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Tim Nardi - 2377 Collins Resort/Sandy Lane Master/West Collins Land � Z City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33444? i LOBBYIST V SED REGISTRATION FORM r C��.f;(`., 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. NARDI, TIM NAME OF LOBBYIST: (Last) (First) (M.1) THE PERRY SOUTH BEACH HOTEL 2377 COLLINS AVENUE MIAMI BEACH, FL. 33139 BUSINESS NAME AND ADDRESS(Number and Street) (City) (State) Zip Code) 305-778-7623 305-604-6750 TNARDI(.MSTARWOOD COM TELEPHONE NUMBER: FAX NUMBER: _ EMAIL: I. LOBBYIST RETAINED BY: SEE ATTACHED EXHIBIT"A" NAME OF PRINCIPAUCLIENT: THE PERRY SOUTH BEACH HOTEL 2377 COLLINS AVE. MIAMI BEACH FL. 33139 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)] • 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 Attached Exhibit"B" II. SPECIFIC LOBBY ISSUE: All land use/zoning and permitting matters regarding property at 2377 Collins Avenue,2340 Collins Avenue and 2322 Collins Avenue, Miami Beach, FL Issue to be lobbied(Describe in detail): Ill. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A)Full Name of Individual/Title B)Any Financial, Familial or Professional Relationship Building Department, Planning&Zoning n/a Department Fire Department and staff City Managers Office n/a Historic Preservation Board and Board of Adjustment and Planning Board n/a D IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (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 4No: 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 COMPENSATIO D ECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FIL EVEN IF THERE HAVE BEEN NO . EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIO J ft Signature of Lob ist— I do solemnly swear that all of the for g facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 oft is each City Code and all reporting requirements. 1 Signature of Lobbyist: Signature of Principal/Client: 4-t.—P i;z�, a Vl. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: R min WUjC4 R ❑ Produced ID W zU ❑ Produced ID UJ Form of Identification �$ / Form of Identification Personally known(Lobbyist) _�d V Personally known(Principal) o �UJ a3 LL VII.SIGNATURE AND STAMP OF NOTARY: X Uj CL2 } State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade Sworn to nd subsc ibed before me ='�: 6r. Sworn a ub d before me : •• •: Thi day of ,20 ,,•° This ay ofjoa ,20 J-3 '4# �- Si to i to ate of Florida Sign a ate of Florida Notar a ' n of L bb i s signature Notariza ' Princi I' signature FOR CLERK'S USE ONLY Annual Registration fee: Yes[ ] No Amount Paid%5Q-0Q_ MCR#3ZJ� Date Paid Lobbyist Registration Fo received and verified by: • ��� Revised 05/05/2010 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139, www.miamibeachfl.gov LOBBYIST NAME: TIM NARDI I understand that no later than October 1st 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 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, 2012, shall be automatically suspended from obbying until all fines are paid, unless the fine has been appealed to the Miami- Dade County mmission on Ethics and Public Trust. Ir�y. 13 Signature: Date: MIAMI 3012488.1 79 794403 5 3 1/11/13 2377 Collin Resort, L.P. Sandy Lane Master Association, Inc. 591 West Putnam Avenue 2377 Collins Avenue Greenwich,CT 06830 Miami Beach, FL 33139 Telephone: 203-422.8195 Telephone:203-422-8195 West Collins Land Investors, L.P. 591 West Putnam Avenue Greenwich, CT 06830 Telephone: 203-422-8195 EXHIBIT "A" 1. CORPOMTION 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.* Hotel 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.Comweticut 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 IMRF 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 IM]U Hotel Member,LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Invesco Mortgage Recovery Master Loans AIV,L.P. 82.77% CoaWr4te Trust Center, 1209 Orange Street Wilmington.Delaware 19801 MIAMI 3 001642.1 7957236593 4/9/122:53 PM EXHIBIT "B" WLR Whole Loan Fund.L.P. 16.41% Comte Trust Center. 1209 Orange Street Wilmington.Delaware 19801 Invesco SPPIF(GP)Feeder Fund LLC 0.82% CgWmte Trust Center. 1209 Orange Suv t Wilmington.Delaware 19801 Inyeseo SPPIF(GP)Feeder Fund LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Invesco.Ltd. 1000/0 CorR2mte Trust Center. 1209 Orange Street Wilmington.Delaware 19801 Invesm,Ltd. CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Publicly Traded on NYSE No Further Disclosure Required LF 24rb&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 Assoc 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 X Pauline Tucker 2010 GST Trust 10% 1907 North Orange Street.Suite 210 Wilmington.Delaware 19801 MIAMI 3001642,l 7957236593 4/9112 2:53 PM RL Capital ItU&Ague LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 99% Corporate Trust Center. 1209 Omgt Street 3yi1minston.Delaware 19801 Stone Control LLC 1% Cho poste Trust Center, l 209 Orangt Street Wilmineton.Delaware 19801 Stone Control LL CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 99% Co[Rorate Trust Center, 1209 Orange Street Wilming on.Delaware 19801 Slone Manage_r Corn 1% Corporate Trust Center. 1209 Orange Street Wilmington.Delaware 19801 Stone Manager Cor® CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New&L Corp Moldings LLC 1 on/ Corporate Trust Center. 1209 Orange Street Wilmin on.Delaware 19801 New ItL Cur®Holding LLC _ CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 100% Corporate Trust Center, 1209 Orange Street Wil[ningWo.QSlaware 19801 MIAMI 3001642.1 7937236593 4/9/12 2:53 PM I SR CaRital Bg ft Asp LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak °/� o_ Corporate Trust Center, 1209 Orange S WilmingtQn.Delawam 19801 Stone Capital Realty LLC 99% C.