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Shohei Shigametsu - Robert S. Wennett:Tishman Realty LP BE, City of Miami Beach Office of the City Clerk 170O Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by o principal who seeks to encourage the poouage, defeat or modification of any ondmonne, reoo|ution, action or decision of any commissioner; any action, duciuion, 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 enbmdociainn'mok|ng process on such action, decision or recommendation that fnn000eob|ywill be heard urreviewed by the city oomm|ao|un, or o city board or committee. The o*nn specifically includes the principal as well on any employee engaged in lobbying activities. The term"Loubyimmo^has specific exclusions. Please refer tm Ordinance 2po4'3435. NAME OF LOBBYIST: 9 (Last) (First) (M.1) BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TIT S31 011-0 2.117- 033� 07�11 � — ' TELEPHONE NUMBER: FAX NUMBER: EMAIL: r" /. LOBBYIST RETAINED BY: Robert mWw ou Tishman Realty LP and/or Affiliate and Entities to be Formed NAME OF PRINCIPAUCLIENT: C= 10OParkAvenue, 18th Floor,New York,New York 10017 _+ -- ---...---NAME AND ADDRESS (Number=."""""" `=,/ (State) (Zip Code) �� (212)399-3600 (212)202-5058 r ` ^ TELEPHONE NUMBER: FAX NUMBER: EMAIL: Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] _96 NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: John Vickers for Tishman Realty L.P.and Robert S.-Wenndft Z-7 IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SU-CH C67PORATION, PARTNERSHIP OR TRUST:Tishman Realty L.P.is wholly-owned indirectly by Tishman Hotel&Realty L.P. x.SPECUFUC LOBBY ISSUE � nFo#uu'/1/1z and related issues Issue to be lobbied(Describe in detail): III.CITY AGE NCUES/I N DU. UDUALS 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 eneral 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 Procurement Division staff;City Manager's Office;Planning and Zoning Staff;City Commission; Honorable Matti 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 registration form filed. Sec 2-482(g)Any Financial,Familial or Professional Relationship | IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) NOT APPLICABLE l" O CA C�C ��N�� Cy��P�S�1, 1 B) 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,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 lobbvinq 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. 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 Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client-7- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification M/Personall Y known(Lobbyist) 0/Personally known(Principal) 1 VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida,County of Miami-Dade Sworn tgf subscribed f re me Sworn#td subscribed before me This day of , 2013 This oo[[0 day of 2013' Mture of Public N a e of Florida Sign ure of Public Not t of Florida rization of Lob 's ignature Not ization of Princi s signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: ]Yes[ ]No Amount Paid$ ° MCR# Date Paid Lobbyist Registration Form received and verified by: o Revised 1/11/2011 mea her Leigh o�`�yy�Y No's i,,eamer Leigh � �,=COMMISS ON#DD939320 °4 ��tl CON+,rY+.SS!ON#DD939320 • �EDCP RES:NOV.17,2013 EXPIRES:NOV.17,2013 vr w,lw.AARON NOTARYc©m Ww 1��`e,, ,�;�:``� w AARONNOTARY.com X111114 City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E.Granada,City Clerk CityClert @rniamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME J tit-d%t 4 LA- I 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, 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. f'& � T a zz k Date 3559625.1 MIAMI 3559730.1 76134/40305 Yj I ANN B EAC H City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfi.gov City Clerk' Office Tel: 305/673 -7411 Fax: 305/673 -7254 ANNUAL LOBBYIST REGISTRATION FORM ( ��n '�Sv� Name: �® � t4- S &,,' � � Business Name: /A . A . Address: (pct v a c �� }�r.Q.e -r it 13 2 ;? N`I Phone: 2 312 Email: S SSA d � a. � S d � �. • CO If more than on Lobbyist, please list. 1} C--) N 2) w 3} WR 2 2— O Amount paid: Date paid: O Processed by: Date: Send this form with a check for $500 payable to the City of Miami Beach for each lobbyist F:\CLER1$ALL1aFORMSILOBBYIST FORMSIANNUAL LOBBYIST REGISTRATION FORIVIAOU I