B. Limited Partners 2, MIAMI 1208974,1 7490521479 11/27/0604:29 PM a, Seville Beach Hotel Corporation Ownership Alfredo Lowenstein 2901 Collins Avenue Miami Beach, FL 33140 Miami Beachfront LP, LLC a. Ownership Edgardo Defortuna 1300 Brickell Avenue Miami, FL 33131 100% 100% 10 49% 49%