=Mle Trust Center, 1209 Orange Street Wilmington,Delaware 19801 tone CaWW 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 Street Wilmington,Delaware 19801 HTL 2010 GST Trust 33% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 JTL 2010 GST Trust 33% Corporate Trust Center. 1209 Orange met 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 Orangg Street Wilmington,Delaware 19801 New RL Ca12ital Realty Aaaoc LLC _ CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New Stone Control LLC 1% Cg„ rate Trust Center. 1209 Orange Street Wilmington.Delaware 19801 MIAMI 3001642.1 7957236593 4/9/12 2:53 PM I Richard LeFrak 99% Grate Trust Center. 1209 Orange Street W ilminan.Delaware 19801 New Stone Control LLC CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS New Stone ManagaCgrp 1% Cowrrate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 Richard LeFrak 99% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 New Stow,Mananr Cor® CORPORATION NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 100% Corporate Trust Center. 1 209 Orange Street ilmington.Delaware 19801 2. TRUSTEE If the property which is the subject matter of the application is owned or leased by a TRUSTEE, list the beneficiaries of the trust and the percentage held by each. Where the beneficiary/beneficiaries consist of 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. HL Pauline Tucker 2010 GST Trust TRUST NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Harrison LeFrak 100% 1007 North QrangeSuite 210 Wilmington.Delaware 19801 JL Pauline Tacker 2010 OST Trust -t4 TRUST NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Jamie LeFrak 100% 1007 North Orangt Street.Suite 210 Wilmington Delaware 19801 MIAMI 3001642.1 7957236593 4/9112 2:53 PM RSL 2005 Family Trust u/a/d 3/21/05 TRUST NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Richard LeFrak 100% 1007 North Orangg Street,Suite 210 WilmingLon.Delawares 19801 HTL 2010 GST Trust TRUST NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Harrison LeFrak 100% 1007 North Orange Street.Suite 210 Wilmington.Delaware 19801 JTL 2010 GST Trust TRUST NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Jamie LeFrak_ 100% 1007 North Orange Street.Suite 210 Wilmington.Delaware 19801 3. PARTNER.SHIP/LIIVITTED PARTNERSHIP If the property which is the subject matter of the application is owned or leased by a PARTNERSHIP or LIMITED PARTNERSHIP, list the principals of the partnership including general and limited partners. Where the partner(s) consist of 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.* 2377 COLLINS RESORT.L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Hotel Place 24 LP.L.P. 100% 591 West Putnam Avenue Greenwich.Connecticut 06830 Hotel Place 24 LP,L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS HP 24 Holdingg LP.L.P. 49.5% 591 West Putnam Avenue Qgenwich.Connecticut 06830 MIAMI 3001642.1 7957236593 4/9/12 2:53 PM Hotel Place 24 Investors.L.L.C. 49.5% 591 West Putnam Avenue Greenwich,Connecticut 06830 Hotel Place 24,L.L.C. l% 591 West Putnam Avenue Greenwich,Connecticut 06830 BP 24 Holding LP.L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS HP 24 Holdings.L.L.C. 100% 591 West Putnam Avenue Greenwich,Connecticut 06830 S®F-VIII U.S.Hotel Co-Invest Holdings.I..P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Direct and indirect ownership interests of SOF-VIII U.S. No Further Disclosure Required Hotel Co-Invest Holdings.L.P.are various 'investment funds and investment vehicles.and such investment funds and vehicles are owned indirectly b, high net worth individuals.endowments,state employment plans,and pension plans and such high ngi worth individuals, endowments.state employment plans,and Rgnsion plans have more than 5,000 interests. Invesco Mortgage Recovery Master Loans AIV.L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS WLR IV PPIP Co-Invest Loans AIV.L.P. 25.33% Corporate Trust Center. 1209 Orange Street Wilmington.Delaware 19801 WLR IV Loans AIV.L.P. 8.06% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 1988QI Invesco Mortgil eQ Recovery Loans AIV.L.P. 66.61% Corporate Trust Center, 1209 Orange Street Wilmington.Delaware 19801 MIAMI 3001642.1 7957236593 4/9/12 2:53 PM WLR IV PPIP Co-Invest Leans ATV.L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Direct and indirect ownershiR interests of WLR IV PPIP No Further Disclosure Required Co-Invest Loans A V.L.P.,are various investment funds and investment vehicles,and such investment funds and vehicles are owned by numerous inyestors,including pension plans.have more than 5.000 interests in The aggMptte. VVLR IV Loans AIV.L.Fi_ .. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Direct and indirect ownership interests of WLR IV Loans No Further Disclosure Required AIV.L.P.,are various investment funds and investment vehicles,and such invegMent funds and vehicles are owned by numerous investors. including.pension plans.have more than 5.000 interests in the age". Iayesco 1dloKteaae Recover Loans AM L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS Direct and indirect ownership interests of Invesco MoUjf& No Further Disclosure R,guiMd Recovery Loans ATV.L.P..am various inv=ent funds and investment vehicles.and such investment funds and vehicles are owned by numerous investors,includingplans. have more the 5.000 interests in the aggregate. WLR Whole Loan Fend,L.P. PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME,ADDRESS,AND OFFICE %OF INTERESTS ]2irect and indirect ownershiR interests of WLR Whole No Further Disclosure Required Loan Fund.L.P.are one or more pgnsion plans having moan than 5.000 interests in the agglgaate. MIAMI 3001642.1 7957236593 419/12 2:53 PM