Dan Tishman - Robert S. Wennett:Tishman Realty LP et al cV4
MIAMI BEACH
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.
Tishman Dan
NAME OF LOBBYIST: (Last) (First) (M.I)
TISHMAN REALTY,L.P., 100 Paris Avenue,18th Floor, New York,New York 10017
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212)399-3600 (212)202-5058
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notlfyy this office N your contact Information changes:address,phone,or a-nail address.
I. LOBBYIST RETAINED BY:
Robert S.Wennett;Tishman Realty LP and/or Affiliate and Entities to be Formed
NAME OF PRINCIPAL/CLIENT:
100 Paris Ovamm 1$1h Floor New York New YoEk 10017
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212)399-3600 (212)202.5058
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Fill out this section if principal Is a Corporation,Partnership or Trust(Section 2.462(c))
e NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: John Vickers for Tishman Realty L.P.and Robert S.Wennett
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:Tishman Realty L.P.is wholly-owned Indirectly by Tishman Hotel i Realty L.P.
%SPECIFIC-LOBBY ISSUE
RFD#22-11/12 and related Issues
Issue to be lobbied(Describe In detail):
III.CITY A dENCIESAIDWIDUALS TO W LOOMED:
Pursuant to City Code Section 2-482(x)(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 eneral nature of the subject contractual relationship.
Sec 2482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
City of Miami Beach Procurement Division staff;City Managers
Office;Planning and Zoning Staff;City Commission;
Honorable Mattl Herrera Bower Mayor
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 mistration fommi filed. ,
Sec 2-482 Any Financial Familial or Professional Relationship J,.-!I Ft 77 1 "
NIA : 230 Z102
f
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)
NOT APPLICABLE
8) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required)) NOT APPLICABLE
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 eaulament or services or on a present or Pending
award for goods.eaulpment 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 apDllcation for a Develgament Agreement with the City or arenilcMo,nnffor
change of zoning moo 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 notdor-profit coroorallon or entity wklon swclal compensation or reirnbuneernent, .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH YEAR EACH LA® YIST SHILL.SlJ6MIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED.IN THE CITY OF MIAMI BEACH FOR
HE PRECEDING C D ST SHALL B9 FILED EygN PENDATURFES O
-COMPENSATION DMG THE REPORTING PERIOD
Dan Tishman
i do solemnly swear that all of the foregoing facts are true andpoffect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miam a City Code and all quirements.
Signature of Lobbyist
Signature of Principal/Client: X-TI-SHMAN P, - Y•
�I,l.J� �,•t-M..N s
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID 0 Produced iD
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known(Princjpo:`Ae,,, ALBERT E.DOTSON,JR.
* * MY COMMISSION 1i EE 021887
VII. SIGNATURE AND STAMP OF NOTARY: EXPIRES:August 30,2014
:°&.�, ALBERT E.DOTSON.JR. '''ql���de�°P Bonded Tlxu Budget Notary Services
State of Florida,County of Miami-Dade MY COMMISSION#EE 021887 State of Florida,County of Miami-Dade
Sworn to and subscribed before me * * EXPIRES:August 30,2014 Sworn and subscribed before me
This day Of G ,2012 .°� g d Thru Budget Notary Services This-!S_day of DE-C-,
Signature of Public Notary-State of Florida nature of Public -Stat e grids
Notarization of k2WMIsfs signature Notarization of EdlIclegils,signature
TO BE COMPLIILD BY CITY CLERK'S STAFF ONLY.,
Annual Regletraidon fee: I ]Yes[ ]No Amount Pald$ MCR N Paid
Lobbyist RegleVetdon Form received and vmWed by:
Revised 1/11/2011
A
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MIAMIBEACH
City of Miami Beack 1700 Convention Center Drive,Miami Beach,Florida 33139,mmmmiamibeach1aov
CFTY CLERK Office
Rafael E.Granada,City Clerk PtQerk9hrn11mbeachfl.g�ov
Tat.305.673.7411 ,Fax:305.673.7254
LOBB NME ®A MIRM AN
I understand that no later than February 28 of each year. I must file the fbIlowing 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 Cleric 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 lobbying until all fines are paid, unless the fine has been appealed to the Miami-
Dade County Commission on Ethics and Public Trust
e-c-e.�
Dan s man Date
MIAMI 3458245.1 76134140305
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