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Gray Davis - 2377 Collins Resort LP Sandy Lane Master West Collins AAIAMI BEACH 2� 22 4 City of Miami Beach Office of the City Clg- ,- -. - _ �� Ca 1700 Convention Center Drive, Miami Beach, FL �33'1' 9' 3 J LOBBYIST REGISTRATION FORM 2013 JAN 15 PM 12: 2 Lobbyist means all persons employed or retained, whether paid or not, by a principal whQ 1k,s, o�encowrage-ti �Passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any brctfo � isio , r�c�onmfndation 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. P AVI S &�} 2 NAME OF LOBBYIST:. (Last) (First) (M.I) lM EYff PAvl C 54-1,,D10 ltie,, / 55 bit AVt, N1 N-1 /0013 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) tit2. f9 2�, S S��j- 211..(v2�.5110 (v� `7DA-y�r�' MM&r,ph f, enK TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address,phone, or e-mail address. I. LOBBYIST RETAINED BY: , NAME OF PRINCIPAL/CLIENT: BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] ri • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: 5&t C_X_111�tblt • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: h-141- 1-490 vS&, ZO0i�b, r' Mc fiJ'rNro I� /'t/L-5 /?-��/� 2;�7 �-Dt✓Ll�-1 S A'l�� 2 a GU�lr�s �� �3'�� Gfi��1�15 � l`�l�( �ii,/��} t'L 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 �vl l✓07140 0 Err 10W H N N tv ZO M W L.,I F I B UEPt F� 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 commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2-482 Any Financial, Familial or Professional Relationship C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc / IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) S� VUN B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): 7Vi� (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)(-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 Section 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 Section 2-482(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. Yesx No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 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. p4ftl/10 Signatur y Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I h ve rea or�@�j a provisio s contained in Section 2-482 of the Miami Beach City Code and all r porting requirements. Notary Public-State of New York W Nth.01 C€4711987 Signature of Lobbyist: Qualified In'New York. u My Comm,sslon Fxpires ,3-e / Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: _Produced ID A v,,-=jo S L ( C NS v Produced ID 42.1 S t-( orm of Identification R Form of Identification N� Personally known(Lobbyist) _Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: W 2 � County of - tL State of Florida, County of Miami-Dade State of-F Sworn to and subscribed before me Sworn and subscribed before me This��day of ,201 ;,•'' :� day of � 201 " " ry of Florida Signature of Public Notary State of Florida Signature of P b Nota Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S S AFF L Annual Registration fee: Yes[ ].No Amount Pad$ MCR# Date Paid Lobbyist Registration Fo received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc r F:\CLEF listration Form.doc Revised 04/27/2012 MIAM' J City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 , Fax: 305.673.7254 LOBBYIST NAME: c0r+y� tS understand that no later than February 28 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, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th, 20129 shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. o. Signat Date: C:\Users\clerhatlWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 2377 Collins Resort, L.P.; 591 West Putnam Avenue Sandy Lane Master Assoclation, Inc. Greenwich, CT 06830 = : 2377 Collins Avenue Telephone: 203-422-8195 Miami Beach, FL 33139 ; Telephone:203-422-8195 West Collins Land Investors;-L.P 591 West Putnam Avenue Greenwich, CT 06830 , Telephone: 203-422-81951, _. EXHIBIT "q•, 1. CORPORATION If the property which is the subject matter of the application is owned or leased by a CORPORATION, list the principal stockholders and the percentage of stock owned by each. Where the principal officers or stockholders consist. of another corporation(s), trustee(s), partnership(s) or similar entity, further disclosure shall be required which discloses the identity of the individual(s)(natural persons) having the ultimate ownership interest in the entity.* Motel Place 24,L.L.C. CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS HP 24 Holdings,L.L.C. 50% 591 West Putnam Avenue Greenwich.Connecticut 06830 Hotel Place 24 Investors,L.L.C. 50% 591 West Putnam Avenue Greenwich.Connecticut 06830 HP 24 Holdings,L.L.C. CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS SOF-VIII U.S.Hotel Co-Invest Holdings.L.P. 100% 591 West Putnam Avenue Greenwich.Connecticut 06830 Hotel Place 24 Investors,L.L.C. _ CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS MIRF Hotel Member,LLC 50% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 LF 24`h&Collins.LLC 50% 1007 North Orange Street.Suite 210 Wilmington,Delaware 19801 IMRF Hotel Member,LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Invesco Mortgage Recovery Master Loans AIV,L.P. 82.77% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 MIAMI 3 001642.1 7957236593 4/91122:53 PM EXHIBIT "B" WLR Whole Loan Fund.Z.P. 16.41% CoMgmte Trust Center: 1209 Orange Street Wilmingion.Delaware 19801 Invesco SPPIF(GP)Feeder Fund,LLC 0.82% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Invesco SPPIF(GP)Feeder Fund,LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS lnvesco.Ltd. 100% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Invesco,Ltd. CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Publiclx Traded on NYSE No Further Disclosure Required LF 24"'&Collins LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS RL Capital Realty Assoc LLC 35% 1007 North Orange Street,Suite 210 Wilmington,Delaware 19801 SR Capital Realty AsWc LLC 45% 1007 North Orange Street.Suite 210 Wilmington. Delaware 19801 HL Pauline Tucker 2010 GST Trust 10% 1007 North Orange Street,Suite 210 Wilmington,Delaware 19801 JL Pauline Tucker 2010 GST Trust 10% 1007 North Orange Street.Suite 210 Wilmington,Delaware 19801 MIAMI 3001642.1 7957236593 4/9/12 2:53 PM RL Capital Realty Assoc LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 99% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 Stone Control LLC 1 Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 Stone Control LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 99% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Stone Manager Corp 1% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Stone Manager Cora CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New RL Corp Holdings LLC 100% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 New RL Corp Holdings LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 100% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 MIAMI 3001642.1 7957236593 4/9/12 2:53 PM SR Capital Realty Assoc LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 1% Corporaje Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Stone Capital Realty LLC 99% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 Sto,=pital Realty LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS RSL 2005 Family Trust u/a/d 3/21/05 33% Corporate Trust Center, 1209 Orange Strcct Wilmington.Delaware 19801 HTL 2010 GST Trust 33% Corporate Trust Center, 1209 Orange Street Wilmington.Del&ware 19801 JTL 2010 GST Trust 33% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 RSL Stone Capital LLC 1% Corporate Trust Center. 1209 Orange Street Wilmington,Delaware 19801 RSL Stone Capital LLC _ CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New RL Capital Realty Assoc LLC 100% Corporate Trust Center, 1209 Orange Street Wilmington,Delaware 19801 New RL Capital Realty Assoc LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New Stone Control LLC 1 Corporate Trust Center, 1209 Oranste Street Wilmington.Delaware 19801 MIAMI 3001642.1 7957236593 4/9/12 2:53 FM