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Matthew Amster - 1600 Lenoxm MIAMIBEACH i6o~ ~t'~~k 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 term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Amster Matthew NAME OF LOBBYIST: (Last) (First) (M.I) Bercow, Radell & Fernandez, P.A. 200 S. Biscayne Blvd., Suite 850 Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) ri305) 377-6236 (305) 377-6222 mamsterCa~brzoninglaw 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 Bavshore Drive 9th Floor 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: ~~ ~~`bf~, II. SPECIFIC LOBBY ISSUE: Rezoning and redevelopment issues concerning 1600 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 Planning Department Staff, Planning Board, and City Commission * None ~k I Inl., .. 1.. ..1 ..4•.. JI IIGJJ OII IJJUC IJ ICyIJIGIIVC III IldWfe, rlannmg rsoara ana city commission members are not lobbied outside of a public hearing setting. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER A) LOBBYIST DISCLOSURE: (Required) $ 285.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ 285.00 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 present or pending bid for goods, equipment or services, or on a present or pending award for oods~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 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 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 X No: Are you reuresenting anot-for-profit corporation or entity without special comuensation 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 EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ~ ignature 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 'ami Beach City Code and all reporting requirements. ,~, ~ Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST ID ^ Produced ID Form of Identification Personally known (Lobbyist) .- VII. SIGNATURE AND STAMP OF NOTARY: ~~ " State of Florida, County of Miami-Dade Sworn to and subscribed before me ~~ This 1 day of 20_+~ i~i W ~VGG // ,,~„ ,, ~~': ~,~ Si ature blic N ota -State of Flori 9 ry da Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification C~Aersonally known (Principal) NOTARY PI;BLIC-STATE OF FLORID:+ State of Florida, County of Miami-Dade ,••''~"'"''~: Georgia Williams Sworn a subscribed before me w : Commission # DD90269U This y"~~day of , 20~D `~•.,,,,,,.•'~ Expires: ;`iUG. O1, 2013 BONDED T'flRti ATI.A.`T:C BG\DL'~G CO., TNrv. Signature Pu lic Notary -State of Florida Notarize on of Principal's signature CLERK'S SE ONLY Annual Registration fee: ]Yes [ ] No ount Paid MCR #~ Date Paid Lobbyist Registration Form received and verifie Entered By: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04 { ~ f ~ _- 9~L I :g ~ ~ ~~ a Y; City +of Miami Beath, 17fJa Canventian Center t?rive, Miami Eieach, Fiarida 33139, www.miarnibecachfl,gov CITY CLERK Office CityClerk~miamibeachfl.gov Tel: 305.b73.741 1 ,Fax: 3Q5.673.725d LOBBYIST NAME: _ f" ~~'""`'`'~~ ~ZS~ 1 understond that no later than Oct~~eir 1st a~ ecaChwea,-r_, ~ must file the faf lowing forms, pursuant to Section 2-4.$5 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) Lobbyist Expenditure Form 2j Qisclosure Form Failure to file these forms on a timely basis will resul# in my name-being transmifited to the Miami-Dade County Commission on Ethics and For code violation evaluation. (n addition, once an issue I harre registered to lobby on has been resolved, I am required to immediately notiFy the City Clerk's C)fFice of lobbyist withdrawal in writing. F:ICLERILDBBYISTILobbyist Registration Fvrm 32708,doc EXHIBIT B Disclosure of Interest 1% General Partner Greenstreet Management, Inc. (Delaware Corporation) 100% shareholder Steven J. Green 2601 South Bayshore Drive Stn Floor, Suite 800 Coconut Grove, Florida 33133 Jeffrey A. Safchik, President/Treasurer/Secretary 1600 Lenox Investors, LLC (Florida Limited Liability Company) 100% Owner & Sole Member Greenstreet SOBE Investments, LLC (Florida Limited Liability Company) l 100% Owner & Sole Member MG Real Estate Partners, LP (Delaware Limited Partnership) 67.0% 32.0% Limited Partner Knowledge Industries, LLC (California Limited Liability Company) Limited Partner Greenstreet Capital, LP (Delaware Limited Partnership) 100% shareholder Michael R. Milken 1250 Fourth Street, 5th Floor Santa Monica, CA 90401 See page 2 Page 1 of 2 .EXHIBIT B continued Greenstreet Capital, LP Greenstreet Capital, LP 99% Green Family Holdings, LP 18.1567% 23.7827% 57.0606% Green Family Green Family Investments II, Investments, LP LP 98.8235% 1.1765% 1.1765% GF Associates Investments, Inc. 98.8235% 100% Dorothea Green 1996 Trust 1% Greenstreet Management, Inc. 1% Green Family Holdings, Inc. 100% /100% - Steven J, Green 2601 South Bayshore Drive ENEFICIARIES 9th Floor, Suite 800 Coconut Grove, Florida 33133 50% 50% Jeffrey A Safchik --- Andrea Green ~. President/Treasurer/Secretary Kimberly Green Page 2 of 2