Alexander I. Tachmes (4)m 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.
NAME OF LOBBYIST: (Last) (First) (M.I.)
Tachmes Alexander I
BUSINESS NAME AND ADDRESS (Number and Street) (City} (State) (Zip Code)
Shutts & Bowen LLP 201 S. Biscayne Boulevard, Suite 1500 Miami, FL 33131
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
(305) 347 - 7341 (305) 347-7754 atachmes@shutts.com
LOBBYIST RETAINED BY:
NAME OF PRINCIPAUCLIENT:
AB Green Raleigh, LLC.
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
The Raleigh Hotel 1775 Collins Avenue Miami Beach FL 33139
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
305.534.6300
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Andre Balazs, Chief Officer
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
Please see attached
II. SPECIFIC LOBBY ISSUE:
Conditional Use permit for Raleigh Hotel f ~~S L'., `-C ~~o ~~
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.) ~~ , ,
~~ ~ ~i~,
A Full Name of IndividuaUTitle B An Financial, ~rriil a# or'jP ssional Relationshi
Mayor ~~tZ i~d
~
Commissioners ~d~
City Administration; City Attorney's Office; Non
Cit Committees; Cit Boards ~ ~ /`t ~ --~' ` `!
I/
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
450.00 oer hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $ 450.00 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 _® No: Are you lobbving on a present or pending bid for goods, equipment or services, or on a
present or pending award for Goods, eauipment 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 lobbvina on a pending application for a Development Agreement with the City or
application for chance of zoning map designation or chance to the Citv's Future Land Use Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"IobbyisY' as set forth in Section 2-481 above) who only appears as a representative of snot-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 64 No: Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST I
^ Produced ID
Form of Identification
crs ~ o
Personally known (Lobbyist) Q ~ o .-+ ~
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VII. SIGNATURE AND STAMP OF ~:~
State of Florida, County of Miami-Dade ~ ~~ ~ b
Sworn to nd subscribed before me ~ 0 ~ w ,„
This ~~~ay of ff ~'i ~ , 2009 H o w ~;
~_~~•rn
h..~
Signatur~~~` ry - S~ for ~ ~e'~
Notarization of Lobbyist's signature >- ~Z
Annual
istration Form received and verlfled
3YISllLobbvist Reoistration Form 3271
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Principal)
~~wyaKlL tJ.~w`fri2K
State of Floxide, County of Cv4iaaai.Be~~
Sworn to and subscribed before me
This 7uz~day of ~P~G,, 200 `I
2~~ t ~~ n~ 0 t`~~--
Signature of Public No ary -State of a~ N~ ~~~-
Notarization of Principal's signature
Y CITY CLERK'S USE ONLY
SARAH PHILLIPS CARTER
Notary PubBc -State of New York
NO. Ol CA6135216
Cuallfied in New York County
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-~o~e Miam~attt~~ect~ and all reporting requirements.
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.oov
CITY CLERK office CityClerk@miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME: Alexander Tachmes
I understand that no later than October 1" of each vear, 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.
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Si nature: Date:
MIADOCS 3466605 1
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