The URL can be used to link to this page

Louis J. Terminello/Royal Palm Hotel Property, LLC b:tr.:d ....,...;,1)11 , 1111' m MI.-l:rTH H",,,r.'h - ~\llI3 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 defined in any manner in this section, 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. I NAME OF LOBBYIST: Terminello, Louis (last) J. (First) (M.I) Terminello & Terminello, P.A. , 2700 S.W. 37th Avenue, Miami, FL 33133 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 444-5002 TELEPHONE NUMBER: (305) 448-5566 FAX NUMBER: ljt@terminello.com EMAIL: I. LOBBYIST RETAINED BY: Royal Palm Hotel Property, LLC NAME OF PRINCIPAl/CUENT: Royal Palm Hotel/Maxim's Lounge BUSINESS NAME AND ADDRESS (Number and Street) 1545 Collins Avenue, Miami Beach, FL 33139 (City) (State) (Zip Code) (305) 444-5002 TELEPHONE NUMBER: (305) 448-5566 FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if prinCipal is a Corporation, Partnership or Trust [Section 2-482 (c)] See attached Exhibit nAn . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: . IDENTIFY All PERSDNS HOLDING, DIRECTLY OR INDIRECfL Y, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Conditional use application for an neighborhood impact establishment Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: I A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship City of Miami Beach Planning Board None IV. DISCLOSURE OF TERMS AND AMOUNTS OF lOBBYIST COMPENSATION (DISCLOSE WHETHER ,",OURL}j FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $15,000.00 flat fee B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $15,000.00 flat fee D Yes:mtNo: Are yOU representing a not-for-profit corporation or entity without special compensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendinq Miami Beach City Code Chapter 2, Article VII. Division 5 Thereof Entitled "Campaiqn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Campaiqn Contributions By Lobbyists On Procurement Issues": DYes JffNo: Are you lobbvina on a present or pendinQ bid for Qoods, equipment or services. or on a present or pendinQ award for Qoods. equipment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach City Code Chapter 2, Article VII Division 5 thereof Entitled "Campaiqn Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Campaiqn Contributions By Lobbyists On Real Estate Development Issues": DYes ~o: Are you lobbvina on a pending application for a Development Aareement with the City or application for chanae of zonina map desianation or chanae to the City's Future Land Use Map? V. SIGNATURE UNDER OATH: ON OCTOBER 1ST 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 of 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 cont~' d in Section 2-482 of the Miami Beach City Code and all reporting requirements. ::::::~:: :: ~:i::~;:~;Client: ---~------- VI. lOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: o Produced ID lJ Produced ID Form of Identification X Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: Form of Identification rsonally known (Principal) State of Florida, County of Miami-Dade Sworn t subscribed beforfi me This day of Novem e"'; 20~6 State of Florida, County of Miami-Dade Swor nd subscribed before me I This da of NovembeJ 20--96 ,,{~tf./;~';'; Michelle Aceba\ f~/ tb ':~~Commission #0057448[, ~'!l.'..~:~lExpires: JULY 17.201 ,'1"J:: c.~. o~, ;;"fOF ~\", NOT ARIA-M\LOBBYIST\LOBBYIST FORM 04 Signature of Pu IC otary - S te of Florida Notarization of Lobbyist's signature FO Annual Registration fee: [ Yes [ ] No Amo Lobbyist Registration Form received and verified by: Revised 02/10/04 F. CLE ORGANIZATIONAL CHART Royal Palm Hotel Or2anizational Chart Column Financial, Inc. First Mortgagee Carbon Capital II, Inc. Jr. Mezzanine Lender Royal Palm Manager, LLC Managers: Robert D. Falor MSD Investment Co.) LLC Members: Mitchell Hotel Group, LLC - 72.74% RobertD. Falor- 2.75% HGCO-RP, LLC-2.75%* MSD Investment Co., LLC - 8.10 % National DF Investments LLC - 4.44 % HGCO-RP, LLC-3.1807% PFI Holdings LLC - 1.2593%** J.C.R Group P.A. - 3.04% Omni Mobile Communications Consultants LLC -0.87% Anwalt Hotel Holdings LLC - 0.87% Royal Palm Hotel Property, LLC Manager: Royal Palm Senior Investors, LLC Member: Royal Palm Senior Investors, LLC (100%) Independent Directors: John R. Hosmer, Jr. and Stephen G. Weigand I 100% Royal Palm Senior Investors, LLC Manager: Royal Palm Junior Investors, LLC Member: Royal Palm Junior Investors, LLC (100%) Independent Director: JobnR Hosmer, Jr. 100% I Royal Palm Junior Investors, LLC Manal!:er: Robert D. Falor Member: Royal Palm Investors, LLC lndeoendent Director: John R. Hosmer, Jr. I 100% Member Royal Palm Investors, LLC Manal!:er: Royal Palm Manager, LLC Members: Royal Palm Manager, LLC - 22.0% Mitchell Hotel Group, LLC - 61.5% Robert D. Falor - 1.0% Jennifer Falor - 1.0% MSD Investment Co., LLC - 2.0% P ADC Royal Palm Holdings, LLC - 12.5% ~ Member and Sole Manager , .. EXHIBIT C - ROYAL PALM MANAGER LLC AGREEMENT ADDRESSES OF MEMBERS FOR NOTICES 1. If to Mitchell Hotel Group, LLC: P.O. Box 565335 Pinecrest, FL 33256 2. !fto MSD Investments Co., LLC: 1- 36400 Woodward Avenue Suite 118 Bloomfield Hills, MI 48304 Attention: Geoffrey Hockman 3. !fto Robert D. Falor: 8609 W. Bryn Mawr Ave., Suite 209 Chicago,lllinoffi 60631 Attention: Robert D. Falor and MSD Investment Co., LLC (attn: Geoffrey Hockman) 4. If to Jennifer Falor: , 8609 W. Bryn Mawr Ave., Suite 209 Chicago, lllinois 60631 Attention: Robert D. Falor and MSD Investment Co., LLC (attn: Geoffrey Hockman) 5. !fto NationalDF Investments LLC: 8609 West Bryn Mawr Ave., Suite 209 Chicago, IL 60631 6. !fto PFr Holdings LLC: 8609 West Bryn Mawr Ave.; Suite 209 Chicago, IL 60631 7. !fto J.C.R Group P.A.: 3838 Bay Shore Road Sarasota, FL 34234 8. If to Omni Mobile Communications Consultants LLC: 5029 Maple Glen Place Sanford, FL 32771 9. If to Anwalt Hotel Holdings LLC: Anwalt Hotel Holdings LLC 250 Civic Center Drive, #200 Columbus, OR 43215 EXHIBIT liB" ~"j;~ ,Y" " / "/ '-'i'm\$.~""~""~"'~""--'-"~''''''_-''''~'_.~'.~'____' EXHIBIT C - ROYAL PALM INVESTORS LLC ADDRESSES OF MEMBERS FOR NOTICES 1. If to Royal Palm Manager, LLC: 8609 W. Bryn Mawr Ave., Suite 209 Chicago, lllinois 60631 Attention: Robert D. Falor and MSD Investment Co., LLC (attn: Geoffrey Hockman) 2. If to Guy Mitchell Hotel Group, LLC: P.O. Box 565335 Pinecrest, FL 33256 3. If to MSD Investments Co., LLC: , 36400 Woodward Avenue Strite 118 Bloomfield Hills, MI 48304 Attention: Geoffrey Hockman 4. If to P ADC Royal Palm Holdings IT LLC: 550 Biltmore Way, Suite 970 Coral Gables, FL 33134 Attention: R. Donahue Peebles 5. If to Robert D. Falor: 8609 W. Bryn Mawr Ave., Suite 209 Chicago, Illinois 60631 Attention: Robert D. Falor and MSD Investment Co., LLC (attn: Geoffrey Hoclanan) 6. If to Jennifer Falor: 8609 W. Bryn Mawr Ave., Suite 209 Chicago, Illinois 60631 Attention: Robert D. Falor and MSD Investment Co., LLC (attn: Geoffrey Hockman) , EXHIBIT "B"