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Alexander I. Tachmes/1100 West Properties, LLCm MIAMIBEACH 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 bond 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 NAME OF LOBBYIST: (Last) (First) (M.I.) c/o Shutts & Bowen LLP 201 South Biscayne Boulevard, 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: LOBBYIST RETAINED BY: 1100 West Properties, LLC NAME OF PRINCIPAUCLIENT: c/o Morgans Hotel Group 475 10~" Avenue New York NY 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305-) 674-4848 N/A agalbut@hudcap.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Exhibit "A" attached. II. SPECIFIC LOBBY ISSUE: Conditional Use Permit Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(g) include a statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the commencement of service of City personnel to be lobbied.) A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship City of Miami Beach Planning Board None ~ i ~ ~ ~ ~' , ~~ ~ ;, ~-~ ~ ~ ~ I j ~. City of Miami Beach Mayor/Commissioners . w None ` City of Miami Beach Committees None ~.~ ~ ~ ~~ ~z ~.~~ ~~~~ t~.~i"'w~:~~~~~ 5~ MIADOCS 3113377 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Hourly - $400.00 6) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). Hourly - $400.00 The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohib[ted Campaign Contributions By Lobbyists On Procurement Issues": ^Yes ®No• Areyouu lobbvinsl on a present or pendina bid for aoods eaulpment or services or on a present ar 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 lobbyina on a pendina appllcatlon for a Development Astreement with the Clty or application for chance of zonlna map des[rainatlon or chance to the Cltv'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 anot-for-profit corporation or entity without special compensation ar 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 representlna anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: A\I A/~TA~Cd ASt f1C CAf~LI VCAL N PERIOD. D Signature of L~56byist -- Alexander I. Tachmes 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 thgh~i~rti Beach Ctity ~d'e ryd all reporting requirements. Signature of Lobbyist: Signaturo of Principal/Client: West Properties, LLC VI. LOBBYIST IDENTIFICATION: Holdings, LLC, Mandger bf 1100 PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ® Personally known (~obbylst) NOTARY PUBLIC - STATE OF FLORIDA VII. SIGNATURE salon #DD651416 State of Florida, County'q, MAit, 23 2011 Sworn to and subscr be~r~~~ c>roNOtNacoyrrc, This _ day of 2008 f S' na re of Public Notary -State of Florida No ization of Lobbyist's signature ~, Produced lD )._. For of Identification ^ Personally known (Principal) NOTARY PUBLIC - STATE OF FLORIDA ,,,",.,., Ianda Christian State of Florida, County of Miai~, 80ornrni'sian #DD651416 ~,,. Expires: MAR. 23, 2011 Swom to and subsc ibed befor D ~U p,y~N'(1C BONDING CO., INC. This 2~ day of , 200 ~.' ~ 5, ~ Gy~-~ to a of Public Notary -State of Florida Notarization of Principal's signature TO BE COMPLETE B CITY CLERK'S USE O d' Annual Registration fee: [ ]Yes (] No Amount Paid $ ~ MCR ~ $ Date Paid Lobbyist Registration Form received and verifted by: F:ICLERILQBBYIST1Lobb ist Re istration Form 32708,doc Revised D312712008 MIADOCS 3113377 1 m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK office CityClerk(c~miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 LOBBYIST NAME: Alexander I. Tachmes I understand that no later than October 1 S` of each year, I must file the following forms, 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 Form 2) Disclosure 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 for lobbyist withdrawal in writing. ~~~ Signa ure: l~ Z~ ~ ~ Date: MIADOCS 3113377 1 1100 WEST PROPERTIES, LLC OWNERSHIP STRUCTURE 1100 WEST PROPERTIES, LLC 1100 West Holdings, LLC 100% (Sole Member of 1100 West Properties, LLC) 475 10th Avenue c/o Morgans Hotel Group New York, New York 10018 1100 WEST HOLDINGS, 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 10th Avenue New York, New York 10018 Residual Hotel Interest LLC 2.9% (See attached c/o 475 10th 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 D O O~ n w 0 rn N A N / _ /~ O Q ~_ /^~ J O /A)• V =} rf ~Cn _ I V ~ r r C~