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Michael Dallas Havener - Golden Palms, LLC cp11103 A-v4L RECEIVED M I AM I BEACH Office of the City Clerk JUL 2 7 2022 1700 Convention Center Drive CITY OF MIAMI BEACH Miami Beach, FL 33139 305.673.7411 OFFICE OF THE CITY CLERK 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 "Lobbyist" has specific exclusions. Please refer to City Code Chapter 2, Article VII, Division 3, entitled °Lobbyists," for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City Clerk. If you need more space to complete an answer, use a separate sheet(s)of paper. If you have nothing to report in a particular section, you must write 'none" or "n/a" in that section. Any change to any information originally filed, or any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Havener Michael Dallas NAME OF LOBBYIST (Last) (First) (Middle Name) Sunstone Hotels Investors, Inc. 200 Spectrum Drive,21st Floor Irvine CA 92618 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 949-382-3010 954-610-6670 mhavener@sunstonehotels.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Golden Palms, LLC Springer Robert NAME OF PRINCIPAL (Last) (First) (Middle Name) Golden Palms, LLC 200 Spectrum Drive, 21st Floor Irvine CA 92618 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-350-7202 c/o Javier Avino-javino@bilzin.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2-482(h)(1)(a) A principal of any corporation. partnership, or other entity who appears as a lobbyist on behalf of that entity,without special compensation or reimbursement for the appearance.whether direct.indirect.or contingent,to express support of or opposition to an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees. If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,write N/A): See attached • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): See attached Page 1 of 5 III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number. Land use, zoning, design and development approvals from the historic Preservation Board, and permitting issues, associated with property located at 4041 Collins Ave, Miami Beach, FL 33140 IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said City Commissioner or City personnel from 12 months preceding such commencement of service with the City to the present date, stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship (If yes,explain) YES NO Title of Person to be Lobbied Planning Director X Planning and Zoning Department staff X Historic Preservation Board members and staff X Planning Board members and staff X City Commission X I 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. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): N/A V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee is prohibited pursuant to City Code Sec. 2-485.3): N/A Salaried Employee Page 2 of 5 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes XNo: 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 City Code Section 2-490, entitled'Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _YesXNo: 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 City Code Section 2-482(h), any person (except those exempt from the definition of"lobbyist" as set forth in Section 2-481)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 city clerk as required by this section, but shall not be required to pay any registration fees. YesX No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. _YesX_No: Are you providing only scientific, technical or other specialized information: appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services within the past election cycle.See Section 2-491 for more information. _Yes )(No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: _Yes XNo: If yes. has it been less than 12 months since the elected official(s) whom you provided campaign consulting services was sworn in? 6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. YesX_No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes, please list the incumbent member(s)of the City Commission: _YesX_No: If yes, were you promised or did you receive economic consideration in exchange for campaign consulting services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ I Yes[ ]No Amount Paid$ C.c MCR# q L ti 1 Date Paid (7 Z Z Lobbyist Registration Form received and verified by: F:\CLER\;ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Revised 03/11/2020 Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A SIGNED STATEMENT UNDER OATH, �ISTINp LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, FOR THE PRECEDING CA,' ND YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED s jO wt. