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Alexandra L. Deas
d 2~ - l 6 ~ ~ LE~vex 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 teen "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Deas Alexandra L. NAME OF LOBBYIST: (Last) (First) (M.I) Bilzin Sumberg - 200 South Biscayne Boulevard. Suite 2500. Miami. Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code) 305-350-7241 305/351-2176 adeasCc~bilzin.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: Lenox Avenue) LLC. NAME OF PRINCIPAUCLIENT: Go Mr. Claude T. Chandonnet 708 Third Avenue New York NY 10017 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 212-557-1400 212-983-4532 caude cC~marxrea~ com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fitl out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] ~ NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Claude T. Chandonnet ~ IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Design Review Board Application/1681 Lenox Avenue 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 Desgin Review Board None Department Staff ~~ ~® :~ ~d S_ ~t0~ 6o0Z A r' ~ ~ \_1 V. :; IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) Hourlv $320 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)._ Hourlv $320 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 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 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 ®No: Are you representing anot-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, 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. Pt,Lav ~ ~ ~~~' Signature of Lobb ist/Alexandra L. Deas 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: Signature of Principal/Client: Alexandra L -~ •----• riOIQQ~T-. TI ~ 1 P~ ~4 V ~TIIGT'~ VI. LOBBYIST IDENTIFICATION: Alexandra L. Deas PRINCIPAL IDENTIFICATION; LENOX AVENUE I, LLC, By: Orange Syndicate, a New York general partnership, its sole member By: Merchants' National Properties, a Delaware corporation, a partner p By: ~ ~ `~-~ Claude T. Chandonnet President & CEO ^ Produced ID Form of Identification ^ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscrib efore me This ~ day of , 20~ ~'~ Signature 529254 ^ Produced ID Form of Identification ~jlwn (Principal) ~~ ~ oz ~ '~KCOU ~~ ~p{,1FIE0 IN 1'~ JV~ Z1• ~M~gtpttE%e of ounty f Sworn and scribed ore me ~ This da 0 Signa ' r Public Notary - ate of1a~ Notarization of Principal' signature I _' rggs~:ar 6rdinewer~ceAO~Y S~R•~~ s«,a•am~ue~+ FOR CLERK'S US ONLY 2 Annua o Amount Paid_L' ~ MCR ~ZO Date Paid 7 Lobbyist Registration Form received and verified by: ; F:\CLER\$ALUMARIA-M\Lobbyist\LOBBYIST FORM 05.doc ~~~ a Revised 12/08/04 MIAMI 1965937.1 7000060511 10/14/09 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.~ LOBBYIST NAME: 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 Beac' 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 Ethicsi 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. /~ Dat . MIAMI l 745138.1 7000060139 10/19/09