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Alexander I Tachmes - 2K Essex, LLC MIAMI BEACH 1 C) 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. Tachmes Alexander I. NAME OF LOBBYIST: (Last) (First) (M.I) Shutts&Bowen LLP 201 S.Biscayne Blvd. Suite 1500 Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-347-7341 305-347-7754 atachmes @shutts.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: 2K Essex, LLC NAME OF PRINCIPAUCLIENT: Essex House Hotel 1001 Collins Avenue Miami Beach FL 33139 `7) r''D BUSINESS NAME AND ADDRESS (Number and Street) ( ) (City) (State) (Zip Code)�� 305)534-2700 n/a TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) == = r Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] IN) + 1 • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: c' See attached. -+` • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached. c 11 II.SPECIFIC LOBBY ISSUE: After-the-fact certificate of appropriateness for installation of a canopy!`variance from Miami Beach Land Development Regulations to allow an encroachment into the side setback area for the canopy. 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 City of Miami Beach Committees and Boards None City of Miami Beach Attorneys Office and Administration None City of Miami Beach Mayor/Commissioners None e 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 None C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc T<Ef nninnnt'e• 7 A 7 A.,1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $570.00 per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $570.00 Der hour (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. Yes✓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 SH L BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ibid..4j2tW Sign ure of L ebyist 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 Mia z each City Code and eporting requirements. Signature of Lobbyist: / / 0 II Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: �����.�,,,,�� PRINCIPAL IDENTIFICATION: Produced ID 410 I Produced ID Form of Identification , I Form of Identification m Personally known(Lobbyist) c chi d I Personally known(Principal) I VII. SIGNATURE AND STAMP OF NOTARY: o �• 3 13 y State of Florida, County of Miami-Dade ac ' 42. , n P State of Florida,County of Miami-Dade Sworn to a d subscri before a ,/ image I Sworn and subscribed before me This day of �1g`7" Ze ) This day of ,2012 / A .!al Signature of Pub c Not. —State of Florida 1 N I Signature of Public Notary—State of Florida Notarization of obbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$_3.--- 2 M if f tel: / Date Paid Lobbyist Registration Form received and verified by: ! • '6 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration,Ferr.doc Revi ed 04/27/2012 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc MIADOCS:7647654v1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required)$570.00 per hour B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $570.00 per hour (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 e/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 o/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. Yes✓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. ` Signature .f Lobb 'st I do solemnly swear that all of the foregoing facts are true and rect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach i Code and all re ng re uirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICAT O; PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known (Lobbyist) /Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida, Count • . Sworn to and subscribed before me Sworn and subscribed -f e '_: Notary Public State of Florida §andra Plazas This day of , 2012 is�`Z�.day of �� y Commission FF 097381 or i`1 Expires 03/02/2018 Signature of Public Notary—State of Florida Signature of Public Notary—State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ 3' " MCR# . Date Paid Lobbyist Registration Form received and verified by: __A�- App.- F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 04/27/2012 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc Rninn rsc• 7GA7GCA....1 P /v\ iA/\A E CH 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: Alexander I. Tachmes 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. Si MI-ture. ate: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 11Ainnr -,c• 7GA7GGA..1 RNLN REAL ESTATE ADVISORS, LP LEGAL ENTITY OWNERSHIP STRUCTURE Beneficiary:Jonathan Neeley(100%) Beneficiary:Steven Neeley(100%) Beneficiary:Alison Neeley(100%) onethen Neele Steven Neeley Alison Neeley Trustee&Settler Trustee&Bottler Trustee&Settler 39.90% 30% 30% THE JONATHAN LEE THE STEVEN LEE THE ALISON NEELEY TRUST, NEELEY 1894 TRUST, NEELEY 1997 TRUST, DATED 4/2/88 DATED 9/22/94 DATED 1/23/97 (REVOCABLE) (REVOCABLE) (REVOCABLE) A CALIFORNIA TRUST A CAUFORNIA TRUST A CALIFORNIA TRUST (AKA:"JLNT") (AKA:'SLNT") (AKA:'ANT") SOLE MEMBER ABIGDESTINATION,LLC A DELAWARE SMLLC / FEIN:28.2206411 0,10% RNLN CAPITAL Ron&Lucille Neeley INVESTMENTS, LP 100% A DELAW FE LII 0ITED x639 PARTNERSHIP G/L-RNLNCAPINVESTLP / RNLN II,LLC 89.05% a�T1 A CALIFORNIA SMLLC • g5% 5% 0.95% zD CLASS B p LIMITED PARTNERS {f RNLN REAL ESTATE ADVISORS` LF' AUEL''AWARE LIMIT Q;lA•RTNERSHIP. • FEI Ng,33.:031.253.,:::: .. • 100% 2K ESSEX,LLC A DELAWARE SMLLC FEIN1/20-4723860 G/L•KESSEX THE ESSEX THE ESSEX HOTEL/ HOTEL BAR/RESTAURANT (FEE SIMPLE) OPERATIONS DISCLOSURE OF INTEREST 3. PARTNERSHIP/LIMITED PARTNERSHIP 2K ESSEX, LLC SPlease see attached ownership structure chart) PARTNERSHIP or LIMITED PARTNERSHIP NAME NAME AND ADDRESS % OF STOCK RNLN REAL ESTATE ADVISORS, LP 100% Mike Palma, 1020 Ocean Drive, Miami Beach, FL 33139 5% Tom Burchett, 1020 Ocean Drive, Miami Beach, FL 33139 5% RNLN II, LLC 0.95% Ron& Lucille Neeley, PO Box 371347, San Diego, CA 92137 RNLN CAPITAL INVESTMENTS, LP 89.05% THE JONATHAN LEE NEELEY TRUST 39.90% Jonathan Neeley, PO Box 81743, San Diego, CA 92138 THE STEVEN LEE NEELEY 1994 TRUST 30% Steven Neeley, PO Box 84118, San Diego, CA 92138 THE ALISON NEELEY 1997 TRUST 30% Alison Neeley, PO Box 8109, La Jolla, CA 92038 ABIGDESTINATION, LLC 0.10% THE JONATHAN LEE NEELEY TRUST Jonathan Neeley, PO Box 81743, San Diego, CA 92138 MIADOCS 10011842 1 ry y1 j� r � ;Aft. ��"'-xi1 „„1- j �TY.l rl.fi. NIlataseNEffiliffiErar City of Miami Beach-Florida Finance Department 1 City Hall 1501213-1 01/12/2015 8R1 1121 Mon Jun!2,2015 03:48AM Trans#39-39 39 $70000 MCRCLERK - MCR-City Clerk MCR#: 401409 1 ITEM(5): TOTAL: $700.00 Check (00484309) PAID $700.00 Have a nice day! Miscellaneous Cash Receipt 1!:')::..t,.-_-I:, 1,,,i--..,7-5, i t 2,12015 0 t., CITY OF MIAMI BEACH - :; d No: Cash D Credit Card Check#0 11,S)7/V 2 ) '' V°.1;) '''''''''' i / ') 1 i 20 / , ' Received of SIIZ/117?-1/ Y ' /`//:// k , . , Address ;;_Ji 17 � -� A �,,,,,-..3,:i f ;:° 1,7'=;” Syr f -`'"_ Fob'.#4 M PL 5 = ; /?) /19-1 1 ,,_.. q a ' h ' / .0 r e,c9 w b // ,/e_ (THIS INFORMATION MUST BE COMPLETED) _ Office of Finance Director :5Y 7 0-a By 3 . - _ Account Number: 0- fr/' s2 Preparers N t • 13' -'t.. / ht-' 2- ( / Dept: EXT / f •