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Bob de la Fuente/1825 Collins Avenue Owner, LLCMIAMI BEACH City of Miami Beach Office of the City Clerk 1700 ConventiolM 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 [he City Manager a' any city board or committee; or any action, decision or recommendation of any city personnel dm'ing 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 rn lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. NAME OF LOBBYISM': (Last) (First) (M.l.) do la Fucntc Bob BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) "1'ewCardenas, I.1 .P 1441 13rickell Avenue, 15~h Floor, Mianu, Florida 33131 TELEPHONE: NUMBEK: FAX NUMBER: EMAIL: (305) 536-8460 (305) 536-1116 BDF@tewLaw.com LOBBYIST RE'TAINEll BY: 1825 Collins Avenue Owner, LLC NAME OF PRINCIPAL/CLIENT: 1825 Collins Avenue Owner, LLC 818 Greenwich Street New York, New York 10014 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 212-796-8400 212-796-8410 TF.LF.PHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) out this section if principal is a Corporation, Partnership or Trust (Section 2-482(c)~ NAMF. OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENMMFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEKES"I' IN SUCH CORPORATION, PARTNERSHIP OK TKUS"f: II. SPECIFIC LOBBY ISSUE: Historic Preservation Board Application Issue to be lobbied (Describe in detail): 1[I. CITY AGENCIES/IND[VIDUALS TO BE LOBBIED: A) Full Name of LidividualfTitle B) An,y Financial, Familial or Professional Kclationship William H. Cary, Director Design none Michael Belush, Senior Planner none Thomas R. Mooney, AICP, Design and Preservation none Manager ~~ ~~ } . ; IV. DISCLUSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)- $375 hourly The following information must he answered: 1) Pursuant to Miami Beach City Code Section 2488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes p~No Are you lobbying nn a present or pending bid for goods equipment or services or on a present or pending award For Hoods c4uipment or service? 2) Pursuant to Miami City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Rcal Estate Development Issues": 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 snot-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 ~1Vo Are you representing a not for-profit corporation or entity without special compensation or reimbursement? IV. SIGNATURE UNDER OATH: ON OCTOBER 1sT OF EACH YEAR, EACH LOBBYIS`1' SHALL SUBMIT TO THN: CITY CLERK A SIGNf:D STATEMENT UNDER OATH, LISTING LOBBYING EXPF,NDITt1RES, AS WELL AS COMPENSATION.,RECEIVED, IN THE CITY OF MIAMI BEACH FOR TIIE PRECEDING CALENDAR YEAH. A STATEMENT SHALL ~ ~.iCED EVEN~THF;RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING TILE REPORTING PERIOD. t/ Signature of Lobtlyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or ant familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and.all reporting requirements. Signature Signature V. ^ProducedlD Form of Identification ^ ProducedlD Form of Identification ersonall known (Principal) .`t"Y p'o. Y nit Godo ~ersonall known (Cobb ist Y ` ~: i~ Y Y ) ~ SPR..p6 VI. SIGNATURE AND STAMP OP NOTARY -~;' ~~?~OR1fTII5S1011 #~~517622 ~~,~ „ate„ odd; Expires: FEB. 13, 2010 ``"""r y State of Florida, County of Miami-1'JAS~„„ ~`' WWW,/~ARONNOTARY.cam State of Florida, County of Miami-Dade :.`~va~~.~ Yanet Godo Sworn o nd s sc c);oZe a off' ~ ~ ~' Swom and subs ri efQ~ n -this da f ~ Du ,zoC) ^~:~~a~cExpiresssioFE DD312010 Tnis ~t day f `r6 20~ ~ r '~hntP`~ WWW,AA80NA{97ARY.9em Sign ur Pu t -State of Florida Si na w ~ o ~ - fate of Florida Nut rizatio of Lobbyist's signature N tarization` of Principal's signature FOR CLERK'S lJ5E ONLY 1~<f f Annual Registration fee: [~- ]Yes [ J No ount Paid ~ ~~1~ ©f.~ MCR #~ Ipatc Paid Lobbyist Registration Form received and verified b~: C.` r E'~:1C'LER\$ALLWIARIA-M1Lobbyist\LOBBYIST 1°O 5. doe lf~, Revised 12/08/U4 484519_l.doc LOBBYIST IllENTIPICATION: rttuvi.rrar, ruc,~ r rriv.r+t ^vi.: Page 1 of 2 Prieto, Silvia From: Yanet godoy [ygodoy@tewlaw.com] Sent: Friday, March 07, 2008 1:06 PM To: Prieto, Silvia Subject: Fwd: Lobbyist Registration Form for 1825 Collins Avenue, LLC Supplement to Lobbyist Registration Form Questions No. II. "for property located at 1825 Collins Avenue" Yanet Godoy ygodoy@tewlaw.com Assistant to Bob de la Fuente & Amanda Quirke Tew Cardenas, LLP Four Seasons Tower, 15th Floor 1441 Brickell Avenue Miami. Florida 33131 (305) 539-2488 Direct Line (305) 536-1112 Mnin Line (305) 536-1116 Facsimile This electronic mail message contains CONFIDENTIAL information which is (a) ATTORNEY -CLIENT PRIVILEGED COMMUNICATION, WORK PRODUCT, PROPRIETARY IN NATURE, OR OTHERWISE PROTECTED BY LAW FROM DISCLOSURE, and (b) intended only for the use of the Addressee(s) named herein. If you are not an Addressee, or the person responsible for delivering this to nn Addressee, you are hereby notified that reading, copying, or distributing this message is prohibited. If you have received this electronic mail message in error, please reply to the sender and take the steps necessary to delete the message completely from your computer system. IRS CIRCULAR 230 DISCLOSURE: Unless expressly stated otherwise, any U.S. federal tax advice contained in this a-mail, including attachments, is not intended or written by Tew Cardenas LLP to be used, and any such tax advice cannot be used, for the purpose of avoiding penalties that may be imposed by the Internal Revenue Service. Yanet Godoy ygod_oy_~tewlaw.com Assistant to Bob de Ia Fuente & Amanda Quirke Tew Cardenas, LLP Four Seasons Tower, 15th Floor 1441 Brickell Avenue Miami, Florido 33131 (305) 539-2488 Direct Line (305) 536-1112 Main Line (305) 536-1116 Facsimile This electronic mail message contains CONFIDENTIAL information which is (n) ATTORNEY -CLIENT PRIVILEGED COMMUNICATION, WORK PRODUCT, PROPRIETARY IN NATURE, OR OTHERWISE 03/ 10/2008