James MacKenzie/Collins Hotel Associates, LLC
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M.I Al\AiB;EA CH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRA nON 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 indudes the principal as well as any employee engaged
if/lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
MacKenzie
NAME OF LOBBYIST: (Last)
Architecture Works, LLC 300
James
BUSINESS NAME AND ADDRESS (Number and Street) (Oty)
305-866-1668 305-866-1687
TELEPHONE NUMBER: FAX NUMBER:
(State)
(M.!)
Bch, FL
(Zip Code)
33141
(First)
71 street, suite 528 Mia
architecturew@bellsouth.net
EMAIL:
I. LOBBYIST RETAINED BY:
Collins Hotel Associates, LLC
NAME OF PRINCPAL./CUENT:
Collins Hotel Associates, LLC 475 Tenth Ave.,
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
212-277-4184
11 floor, NY,NY
(Zip Code) 1 00 1 8
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 BENEFICARY:
Marc Gordon, Executive Vice President
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUO!
CORPORATION, PARTNERSHIP OR TRUST:
II. SPEOFICLOBBYISSUE: Application for certificate of appropriateness
for property located at 1690 Collins Ave and 1685 James Ave.
Issue to be lobbied (Describe in detail):
m. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Thomas Mooney none
William Carey none
lV. DISClDSURE OF TERMS AND AMOUNTS OF LOBBYlSTCOMPEIISAllON (t'1SQ.OSE WHE11IER HOIJRJ.Y,
I'IAT RATE Oft D7HEIl):
A) LOBBYIST DJSO..()StR!: (RequIred) 12':115 ' ~ per hour
8) PRINCIPAL'S DISCI.OSURE (OF lOB8V1ST ~11ON): (RequIred). "or ~ 1.;) .. "~ per hour
The following information must be answered:
1) Pursuant to Miami Beach CIty COde Section 2-488 Entitled "'ProhIbited campaign COntrlbuUons By lobbyists
On ProcI.I'ement Issues'":
o Yes ~ Are YOU Iobbvina on a .. ... or DI!IIdina bid for CJ09dS. eauimnent or S8I'Vic8s.. or an a
DI"8S8IIt or aendlna award for........ 8aUIDment or servIc:&?
2) Pursuant to Miami Beach CIty COde 2-490 EiU:Ied "'ProIWbi1ed campaign contributions By LobbyIsts On Real
Estate Development Issues":
DYes 1XNo: Are YOU IobbvIna on a aendlna aDDlication for a DeveIoameIll: Aareement with tile CitY 01'
aDDIk:ation for c:hanae ofzonina mao d~ ..~ or c:hana8 tit tINt Cltv"s Future land Use
!BI1
3} Pursuant to MiamI Beach Oty COde 2-484 (h) Mt person (except those exempt from the definition of
"'lobbyIst" as set forth In section 2-481 above) who only appears as a repreSleutal:ive of a not-for-profit
corporation or entity wI:hout spedaI COITlpefl!llltb, or reimbursement for the appearance, whether direct, or
fndl~ to express support of or opposition to any ftem, shaH register with the der1t as required by this
section but, shall not be required to pay any reglsbdtion fees..
DYes 111 No: Are YOU ~entIna a nottfor..araftt: qJrDOI'lItion or entitv without SDeCiaI mmaensBtion
or reimlalrsement. .
V. SIGNATURE UNDI!R 0A11I:
ON OCTOBER 1ST OF EACH YEAR, EAat LOBBYISI' SHALL SUBMIT TO THE Cl1Y CLERIC A SlGI'ED
SfATEMENT UNDER OATH, USTING LOBBYING EXPENOnuRESvAS- AS COMPENSATION
RECEIVED, IN 1HE CITY OF MIAMI BEAat FOR ING A SfATEMEIn'
SHALl. BE FD.ED EVEN IF THERE HAVE BEEN NO RES :nON DURJNG THE
REPORTING PERIOD.
SignabJre of Princi
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that J have read or am
Code and all reporting
VI.
L088'YJST
DON:
PRINCIPAL IDI!N1D'ICA1JON:
o Produced 10
GRACE G. CHEr,;
u Produc:ed 10 NOTARY PUBLIC. STATE OF NE::W VORl<
Form of IdentIication NO. 01-CH6056883
rC? '--_ ~"""1 M' QUALIFIED IN QU...EEN.'S CC./'.JNTY .. .~.
.~ ........... ,.-o"--".'IY COMMISSION EX?\il[~: " ...: .0_(
Form of Identification
/Perscna/ly known (Lobbyist)
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SIGNATURE AND STAMP OF NOTARY:
FORCLERK"S ~~ J
AmuaI Registration fee: [ ] Yes [ ] No IvmI.1iEPaId ~ # ~32.. Date Paid ~ 0 (>
lnbbyist ~ oItiuiI Form received and verified ~~c...
J=:\ClER\$ALL\MAIUA-M\l.oIlbylst\LoerMST IORM Revised 12/08/04