David J. Coviello - 1100 West Properties, LLC GL'
ehl JAMIBEACH
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.
Coviello David J
NAME OF LOBBYIST: (Last) (First) (M.I)
c/o Shutts & Bowen LLP, 201 S. Biscayne Blvd., Suite 1500, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 -415 -9437 305 - 415 -9837 dcoviello @shutts.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
I. LOBBYIST RETAINED BY:
1100 West Properties, LLC
NAME OF PRINCIPAL /CLIENT:
c/o Morgans Hotel Group, 475 10th Avenue, New York, NY 10018
BUSINESS NAME AND ADDRESS (Numb r and Street) (City) (State) (Zip Code)
305 - 674 - 4848 n/a agalbut @hudcap.com
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:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Exhibit "A" attached.
II.SPECIFIC LOBBY ISSUE:
Planning Board - Conditional Use Permit rt : 1 1 DO w'esT A0
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date, stating the general nature of the subject contractual relationship.
Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO
title of person to be lobbied
City of Miami Beach Planning Board x
City of Miami Beach Mayor /Commissioners x
City of Miami Beach Committees
x
Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional
relationship, or other relationship giving rise to an appearance of an impropriety, with any current city com i ' ror ci yj iersonnel who is
sought to be lobbied as identified on the lobbyist registration form filed -
Sec 2- 482(g) Any Financial, Familial or Professional Relationship
None ofl t ( tiny wiz
None
None
. t
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE: (Required) Hourly- $ 32 0
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): Hourly -$320
(Required).
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 J 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 a not - 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 a not- for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th 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.
,)//GC29
Signature of Lobbyist David J . Covi 110
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 Miam' h C Code and all reporting requirements.
Signature of Lobbyist:
David C vielloGi \ }/09 , 1A/N \ R
Signature of Principal /Client:
Abra am Galbut, President of 1100 West Holdings LLC, Manager of 1100 West Properties LLC
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID El Produced ID 0) N
Form of Identification Form of Identification
16 Personally known ( Lobbyis ;�.��� ��!'. ' NANCY COTTA Personally known (Principal) WO \ �, = Not P ublic - S tate of F .
VII. SIGNATURE AND STAMP , My Comm. Expires Nov 18, 2013 I :§ ( §I
4, : Commission # D 937220
State of Florida, County of Miami -Da "� tate of Florida, County of Miami -Dade 5All
Sworn to an subscrib -d before me Sworn and subscribed before me LL ' _
This a of 2011 , • "L ••
y ..._ �'s .,2.-- Z�- day of r` , 20 ••• ":��b;
OP"- 0 __, ,,,} — 11 -.", l ' . 0181
Signature of P .,,,=-.. .:. • .. Signature of Public . 'Wry - State of Florida ...,
Notarizatio : • • • vest's signature Notarization of Principal's signatur
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ] Yes [ ] No Amount Paid $ * 3 5' 0 MCR # 3 /1 "--- 9 O _ Date Paid
Lobbyist Registration Form received and verified by:
F: \CLER\$ALL \aFORMS \LOBBYIST FORMS \lobbyist Annual Registration Form.doc _ / v Revised 1/11/2011
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: David J. Coviello
understand that no later than February 28th of each year, I must file the following
form, 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 and Compensation 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 of lobbyist withdrawal in writing.
cf_atia2.9 V211/
i
Signature: David J. Coviello ate:
March 29, 2010
MONDRIAN CONDOMINIUM HOTEL
MIAMI BEACH, FLORIDA
ORGANIZATIONAL CHART
13% Daniel Galbut
Mordi Bitton
25 %"
° Abraham Hayun Seth and Kimberly Frohlich
25/0,
7%
25% Erica Kahn Joan Brent
5%
Sonny Kahn ° David & Gita Galbut
25 %, 7 /°
7% Robert & Rita Galbut
SEAM Holdings, LLC Keith Menin
a Florida limited liability 17%
Company Abraham and Nancy Galbut
20% 24%
Sanctuary West Management, LLC _ Manager
a Delaware limited liability company Russell W. Galbut
Manager
95%
Gladys Brownstein 2.5% Sanctuary West Holdings, LLC Morgans Group, LLC
a Delaware limited liability company a Delaware limited liability company
Honey Waldman Sole Member and Manager Sole Member and Manager
2.5%
100% 1 1 100%
Sanctuary West Avenue, LLC Mondrian Miami Investment, LLC
a Delaware limited liability company a Delaware limited liability company
50% 50%
1100 West Holdings II, LLC
a Delaware limited liability company
Sole Member and Manager
1 oo %o
1100 West Holdings, LLC
a Delaware limited liability company
Sole Member and Manager
Hotel Manager loo %a
Morgans Hotel Group 1100 West Properties, LLC
8/23/2011 Management, LLC a Delaware limited liability company
Property Owner
Residual Hotel Interest, LLC
Ownership Structure
Schager Family - Schager Family
1999 Trusts Ian Schrager Spray Trust
UTA dated (Managing Member) UTA dated
August 29, 1999 September 29, 1999 40
RSA GP Corp Ian Schrager RSA New York Associates, LP. RSA New York Corp RSA Family Holdings, LLC ISB Family Holdings, LLC
(General Partner) (General Partner) (Limited Partner) (Limited Partner) (Limited Partner) (Limited Partner)
.781609% 7.579319% 11.40095% .238116% 65.00% 15.00%
Northstar Partnership L.P. and its partners RSA Associates L.P.
•
(induding NCIC) (DE LLC)
84.196 15.996
Residual Hotel Interest, LLC
Updated April 30, 2007 (f/Ida Morgans Hotel Group LLC)
mIADOCS 3016242.1