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Alfredo J. Gonzalez - Crown Miami Hotel Owner, LLC tv, , \ \ t ik°\ Cl°\\:ji tkO 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. GONZALEZ ALFREDO J. NAME OF LOBBYIST: (Last) (First) (M.I) GREENBERG TRAURIG 333 S.E.2nd Avenue,44th Floor MIAMI FL 33131-3238 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0588 305-961-5588 GONZALEZAJ @GTLAW.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: Crown Miami Hotel Owner,LLC NAME OF PRINCIPAUCLIENT: Same Pier 5,The Embarcadero, San Francisco CA 94111 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (415)694-5820 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: Sandor Scher,Thomas Gottlieb,Manager of Crown Miami Holding Co.,LLC,which is the the sole member of Crown Miami Hotel Ow'LLC • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCHtORPO ATIOTV PARTNERSHIP OR TRUST: See attached C-7 II.SPECIFIC. LOBBY ISSUE: _I 4 ___ Development approvals&permitting issues for Crown Hotel&Parking Garage located at 4041 Collins Avenue&228 W 40th Street Issue to be lobbied(Describe in detail): Ill.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 I.obb ist'tias entered Y � p 9 Y �� into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding s ch person's commencement of service with the cit to the 'resent date,statin• the•eneral nature of the sub'ect contractual relationshi•. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied Board of Adjustment,Dept of Public Works,Historic Preservation Board N/A City of Miami Beach Commissioners,City Manager,City Attorney,Fire Dept. N/A Planning Board,Design Review Board,Building Dept.,Planning Dept. N/A 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 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) S5Sn nn HnI IRI Y B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $550 On i-a I IRI Y 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": _Yeso: Are ou lobb in• on a •resent or •endin• bid for •oods e•ui•ment or services or on a •resent or •endin e 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": _YesoNo: 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. _Ye1lo: Are you representinq 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 COMPENS'TION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE Fl 'II VEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 4 �•' �A. Signatur- of L•. gist I do solemnly swear that all of the for-••ing facts are true and correc an•;tha I aye read or am familiar with the provisions contained in Section 2-482 of the Mi_•-. -.eac' ••ty Code •,II reporting requirem- ts. / '.' Signature of Lobbyis !` / �' �_._ _ ��-"' �. =.;e of Principal/Client: _.. / ■ 8V:p LOBBYIST IDENTIFICATION: �- PRINCIPAL IDENTIFICATION: a fr W v f. .. It. Produced ID Produced ID `1' . '! Form of Identification Form of Identification 3 I'. E E Personally known(Lobbyist) Personally known(Principal) B '" Ingd Lee • g 1l'-' SIGNATURE AND STAMP OF NOTAR4,� Wilde s �y es1•ue•y� rn X� cOM oN,FFI!;':Ys. ;•`�� •:- • Florida,County of Miami-Dade s �`�'- ter- of Florida,County of Miami-Dade •, and subscribed efore me 'f,,,C�' +,�� ti/. an sub cri ed before me ��. -,..