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David Rabin/Tudor South Beach RealtyAUG-22-2008 FRI 02:05 AM FAX N0, P, 01 m MIAMIBEACH City of Miami Beach Office of thle City Clerk 1700 Convention Center Drive, Miarrlii Beach, FL 33139 I_CiBBYlST 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 durung 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 commis ion, or a city bond 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. Ralbin David NAME OF LOBBYIST: (Last) {Fir:>t) (M.I.) ~~ f; ic~+r ~~ t' I ~JtA,} ~ ~~ N Y N`'it , o0 BUSINESS NAME AND ADDRESS (IJu ber and S rest) (C;ity} (State) {Zip Code) y~ L LSS P'IOIGO ~t~ 2' ~ ~,~j,,,L2~D,~L- IL 4 ~. drabin_lotus@hotmail.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: TBS Realty, LLC; Tudor South Beach Resort Condominium, Inc;..; and Tudor South Beach Resort-North Condominium, Inc. NAME OF PRINCIPAL/CLIENT: 1111 & 1119 Collins Avenue Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (C:ity} (State) (Zip Code) {212} 474-9865 _ NIA ~ jstein@hh-r.com TELEPHONE NUMBER: FA}:NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a p or Trust NAME OF CHIEF OFFICER, PARTNER, OR BENEI=ICIARY: Rabinder Pal Singh and Jay Stein • IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY,. A 5% OR MORE OWNERSHIP INTERIECiT IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ~' ~ --± c:~ coo See Exhibit "A" attached. ~ ~ G r -- ~) 11. SPECIFIC LOBBY ISSUE: ~ "~ ~: =~'= Conditional Use Permit '~' tv .~ Issue to be lobbied (Describe in detail): t11 ..,t III. CITY AGENCIES/INDIVIDUAL: 'TO BE LOBBIED: (Pursu;ant to City Code Section 2-482(g} include a statement of the extent of any busine:>s, financial, familial, professional or other relationship, giving rise to an appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the commencement of service of City personnel to be lobbied.} A Full Name of Individual/Title Bl Any Financial, Familial or Professional Relationshi _ City of Miami Beach Planning Board None City of Miami Beach Mayor/Commissioners None City of Miami Beach Committees None f~~ i ,.!••~t ~1 + ~1"i PAGE 1!3 * RCVD AT 8!2212008 3:15:03 PM [Eastern Daylight Time] * SVR:FAXSERVERI11 * DNIS:7720 * CSID: * DURATION (mm•ss):01-46 RUG-22-2008 FRI 02 22 RM FAX N0, P, 02 IV. DISCLOSURE OF TERMS ANLI AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) No special compensation ~ - g) PRINCIPAL'S DISCLOSURE (OF= LOBBYIST COMPENSATION;i: (Required). No special compensation - The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-46B Entitled "Prohiibited Campaign Contributions By Lobbyists On Procurement Issues": re56fll {JI cnu , -• -- - - 2) Pursuant to Miami Beach City Cade 2-490 Entitled "Prohibite:ci Gampaign Contributions By Lobbyists On Real Estate Development Issues": L a ~_ Ica.. .. a 114PLIV1c cvc v, ~~ ~~ --•----- 3} Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "lobbyist" as set forth in Secticln 2-481 above) who only appears as a representative of anot-for-profit corporation or entity without special compensation or reimbur::;eament for the appearance, whether direct, or Indirect, to express support of or opposition to any item, shrill register with the clerk as required by this section but, shall nat be required to pay any registration fees.. 1 -- v clr^_AIATI Ii2F TINDER OATH: Signature of Lobbyist: Signature of Principal/Client; _ -_ - VI. LOBBYIST IDENTIFICATION: -.. ,. . - _~ ` [~ :Produced ID ~- Form of Identification ~~~~~~~~ ••~•.'~- 1~"~ Personally known (Lobbyist) DTAAY PUBI.~c U"r i JERS~V ~ ~~[~07~NATURE AND STAMP OF NIOTARY: State of Florida, County of Miami-Dade Sworn o and subscribed before me Thisa~ day of CL~ , 2008 Signature of Public Notary -State f Florida Notarization of Lobbyist's slgna ure TO BE COMPLETED BY C Form received and verified by: PRiNCIF'AL IDENTIFICATION: ^ Produced ID _ Form of Identification ^ Pe:rsonaliy known (Principal) State of F=lorida, County of Miami-Dade Sworn to and subscribed before me This `_ day of , 2008 Signature; of Public Notary -State of Florida Notarization of Principal's signature Y PAGE 213 * RCVD AT 8!22!2008 3:30:51 PM [Eastern Daylight Time] * SVR:FAXSERVER111 * DNIS:7720 * CSID: * DURATION (mm-ss):07.54 1 do solemnly swear that all of the for -o~n facktrue and con'ec;i. and that I have read or am familiar with the provisions contained in Section 2-48 of t ~Mia ch City Code and all reporting requirements. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) - . B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ ~'~a <,-~-~ ~~~`ti,_,7t.Uti_.~~;~.;_G~-.