Todd Tragash/1600 Lenox Investors, LLC Greenstreet Partners, LPm MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
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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 teen "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Tragash Todd
NAME OF LOBBYIST: (Last) (First) (M.I)
STA Architectural Group 3526 North Miami Avenue Miami Florida 33127
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 571-1811 (305) 571-1821 toddCa staarchitecturalgroup com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
1600 Lenox Investors. LLC c/o Greenstreet Partners. L.P
NAME OF PRINCIPAL/CLIENT:
2601 South Bayshore Drive. Suite 800 Miami Florida 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 858-4225 (305) 858-2334
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: Jeffrey Safchik, President
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
See- a-I~ae-I~.~c.~
II. SPECIFIC LOBBY ISSUE:
Historic Designation, revocable permit, flood plain variance and redevelopment issues concerning 1600 Lenox Avenue
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
Planning and Zoning Department Staff, HPB, BOA, City
Commission
B) Any Financial, Familial or Professional Relationship
None
an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a public hearing setting.
C~
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'IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HO[JRLY,
FLAT RATE OR OTHER
A) LOBBYIST DISCLOSURE: (Required) $~~5.00 Der hour R
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $~ T~.00 per hour
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 X No: Are you lobbying on a Wresent or Wending 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 X No: Are you lobbving on a Wending application for a Development Agreement with the Citv or
application for change of zoning map designation or chance to the City's Future Land Use
Mau?
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 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 X No: Are you representing snot-for-profit corporation or entity without special compensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ 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 EXPENDIT OR COMPENSA N DURING THE
REPORTING PERIOD.
S' ture of Lobby'
I do solemnly swear that all of the foregoing facts are true and correct and at I have read or am
fag iliar with the provisio c nta~ ed, in Se 2}82 of the Miami Beach City Code and all reporting
re uirements. ~~
Signature of
$.-w"„"~ 13b`f~'~y°~+ui,~rc'atate
`'~/ William Pink s
11~Commi:01
~~~~ Expires 10/03/2011
CoN,~S~DnI :.~~ 7ZIF.;~a Form of Ide
5Y Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to nd subscribed efore me
This ~>~day of ~ ~fF , 206 ~
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
~sonally known (Principal) NOTARY Pt)BLIe-~~?~ OF FLORIDA
_ ~ G~:~~~;,;T~~ ~~:~,rlliams
CCiii'iii;i~Jl(~(i ~ ~~i)'4~~905
L~:R~fles: Ai~C~ Ol, 2004
State of Florida, County of Miami-D~B~dea T1uutArlantic Bonding co., Inc.
Sworn and subscribed before me
This ~L~''tilay of , 20~
Signature P lic Notary -State of Florida
Notarization of Principal's signature
FOR C ERK~a ~ USE ONLY
Annual Registration fe~ ]Yes [ ] No Amou id 8 R # ~ i ~ Date Pai
Lobbyist Registration Form received and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST FORM OS.da Revised 12/08/04
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: ~~D~ 'r"`7"`~'~
I understand that no later than October 1st 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 of lobbyist withdrawal in writing.
~liila~
Signatu Date:
F:ICLERILOBBYIST1Lobbyist Registration Forrn 32708.doc
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Organfzatfon Chart - 1600 Lenox Investors LLC
Steven J. Green -
i0D% shareholder
Jeffrey A. Safchik -
Preside ntlTreasu rer/
Secretary
1
"General Partner"
Greenstreet Management, inc
(Delaware Corporation)
1%
"Limited Partners"
Greenstreet Capital, LP - 32.00%
Knowledge Industries. LLC- 67 00%
99%
MG Real Estate Partners, L P
(Delaware Limited Partnership)
100%/Sole Member
Greenstreet SORE Investments.
LLC
(Delaware Limited liability
Company)
100%fSole Member
1600 L+enox Investors. LLC
{Delaware limited Liability
Company)
1
Property