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Alex Novo - 1100 West Properties, LLC i G✓ MIAMI BEACH G City of Miami Beach Office of the City Clerk I 00 U� 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 20043435. Novo_ Alex NAME OF LOBBYIST: (Last) (First) (M.I) Mondrian South Beach Hotel 1100 West Avenue Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-514-1900 305-514-1909 alex.novoQ_mhgc.com TELEPHONE NUMBER: FAX NUMBER: EMAIL- Please notify this office if your contact Information changes:address,phone:or e-mail address. 1. LOBBYIST RETAINED BY: 1100 West Properties,LLC _ NAME OF PRINCIPALICLIENT: clo Morgans Hotel Group 47510th Avenue New York NY 10018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 212-2774130 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 S%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST. See Exhibit A attached u.SPECIFIC LOBBY-ISSl1E Conditional Use Permit — i�®o 0'�-5�- Issue to be lobbied(Describe in detail): Ill.CITY AGENCIES11NDIVID.UALS-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 Bead Committees and Boards None Vol City of Miami Beach Attorneys Office and Administration None ✓ City of Miami Beach Mayor/Commissioners None ✓ Pursuant to City Code Section 2-482(g)Every registrant shall be required tD 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 tiled. Sec 2-482 Any Financial Familial or Professional Relationship None 1� 1 C:\Userslclerhati Data\Local\Mic rosoft%Vlhndows\Tempos Internet Files\Content.Outlookl83LGQDDMLobbyist Registration �Pp ry Formrevised 5-30-2012.doc MIADOCS:7647654v1 XK/ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) No special compensation B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No special compensation (REQUIRED). The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes LNo: 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 LNo: Are you lobbying on a pending application for a Development Agreement with the City or application for change of coning 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. _YesyNo• 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 SUBMW10 THE C CLERK A SIG ATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMIRMSATIONXEGIENED.IN THE OF MIAMI BE6CIJ FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BZFILED SMAr THERE HAVEAWN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Sig of Lo I do solemnly swear that all of foreg ' cts are a co at I have ad or am familiar with the provisions contained in Section 2-482 of the Miami ach a an al uirements. Signature of Lobbyist: Signature of Principal/Clie VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID _Produced ID Form of Identification Form of Identification ✓ Personally known(Lobbyist) Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: � Y .11, Avril Ellis Von Cannon,III State of Florida,County of Miami-Dade ,.�1 •. •, State of Florida,County of AAiami-Dade Sworn and subscribed before me =�;•' `�c+ comMISSION#EE 129881 Swom and subscribed before me This day of 20� :�� '` EXPIRES: SEP.13,2015 This day of .2012 Ww .AARONNOTARY.com Signature of Pi 1blic Notary— e o lorida Signature of Public Notary—State of Florida Notarization of Lobbyists signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF otoomy Annual Registration fee: M Yes[ ]No Amount Paid$ MCR# 7 !X%Y___z1__DaW Paid Lobbyist Registration Form received and verified by: F:NCLER\$ALL\aF0RKS\L0B13YIST FORMS1LobbyistAnnual Registration Form.doc v Revised /27/2012 C:%UserslclerhaN lAppData\LocalXMicrosoft Vviindows\Temporary Internet Files\Content.Outlook183LGODDHILobbyist Registration Formrevised 5-30-2012.doc M IADOCS:7647654v1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) No special compensation B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No special compensation (REQUIRED). The following Information must be answered: 1) Pursuant to Miami Beach City Code Section 24188 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes LNo: Are you lobbying on a argsent 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 LNo: Are you lobbying on a Pending application for a Devetonment 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 Cone Section 7-482(1*0 Any parson(except those exempt from±he definition of'lobbyist"asset forth in Section 2481 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 cleric as required by this section but,shag not be required to pay any registration fees. _YesyNo Are you representing a not-far profit corporation or en%X Milthout special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 8 OF EACH YEAR EACH LOBBYIST SHALL SUB O TH C.;/CLERK A SIGNER,1117ATEME UNDER OATH uSTINQ LOBBYING EXPENDITURES AS WELL AS COMPIMSATIONAEGEIVED,IN THEA1 OF MIAMI BE6C FOR THE PRECEDING CALENDAR YEAR- A STATEMENT SHALL BETILED FXgNjf THERE O EXPJgNDITURES OR rgOMPENSATION DURING THE REPORTING PERIOD. Signal of Lo do solemnly swear that all of forme g ' acts are a oo at I have ad or am familiar with the provisions contained In Section 2-482 of the Miami ach de an al yuirements. Signature of Lobbyist: Signature of PrincipalfClie VI. LOBBYIST IDENTIFICATION: PRINCIPAL 1 NTiFICATION: ®Produced ID _Produced ID Form of Identification Form of Identification ✓_Personally known(Lobbyist) Personally pp�TURPEN 'Y MY COMMISSION#EE 839483 VII. SIGNATURE AND STAMP OF NOTARY: EXPIFiFS:October 20,2016 �+ Bonded Tlw 40;e Publk Undsrw-fi'ers #11"'14, Avril Ellis Von Cannon,it State of Florida, State of Florida,County of Miami-Dade �•,Sworn and subscribed before me ;:•' ?COMMISSION#EE12988 Sworn bs re me This _ day of ,2013 � ,.