~, 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 lobbvinq on a present or pending bid for goods equipment or services or on a present or pendina 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 6a No• Are you lobbvinq on a pending application for a Development Agreement with the City or application for chance 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, shalt not be required to pay any registration fees.. ^Yes 6a No• Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: 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 Lobbyist: Signature of Principal/Client: Jay VI. LOBBYIST ^ Produced ID Condominium, Inc. Form of Identification ® Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This _ day of , 2008 Signature of Public Notary -State of Florida Notarization of Lobbyist's signature Resort Condominium, Inc. PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification Personally known (Principal) State of Florida, County of Miami-Dade Sworn to and subscribed before me This ~ day of ArVC,- ~ 008 ~. ~~~ Signature o~f ~'ublic Notary - Sta dr~a A H M E D Notarization of Principal's ~i~r1~t lic state of New York o. 01AH8036953 Commission Expires March 20.10 TO BE COMPLETED BY CITY CLERK'S USE ONLY Annual Registration fee: [ ]Yes (] No Amount Paid $ MCR # $ Date Paid Lobbyist Registration Form received and verified by: F'\CLER\LOBBYISlILobbyist Registration Form 32708 doc Revised 03/27/2008 MIADOCS 2973020 1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE,~OF LOBBYIST COMPF,,d~1SATION): (Required). `~~-1 t-~-~-~r' ~~~,,;; <e. tt_~ ~sv7 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 lobbvinq on a present or pending bid for goods, equipment 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 lobbvinq on a pending application for a Development Agreement with the City or application for chance of zoning map designation or chance to the Citv'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.. I-IYes 6ZI No: Are you representing snot-for-profit corporation or__entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: 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 Lobbyist: _.___._ _... --- Signature of Principal/Client: ~-' ~-~w~~.~.~.. ,~ .,.... _____ c .~ Rabinder Pal Singh on behalf of TBS Realty, LLO- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ® Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me This _ day of , 2008 Signature of Public Notary -State of Florida Notarization of Lobbyist's signature ^ Produced ID Form of Identification ~ Personally known (Principal) State of Florida, County of Miami-Dade Sworn to and subscribed before me This 21 day of AcVCr- , 2008 Signature of Public Notary -State of Ftertida N `j Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S USE ONLY M U N I R A H M E C Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ Date RAtda.[.y Putflic Slate of New Lobbyist Registration Form received and verified by: No. OtAH6038953 F:\CLER\LOBBYISlILobbyist Registration Form 32708.doc R®~eisedi93127128Yaires Marct York 20,Ic~ MIADOCS 2972884 1 AUG-22-2008 FR I 02 : 22 Ahl FAX N0. P. 03 m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drlve, Miami Beach, Florida 331:3!3, www mia ibeachfl.gov CITY CLERK office C'ityClerk(c~miamibeachfl.aov Tel: 305.673.7411, Fax: 305.673.7254 LOBBYIST NAME: David Rabin f understand that no later than October 1St of each near, l must file the following forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) Lobbyist Expenditure Form 2) Disclosure Form Failure to file these forms on a timely basis wi11 result in my name I~eing transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, one n issue I have registelre;d to lobby on has been resolved, I am required to immediately notify the City Clerk's is or lobbyist withdrawal in writing. ys od' 5ignat e: J D:~•te: MIADOCS 2974060 1 PAGE 313 " RCVD AT 8!22!2008 3:30:51 PM [Eastern Daylight Time] " SVR:FAXSERVER111 " DNIS:7720 " CSID:' DURATION (mm•ss):01.54 ~. . . ~ STRUCTURE , V'ilcra~ C1~atuvt~ 1 • ' ~ax~.n~.a~n~~. Cha~al ~i~©1~; Claatuu~ .~ , ' n ~On/a 2'Sa~n ~S /n ' • ~ •Chatvcrs~'Feuxily, L~.C Z~ limned u.a'6i~.'ty' ,1bi~p~Y , 100a/o , . ~ CiYtuzn,el Fxoparties, T.~~C ~ , ' ~ ~ I~ limi't~a Iia~'i~.tty aou~.pat~.y . 1Q0a/u • ~ TSS Patel ~vTanagam,~a't Corp, , ' . .~"L o~rporation ~ ' . ' ~ 'z~S Rea1.~y 7.,L.C ~ ~ , 11~L'LL1;Bi~ Y].~~']1~~~' G~LP%1'lY - ' ~ ~.1TGa'CCl Sp1T,~~C&411 , ' • 1.111-•1~.T4 Ca1lin8,Avon,~e , . .. ~ ~i,EUZti ~ saoh, ~ ~ ~ , v, C:1Aacumca~ and ~ntt1pB91L72Q1T-Deal BaLtinAn\Carnposm'Y Y11lcrnLl PilaolQif4} CA~sVuou.irea Chur~doc .