„,tit,-,‘ .4 . VI day of 20 15 i ,•. o v rte,20 15 tJ :: I SF 'k+.eye��`' ' `r� y •e of Pu•is No - w State of Florida Signature of Public No=ry—State of Florida Notarization of Lobbyist's signature Notarization of Princ pal's signature TO BE COMPLETED BYSITY CLERK'S ST•FF ONLY ,, r Annual Registration fee: [ ]Yes[ No Amount Paid$ l -- MCR# /� Date Paid 3 Ia..,.g Lobbyist Registration Form received and verified by: • t F:\CL R\SALL\aFO€RMS\LOBBYIST FORMS\Lobbyist A nua?Registratiof o€n.doc Revised 11/18/2013 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 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:305.673.7411 ,Fax:305.673.7254 LOBBYIST NAME: Alfredo J. Gonzalez 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 30, shall be automatically suspended from •bbying until all fines are paid, unless the fine has been appealed to the Miami-Da• /C• my, f'mmission on Ethics and Public Trust. -0-0111MMAalk■ / Sig 'urf ''�/ ` 1111 Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IssicamiavienammasEasr Nimpaissessmagmaingir City of Miami Beach-Florida Finance Department 1 City Hall 1508220-1 03/23/2015 BR1 1131 Mon Mar23,2015 11 :26AM Trans#29-29 29 $350.00 MCRCLERK - MCR-City Clerk * MCR#: 402772 1 ITEM(S): TOTAL: $350.00 Check (657375) PAID $350.00 Have a nice day! Miscellaneous Cash Receipt I �9 , �� CITY OF MIAMI B ✓,,a 3 r¢ No 0 Cash ❑Credit Card Check# � 3 20 1 t Received of -t t _.� c .: � ► f Address `� 0 0 1.1. LA, 1 .f�' For _. ;-[ }-- - • • (THIS INFORMATION MUST BE COMPLETED) ) ®ffice of Finance Director By . Account Number: r 7-01.3-0 3 G9 . Dept: t. EXT� , f J LaRosa, Clara From: GonzalezAJ @gtlaw.com Sent: Wednesday, March 25, 2015 1:23 PM To: LaRosa, Clara Subject: Alfredo J. Gonzalez/ Lobbyist for Crown Miami Hotel Attachments: Ownership - Crown Miami Hotel Owner, LLC.pdf Hello Clara , Here is the ownership disclosure I needed to provide you. Take care, Alfredo Alfredo J. Gonzalez Shareholder Greenberg Traurig, P.A. l 333 S.E. 2nd Avenue I Miami, FL 33131 Tel 305.579.0588 l Fax 305.961.5588 GonzalezAJ®$tlaw.com l www.qtlaw.com GT...._....... reen erg 'raurig If you are not an intended recipient of confidential and privileged information in this email, please delete it, notify us immediately at postmaster @gtlaw.com, and do not use or disseminate such information. 1 EXHIBIT DISCLOSURE OF INTEREST for Crown Miami Hotel Owner,LLC 4041 Collins Avenue Miami Beach,Florida 33140 Members of Geolo JdV,LLC: . Geolo Capital II,LP-Lewis Linn,Trustee(72.82%) Pier 5,The Embarcadero, Suite 102 San Francisco,CA 94111 Stephen T.Conley(23.10%) 530 Bush Street,Ste.501 San Francisco,CA 94108 Michael J.Wisner(1.36%) 530 Bush Street, Ste.501 San Francisco,CA 94108 Ingrid Summerfield and Ron Hartman(136%) 530 Bush Street, Ste.501 San Francisco,CA 94108 Christian Strobel(1.36%) 530 Bush Street,Ste.501 San Francisco,CA 94108 ii. Thompson BP,LLC(50%) 54 Thompson Street,5th Floor NY,NY 10013 Members of Thompson BP,LLC: Jason Pomeranc(25.00%) 388 West Broadway New York,NY 10012 Michael Pomeranc(25.00%) 276 Linden Ave Englewood,NJ 07631 Lawrence Pomeranc(25.00%) 203 Walnut Street Englewood,NJ 07831 Stephen Brandman(25.00%) 270 East Saddle River Road Saddle River,NJ 07458 3 EXHIBIT DISCLOSURE OF INTEREST for Crown Miami Hotel Owner,LLC 4041 Collins Avenue Miami Beach, Florida 33140 c. Jason Pomeranc(0.913%) 388 West Broadway New York,NY 10012 d. Michael Pomeranc(0.913%) 276 Linden Ave Englewood,NJ 07631 e. Lawrence Pomeranc(0.913%) 203 Walnut Street Englewood,NJ 07831 f. Stephen Brandman(0.913%) 270 East Saddle River Road Saddle River,NJ 07458 TOTAL for Crown Miami Holding Company,LLC: 100.00% 4