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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33~~~~d '9 Ali 9: ~ $
LOBBYIST REGISTRATION FORM C ~ T Y C L ~ fs; i"'t ' ~ ~ ~ ~ ~ (; ~
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 atachm es@shutts.com
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAUCLIENT:
2K South Beach Hotel, LLC
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
The Clevelander 1020 Ocean Drive Miami Beach, FL 33139
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
786) 276-1414 N/A moalma aC~.clevelander.com
__
i out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
Mike Palma, Manager
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
Mike Palma, Tom Burchett, Alison Neeley, Steven Neeley, Jonathan Neeley, Ron and
Lucille Neele
II. SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail): Historic Preservation Board application
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) An Financial, Familial or Professional Relationship
Mayor None
Commissioners
City Administration; City Attorney's Office; None
Cit Committees; Cit Boards
~~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION {DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
$ 450.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required). $ 450.00 per hour
The following information must be answered:
1) Pursuant to Miami Beach Ciry Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
_ -. _ _- _ - Yes-~-No:-Are vou-lobbvinq 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 6a No: Are you lobbvinq 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 Mae,?
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 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..
QYes ~ No: Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
PERIOD.
Signature of Lobbyist
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: .
VI
LOBBYIST IDENTIFICATION:
AL IDENTIFICATION:
Produced ID ^ Produced ID
Form of Identification Form of Identification
^ Personally known (Lobbyist) ~, Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sworn to and subs ribed before me ~ ~~~(~ ~T~~Q
This _ day of , 2008 This S d f Of/, , 2008 ~' ir~' Notary Pub6o,StaEeaf Fbrida.
~ sF°~,u~g Commission ~DD754875
''+'aF~d`' My Commissron Flies fe6.03, 2012
Signature of Public Notary -State of Florida nature of Pu lic Notar a of Florida
Notarization of Lobbyist's signature Notarization of Principal's ignature
TO BE COMPLETED BY CITY CCERK'S USE ONL
Annual Registration fee: ]Yes (] No Amount Paid $ MCR # $ Date Paid
Lobbyist Registration Form received and verified by:
F:ICLER\LOBBYISTLobbyist Registration Form 32708.doc ~ Pl ~ ~ R4~~~pd nar~n~nna
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
450.00 per 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 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 6a No: Are you lobbvina on a nendina application for a Development Agreement with the City nr
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 6d No: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: ~RINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
~S~w~~orn t and sub cri pe~d~~ efore me
Signature of Public Notary -State of I'lorida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This -day of , 2008
Signature of Public Notary -State of Florida
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S USE ONL
Annual Registration fee: [''J Yes [ ] No Amount Paid $ o ~ MCR # $ / .Date Paid
Lobbyist Registration Form received and verified by:
F:\CLE YIS11L n Form 32708.doc Revised 03/27/2008
OOY OOIr901S310N t OD 869088
* EXPIRES: February 28, 2018
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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 2-48~~he Miami~e~FrEit~r~Ejode and all reporting requirements.
a? MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK office CityClerk a(~.miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME: Alexander Tachmes
I understand that no later than October 15` 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.
ignature:
~ C .~ o`~
Date:
MIADOCS 3890723 1