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATI a U G THE REPORTING PERIOD.' Signature of Lobbyist: Date 7 ( - a atie // I do solemnly swear or affirm that all f fo going facts, statements, and disclosures in this form are true and correct, and that I have read or am familiar i he rovisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists' of the Miami Beach City Code and all requirements. r . (G. 7-C2z7 Signature of Lobbyist: Date a ner Signature of Principal: Date -1 - - 'Z - Rot Spri/} er VII. NOTARY SIGNATURE ANf SEAL: LOBBYIST: J PRINCIPAL State of C & \A a N.O"- State of CAL. o' r• �` County of: 0 f( o County of: (it- Sworn Q--� to (or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of 0 physical presence by means of 0 physical presence or 0 online notarization, or❑ online notarization, this day of 20_, by this_day of ,20 ,by Michael Havener Robert Springer NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID -'' _Produced ID FORM OF EN ATION FORM OF IDENTIFICATI4 Personal) _Personally Known S' n of Notary Public Signature of to ublic ame of Notary,Typed, Printed or Stamped Name otary,Typed, Printed or Stamped (NOTARY SEAL) (NOTARY SEAL) 1 The term lobbyist"specifically excludes the following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE§8202 '(See Attached Document (Notary to cross out lines 1-6 below) O See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of C' �. .� on this X S day of l , 20?Z , by Date Mdnth Year (1) m'c "o&\ \ 7.4A-fQ (and (2) ), e.. LYNNAE STOEHR NELSEN Name(s)-of Signer*. Notary Public•California Orange County proved to me on the basis of satisfactoryevidence •� 9'i, Commtuton+K 21374675 `�: My Comm.Expires Sep 11,2025 to be the persons)* who appeared before me. Signature 'Arimature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5910 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE§8202 `'See Attached Document(Notary to cross out lines 1-6 below) ❑See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) J Imo_ Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of _bears t �. on this t 5 day of .r..\,1/44 , 20 2"Z , by Date Moth Year (1) 000er k S��•yn�e r (and (2) ), Name(sr)-of Signer(a)- LYNNAE STOEHR NELSEN ; Notary Public-California _ ,.a:= Orange County proved to me on the basis of satisfactory evidence • '.• Commission M 2374673 to be the person(s) who appeared before me. ,ro My Comm.Expires Sep 11,2023+ �I Signatu Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: ©2014 National Notary Association •www.NationalNotary.org• 1-800-US NOTARY(1-800-876-6827) Item#5910 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139 www.miamibeachA-gov Office of the City Clerk Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel: 305.673.741 1, Fax: 305.673.7254 NAME OF LOBBYIST: Michael Havener 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 of each year, 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. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand antlual registration of all lobbyists shall be required for each 12-month period commencing Qctober 1 of each year, and the fee for such annual registration shall be $500.00 pursdant o Section 2-482 of the Miami Beach City Code. ../// 0//// 1 2©zZ Signature of llob 1st Michael Havener Date F:\CLER\$ALL1aFORMS\LOBBYIST FORMS1Lobbyisf Registration Form Revised 03-11-20 REG.doc Page 5 of 5 THE CONFIDANTE MIAMI BEACH Organizational Chart PUBLICLY TRADED I SUNSTONE HOTEL INVESTORS, INC., a Maryland corporation ("REIT") EIN 20-1296886 100% 9.0908% 90.9092% SUN CHP I, INC, a Delaware corporation EIN 20-3761692 SUN SHPI1, LLC, 98.9"o a Delaware LLC EIN 20-3761744 1.1% SUNSTONE HOTEL PARTNERSHIP, LLC, a Delaware limited liability company ("OP") EN 20-1646175 100% SUNSTONE HOTEL TRS LESSEE,INC., a Delaware corporation 100% ("TRS") EN 20-1620867 100% GOLDEN PALMS,LLC., GOLDEN PALMS LESSEE,INC., a Delaware limited liability company a Delaware corporation EN XX-XXXXXXX EN:XX-XXXXXXX Land,Building,FF&E Vehicles,Inventory,Supplies N._ / Management,,Agreement t t Operating Lease ' ' The Confidante Miami Beach FF&E t r t 4041 Collins Ave Hyatt Corporation Miami Beach,FL 33140 MIAMI BEACH RECEIVED City of Miami Beach 1700 Convention Center Drive JUL 2 7 2022 Miami Beach, Florida 33139 www.miamibeachfl.gov CITY OF MIAMI BEACH City Clerk's Office OFFICE OF THE CITY CLERK Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: Michael Dallas Havener Business Name: Sunstone Hotel Investors, Inc. Address: 200 Spectrum Center Drive, 21st Floor, Irvine, CA 92618 Office Telephone Number: (949) 382-3010 Cellular Telephone Number: (954) 610-6670 Email Address: mhavener@sunstonehotels.com If more than one lobbyist, please list: 1) 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Office Use Only MCR #: Amount paid: Date paid: Processed by: Date: F:\CLER\BALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx