Alex Tachmes/TBS Realty, LLCm MIAMIBEACH
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.
NAME OF LOBBYIST: (Last) (First) (M.I.)
Tachmes Alexander I.
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
8hutts & Bowen LLP; 201 S. Biscayne Blvd., Suite 1500, Miami, FL 33131
TELEPHONE NUMBER: FAX NUMBER: EMAIL
(305) 347-7341 (305) 347-7754 atachmes@shutts.com
L LOBBYIST RETAINED BY:
NAME OF PRINCIPAUCUENT:
TBS Realty, LLC
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
200 West 55th Street, Suite 42, New York, NY 10019
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
(212) 474-9865 jstein@hh-r.com
Fill out this section If principal Is a Corporation, Partnership or Trust [Section 2.482 (c)J
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Rabinder Pal Singh, Vice President
• IDENTJFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 596 OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Attached
II. SPECIFIC LOBBY ISSUE: Historic Preservation Board and Board of Adjustment applications
regarding certificates of appropriateness and variances in connection with renovations for 1111
and 1119 Collins Avenue (a.k.a., the Tudor and Palmer House hotels)
Issue to be lobbied (Describe in detail):
tll. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Fufl Name of IndividuallTitle B) Any Financial, Familial or Professional Relationship
Mayor None
Commissioners
City Administration None
Cit Attorne 's Office
City Boards None
Cit Committees
MIADOCS 259107 1
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: {Required) $450.00 per hour
B) PRINGIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) $450.00 per hour
The following information must be answered:
1) Pursuant io Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On
Procurement Issues":
D Yes rr3 No: Are you lobbying on a present or pending bid for snoods, equipment or services, or on a present or pending
sward for snoods. eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
^ Yes D No: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning map designation or chance 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 anot-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..
^ Yes D No: Are you representing a notfor-profit corporation or entiri without special compensation or reimbursement.
SIGNATURE UNDER OATH:
ON OCTOBER 1" 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 REPORZIWG PERIOD.
Signature of~66byist
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 Sect~~182 of the Miami B~i~City Code and all reporting requirements.
Signature of
Signature of Principal/Client:: ~
VI . LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Produced ID o z
Form of Identification ~. ~
~.
ersonally known (Lobbyist ~ ~ ~ ~
VII SIGNATURE AND STAMP OF NOTAR'~ y' ~ ~,
~ " ~.`~ y
State of Florida, County of Miami-Dade ~ ~ ~
Sworn to and subscribed fore me ~` ~ ~ ~
This ~3 ~ day of , 20~~ ~ d ~ o
~~. I ~p~.~ ~~ c N O~ O
Signature of ublic Not ry -State of Florida r' o rn w a
Notarization of Lobbyist's signature
Produced ID
Form of Identification
Personally known (Principal)
+~,~. p~ stN~
MUNIR AHME~D
State of Florida, County of Miami-D!>Idf~ry Public Stale of Mew York
Sworn to and subscribed before me No. 01Ak803fl933
This ~ day of -/~l) b- C,o~j~on E'trpfna Wrch 20.10
`~~~~~
Signature of ublic Notary -State of Florida
Notarization of Principal's signature
012 CL/6~2)K'S USE ONLY
Annual Registration Fee: ( es [ J No Amoun a v MCR #~~ ~~ Date Paid ~
Lobbyist Registration Form received and verified by:
Revised 12/08/04
MIADOCS 2259107 1
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