=EXPIRES: SEP.13,2015 This da f'�'.�;�Ez .264i►�-� '4�`,, .•'r WWW.AARONNOTARY. Signature of Public Notary—A#15`717fiorida Signature of Public Notary—State of Florida Notarization of Lobbvlst's ss nature Notarization of ErinCIRal,s signature TO BE COMPLFM.JY CITY CLERICS STAFF ONLY A Annual Registration fee: ]Yes( j No Amount Paid S CR# Datq Paid Lobbyist Registration Form recelved and verified by: F:\CLER\$ALL\aFORNS\LOBBYIST FORMStLobbyistAunual Registration Form.doc Revised 04/27/2012 C:\Userskcierhatl\AppDatelLoceWicrosoft\Vdndom\Temporary Internet FileslContenkOudookl83LGQDDH$Lobbyist Registration Formrevised 5-30-2012.doc MIADOCS:7647854v1 i' MIAAMBEACH City of Miomi Beoch,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E.Granada,City Clerk CiyClerk @miamibeachfl.gov Tel:305.673.7411 ,Fax:305.673.7254 LOBBYIST NAME. Alex Novo 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, 1 am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2485(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 maybe 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 to the re i Statement by April 30th, 2012, shall be automatically s ended m lobbyi g u I all fines are paid,unless the fine has been appealed to th is a Coun mission on Ethics and Public Trust. a cs Signatur : Da . C:\Users\clerhatl\AppData\Local\MiansofhWindowrs\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc MIADOCS:76476540 I 1100 WEST PROPERTIES, LLC OWNERSHIP STRUCTURE 1100 WEST PROPERTIES, LLC 1100 West Holdings, LLC 100% (Sole Member of 1100 West Properties, LLC) 475 10th Avenue c/o Morgans Hotel Group New York, New York 10018 1100 WEST MOLDINGS, LLC 1100 West Holdings II, LLC 100% (Sole Member of 1100 West Holdings, LLC) 475 10th Avenue c/o Morgans Hotel Group New York,New York 10018 1100 WEST MOLDINGS II, LLC Mondrian Miami Investment, LLC 50% 475 10th Avenue c/o Morgans Group, LLC New York,New York 10018 Sanctuary West Avenue,LLC 50% c/o Hudson Capital 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MONDRIAN MIAMI INVESTMENT, LLC Morgans Group, LLC 100% 475 10th Avenue New York,New York 10018 MORGANS GROUP LLC Morgans Hotel Group Co. 97.1% 475 10"i Avenue New York, New York 10018 Residual Hotel Interest LLC 2.9% (See attached MIADOCS 7573739 1 475 10`h Avenue flow chart) New York,New York 1001 S MORGANS HOTEL GROUP CO. Morgans Hotel Group Co. is a publicly held corporation SANCTUARY WEST AVENUE, LLC Sanctuary West Holdings, LLC 100% (Sole Owner of Sanctuary West Avenue, LLC) 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 SANCTUARY WEST HOLDINGS,LLC Sanctuary West Management, LLC 95% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Gladys Brownstein 2.5% Honey Waldman 2.5% SANCTUARY WEST MANAGEMENT, LLC SEAM Holdings, LLC 20% 2200 Biscayne Blvd., 7th Floor Miami, F133137 Abraham Galbut &Nancy K. Galbut, his wife 24% 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Keith Menin 17% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Daniel Galbut 13% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Seth Frohlich& Kimberly Frohlich, his wife 7% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 MIADOCS 7573739 1 Robert N. Galbut and Rita Galbut,his wife 7% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 David Galbut and Geta Galbut, his wife 7% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 Joan Brent 5% c/o 4770 Biscayne Blvd., Suite 400 Miami, Florida 33137 SEAM HOLDINGS, LLC Mordi Bitton 25% Abraham Hayun 25% Erica Kahn 25% Sonny Kahn 25% MIADOCS 7573739 1 � J 2, 0 J ^L, W M 0 rn C L �' N ° LL F..• c0 L � � p L CM M Q M 2 6 U a E E LL cn � v J m N � U J •U J Q J N W ch � E vi o Q 0)c c LO L Lr; U L} CO UN) T (6 � m U- v co cr- CD Q U rn —� E 0 -00) co ., l- R 1 Q N 1— a N O V U)C, Yc UJ U 10, L M J J i Q (D U) <U) = o N n o CD o F 2 � L = c N a c� C: -i N_ 50 O •V � o N rn N (u co cle) ^' Q a. L L.J.. c Co E ~ cu � � a Z N Q U_ � U Z Q N L a. I- i O aD C C_ CL j v CL L a U p N a a Z �O 0 Q N W � O 0 Q City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk' Office Tel: 305/673 — 7411 Fax: 305/673 - 7254 ANNUAL LOBBYIST REGISTRATION FORM Name: Alex Novo Mondrian South Beach Hotel Business Name: Address: 1100 West Avenue, Miami Beach, FL 33139 Phone: 305-514-1900 Email: alex.novo @mhgc.com If more than on Lobbyist, please list: 1) 2) 3) MCR #: 3 Amount p aid: Date paid: i Processed by: Date: Send this form with a check for $500 payable to the City of Miami Beach for each lobbyist M IA7445816.1