Max Sturman/TBS Realty, LLC Jay Steinm 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.)
Sturman Max
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
Max Wolfe Sturman Architects, Inc., 3048 S.W. 27th Ave., Coconut Grove, FL 33133
TELEPHONE NUMBER: FAX NUMBER: EMAIL
(305) 441-1171 MaxWolfe@aol.com
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAUCLIENT:
TBS Realty, LLC
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
c/o Jay Stein, 200 West 55th Street, Suite 42, New York, NY 10019
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
(212) 474-9865 jstein@hh-r.com
FIII out this section if principal is a Corporation, Partnership or Trust [Section 2.482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Rabinder Pal Singh, Managing Member
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Attached
Il. SPECIFIC LOBBY IssuE: Historic Preservation Board application regarding certificate of
appropriateness 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):
III. CITY AGENCIESlINDIVIDUALS TO BE LOBBIED:
A) Full 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 2627975 1
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $785 per hour
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) $785 per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On
Procurement Issues":
^ Yes ®No: Are you lobbvina on a present or pending bid for goods. eauipment or services. or on a present or pending
award for Goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
^ Yes ®No: Are you lobbvina on a pending application for a Development Agreement with the Citv or application for
change of zoning map designation or chance to the City's Future Land Use MaD?
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 ®No: Are you representing snot-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1't 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 contained in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of
Signature of
VI . LOBBYIST IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Lobbyist)
PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Principal) y,/
VII SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This S day of ~+ArZc'.i( , 20C~
~~~~~"`~ MUN~R AHMED
Signature of Public Notary -State of ~l9F~ public State of New York
Notarization of Principal's signature No. 01AH8Q38953
Commission Expires March 20.Ib
FOR CLERK'S USE ONLY ~J ) ~
Annual Registration fee: [ ]Yes [ ] No Amount Paid S~ ~- MCR # / ~ ~ ~ Date Paid
lobbyist Registration Form received and verified by: ,
Revised 12/08/04
MIADOCS 2627975 1
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pardaman YC. Chatwal Vi~ek Ghatvs+al Vikram Chatvsral , •
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25% ~°/a '
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~Chatt'cval~ FarniIy, LLC .
NY limited liability company '
' ~ 100%
Channel Properties, LLC ~ .
. NY limited liability compaszy
• 100%
TB5 Hotel _
Management Carp.
• FL corporation ~ ~ ~ .
• ~ l% 99% ~• ~ '
TBS Realty LLC '
• ~ FL limited Jiability company
Dream South Beach -
. ~. I lI 1--1114 Collins Avenue
. Miami B each, FL
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