Alex Furrer - Setai Hotel Acquisition, LLC -- miAmiBEAcH
St55
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 20044435.
Furrer Alex
NAME OF LOBBYIST: (Last) (First) (M.1)
2001 Collins Avenue Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 942-7788
TELEPHONE NUMBER: FAX NUMBER: EMAIL
Please notify this office if your contact information changes:address,phone,or e-mail address.
1. LOBBYIST RETAINED BY:
Setai Hotel Acquisition, LLC, a Foreign Limited Liability Company
NAME OF PRINCIPAUCLIENT:
•
2001 Collins Avenue Miami, Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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:
Salem Mounayyer, Managing Partner
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: 0 :
Nakash Properties, LLC - 85/o and Von Furstenberg Trust - 15%
II.SPECIFIC LOBBY-ISSUE:
Impacts involving the Setai Hotel and related Setai units concerning HPB File No.7515,Shore Club,and related matters. go/ • Cist,Lp�;
Issue to be iiobbied(Describe in detail):
)(1,1.A.0/14ii %
w.CITY AGENCIES/INDWIDUALS TO BE LOBBIED:
'Pursuant to City Code Section 2-482(aX4)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) . S NO
title of rson to be lobbied �-
s - _
Planning Board None X
Land Use Board
alone X
City Commission None
Planning Staff - X
!Vane X_—.
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial orprofessional
relationship,or other relationship giving rise to an appearance of an Impropriety,with any current city commissioner or city-per gnne1 who is
sought to be lobbied as Identified on the lobbyist registration form tiled.
Sec 2-482(e)Any Financial,Familial or Professional Relationship r-
City City Agencies/Individuals To Be Lobbied:
Citv s_ORce Nona X
City Attorney's Office None
X
Historic Preservation Board None X
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY.FLAT RATE OR
OTHER):
A)LOBBYIST DISC1_osURE: R uired)
No special compensation for representation; salaried manager.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(Required). No Compensation
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 ou lobb in• o a • ;=•nt or • :ndi bid for ••ods :•ul•mentor services or on a •resent or ndi •
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":
0 Yes gl 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 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 debt as required by this section hut,shall not be required to pay any registration fees.
Yes 12111O: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH Y - EACH LOBBY, T S ALL S = I O THE CITY C' SIG.._• ST.TE , NT UNDER
OATH. USTING LOBBYING EXPENDITURES.AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHAL E FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
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a
Sign.73! . Lobbyist
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 B City Code and all reporting requireme -'.
Signature of Lobbyist: ,
l
S
ids '
ignature of Principal/Client
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VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
til Produced IDFL DUI ret'O—;•i) .' • J.P.0 0 Produced ID
Form of Identificatio Form of Identification
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0 Personally known(Lobbyist) ,�e.� �\ o1 •.N. ''�.� 4 Personally.kn• -.- 1-
�4 e*o) 22,2p�'�`.•. a N Notary Public State of Florida
VII. SIGNATURE AND STAMP OF N9TARt4 Q • = ' James Norton
. _ `�c My Commission EE 060583
d ?of�d Expires 04/13/2015•
State of Florida,County of Miami-Dade �e .#1.-�91ti09 g• ° ; State of Florida, w _ :• +..;
SW*.. nd subscri•-• be • e . •.� S,�e ,°� Sworn and subscribe before me
iir day of /_ ,! _ 1 r 013 '' elf,gy'�ro°�'�-.�o`�` � This. day of, ,/ 201>�
. , ■ '�i PUBLIC.S-cP I
A 1'..1 .�/1 . / . /. . . �"Ill/HIlIII11No" -
Signa/ re o• • �:r c otary—Sta a of Florida gnature of P ' o —State of Florida
Notarization of Lobbyist's signature No - on o rin i l's signature
TO BE COMPLETED BY CITY CLERK'S TAFF ONLY
Annual Registration fee: [ Yes[ ]No Amount Paid$ MCR 0 Date Paid INK
Lobbyist Registration Form received and verified by: //�
F;\CLER\$ALL\aFORMS\LOBBYIST FFORMS\Lobbyist Annual Registratibirr6h 1. L� Revised 1/11/2011
MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: #Ear a.•c.t-vIL
I understand that no later than February 28th 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, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
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