Alexander Heckler 1600 Lenox Avenue
MIAMIBEACH
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City o1F 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
Cityw 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
inigbbying activities. The term."Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Heckler Alexander
NAME OF LOBBYIST: ~ (Last) ` (First) (M.I)
LSN Partners; LLC ~ 801 Arthur Godfrey Road, Suite 401 Miami Beach Florida ~ 33140
.BUSINESS .NAME AND ADDRESS (Number and Street) {City) ~ (State) (Zip Code)
...(305).673-2585.. (305) 673-2588.. AHecklerCa~LSNPartners com
TELEPHONE NUMBER: ~ FAX NUMBER: EMAIL'
I. ~ tOBBYIST RETAINED BY: .
1600 Lenox Investors, LLC c/o Greenstreet Partners,'L.P
NAME'OF PRINCIPAL/CLIENT:. ~ '
.. ,
2601 South BavshoreDrive, 9th Floor Miami Florida 33133
BUSINESS NAME AND ADDRESS (f~umber 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 Tirust [Section 2-482 (c)]
.NAME OF-CHIEF OFFICER; PARTNER, OR BENEFICIARY: Jeffrey Safchik,-President
a IDENTIFY ALLPERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% DR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: ~`
IL ~ SPECIFYC iO03BY ISSUE:
Rezoning and redevelopment~issues concerning 1600 Leriox Avenue
Issue to be lobbied (Describe. in detail).:.
YIL! ~ CITY AGENCIES/YNDIVIDUAILS TO BE LOBBIED:
A) Full Name of %ndivadual/Title - B) Any Financial, Familial or Professional Relationship
Planning Department Staff, Planning Board,, and City
Commission * None
* Unless an issue is legislative in nature, i?lanning Board and Gity Commission members are not lobbied outside of a public hearino settinn_
IV. 'DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERS ,
A} LOBBYIST .DISCLOSURE: {Required) _ $ 300.00 per hour
B) PRINCIPAL'S DISCLOSURE (OF"LOBBYI ST COMPENSATION): (Required). $ 300.00 per hour
The~following information must be answered: ~ "
" 1) Pursuant to Miami Beach City Code- Section 2-488 Entitled "Prohibited Carripaign -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 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 obbying on a uending aaalication for a Development Agreement with the City or
,application for changie of zoning map designation or change to the Citv's Future Land Use
Mats?
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 representing a not-for-profit coruoration or entity without special compensation
or reimbursement.
,,
V.. ., SIGNATURE UNDER OATH: .
- •~ ~. ~ .
ONE OCTOBER 1~ OF EACHYEAR, EACH LOBBYISTS A L SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING E E ITURES, A WELL AS COMPENSATION
. RECEIVED, TN THE CITY OF MIAMI BEACH FOR THE PRE EDING CAL NDA YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE; HAVE BEEN NO EX END TU OR OM'PE SATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist
I d'o solemnly swear than all of a foregoing facts are tru nd -correct and that I have read or am
" familiar with the provisio cont ed 'n S tion 2-4 2 of t e iami .Beach City Code and all .reporting
requirements.
,.
Signature of Lobbyist: ~ - -
Signature of Principal/Client: ~ .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID ~ ^ Produced ID
~'~ ,° r ~ Form of Identification.. Form of Identification
O . N c. .
~ ° ~.N Personally known. (Lobbyist). - - o Personally known .(Principal)
- ` c~ z 4' _
•~
~; VII. SIGNATURE AND STAMP C>F NOTARY:
~,gwo - ~.
.~~~~~
" ~ ~~~ } "~ ~ ~ State of Florida, County of "Miami-Dade State of Florida, County of Miami-.Dade .
m Sworn to an~d~subscribed before~rrie Sworn and subscribed before me.
~, ~ .:. .
Q,~~`~~~ ' This day of . - ( , 20~`~ ~ This ~ .day of , 20_
~ ~~ ~
~~oN......~~
..~.«
~.gr~ u Public. Notary -State of Fllorida -- Signature of Public Notary -State of Florida
:. Notarization of Lobbyist's signature ~ Notarization of Principal's signature
Ann F CLE 'S SE ONLY -
('~,
ual Registration fee: [ , ]Yes [ ] No • Am t Paid CR # ~`-' I Date Paid , -
Lobbyist~ Registration Form received and verified b ~ Entered By:
=:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04
IV, DISCLOSURE OF TERMS AND Ai~fOUNTS OF LOBBYTST~C06NPENSATION (DI~CL®SE 11VHETHER HOU/aLY;
FLAT l~4 TE OR OTHERf
A) LOBBYIST DISCLOSURE: (Required) _ ~.00'perhour - ~ 1
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $ x.00 der hour
The following information moist bE~ answered:
- 1) Pursuant to 'Mia.mi Beach City Code Section 2-488 Entitled °Prohibited Campaign Contributions By Lobbyists
.. On Procurement Issues":
o Yes X_ No: Ara you lobbying on a preseint or isending 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": ~ ~--
oyes X No: Are Kou lobbying on a pendingapplication for a Development Agreement with the City or
., ~ application for chang~,e of zonings map designation or change to the City's Future Viand Use
Map? ,
3} ~ Pursuant to Miami. Beach Ciiy Code -2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth , in Se~rtion 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 cif or opposition~to any .item, shall register with .the clerk as required by this
section but, shall not be required-to pay any registratiori fees..
o Yes X ` No: Are you ~representini~ a_not-for-profit .corporation or entity without special cori'pensation
or .reimbursement. .
V. SIGNATURE UNDER OATH: .
ON OCTOBER 1~ 0~'EACH YEAR, EACH LOBBYIST: SHALL ~SUBhIIT TO THE C%TY CLERK A SIGNED
. STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL .AS COMPENSATION
RECEIVED, IN THE CITV 00= M%A~MI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN' IF THEitE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD. -
. ~ ~ Signature of 'Lobbyist
I do solemnly swear that all of tlhe -foregoing facts are .true and correct and that I have. read or am
- _ familiar with the. provisior?s contained in Section 2-482 of. the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. ~ LOBBYIST`IDENTIFICATIO PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of IdE~ntification
Personally .known (Lobbyist)
VII,. SIGNATURE AND STAMP C1F NOTARY:
. State of Florida, County of Miami-Dade .
Sworn. to and subscribed before me
This day. of ~ 20 _
Signature of Public Notary:- State of Florida
Notarization of Lobbyist's signaturre
^ Produced ID
Form of Identification
Personally known (Principal)
r,'.OTARY PL'I3LIC•STATE OF FLORIDA
<,."'.;,,, ':Georgia ~~'iliiams
. ~ =Commission ~= Dll90269Q
'-.,,,,,,,,.~ Expires: AL'G. O1, 2013
State of Florida, County of Miami-Dac#arrD~ rxRU nTL~~-~tc i3o`n>;,G co., >xa
Sworn an~ subscribed before me
This ~~ day of 2010
• , ,
'~ "~A~ ~ -
Signature f Pu is Notary -State of Florida
Notarizes ion of Principal's signature .
FOR CLERK'S USE ONLY
Annual Registration fee: j ]Yes. [ ] No Amount Paid MCR # Date Paid
.Lobbyist Registration Form received. and verified by: Entered By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05doc Revised 12/08/04
- EXHIBIT B "
Disclosure of Interest
.~ ..,~-. . .. _... ~...._r --~_.. _... . --~ .1600 Lenox Investors,.,LLC ...
.... _
. (Florida Limited :Liability.: .. _ .
,
. _ .
.. ,. ~ -
, Gom pant').
. ,
_ ..
-.
r,
.
.. ,
100% Owner & Sole Member, ,
.._ -
Greenstreet ~SOBE _: ..
Investments, LLC (Florida
Limited Liability Company)
' .- 100%:Owner & Sole Member ,.
MG Real .Estate Partners;
"' ~ .
.. .
- LP (.Delaware Limited
.
. .
_
m..
Partnership}
-
. " , ~_ _
.. ` 1.%
~~ ~ ,
67.0% 32.0%
General Partner ~ Limited Partner
- ~ ~ Limited.Partner
Greenstreet Management, Inc. Knowledge Industries, LLC
. _ (Delaware Corporation) (California Limi#ed Liability Greenstreet Capital, LP
-
= _ Company) - (Delaware Limited
>g ~ Partnership)
~. :.. ...
... .,- ..
~ 1p0% shareholder
-
.-... ;- ..
. . ..
" .<. ~ .100% shareholder . .
` Steven J: Green.
~~: -
Mi
-
h ~ ...
~ - --`-_ 2601 South Bayshore.Drive_ - - -- . _ Milken..
c
ael R. ...... - -
~ .
,
"
: . th
.. ~ 9 Floor,Suite 800. °" . " .. :.e..
_
.: :1250 Fourth Street, 5th Floor
.. ~ ~
.... See page 2
~` . __ ~ -
Coconut. Grove, Florida 331.33 ~. ~~ ~ ~~ Santa Monica, CA 90401 .
~ ~ ~~
_. .
Jeffrey A._Safchik; ~~ ..
~EXHI~IT B continued
Greenstreet Capital, LP
Greenstreet-Capital, LP
Page 2 of 2