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HomeMy WebLinkAboutc/o Bruce Eichner So Be Ocean .tD ~~ Oty of Miami Beach Office of tihe Oty Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@ci.miami-beach.fl.us LOBBYIST REGISTRATION FORM (CIty of Miami Beach, City Code Chapter 2, Division 3, Section 2-4B1) .os Check Box If an Amendment (~OS) $3{,- \U..2 TELEPHONE NUMBER: BoS') ,<;3b- U\1o FAX NUMBER: eofoo (M.!) DATE QUALIAED AS LOBBYIST ,:t. 3~13 (Zip Code) lxJ.p. DieuJbw .&rrl EMAIL: riD 0 a f1).U~U NAME OF LOBBYIST: (Last) L LOBBYIST RETAINED BY: \.~"1lQ:..h PuCL.cl-. ()~ JoJW. bid - do ~ &11.~ tiUtvUI" NAME OF PRINCIPAl/CLIENT: (g(pt) ~~ a.w~ BUSINESS ADDRESS: (Number and Street) I /l.(iI> ~( I hJ1,d ~Jc 'nCO 100~1 (City) (State) dip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) FIll out thla aedIon If prlndplll Is a CorponItIon, PlIrtnenhlp or Tr1I8t [SedIan 2-482 (c)) ? NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Wan Rrru <?.t. .$..c.tvw ? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARJNERSHIP OR TRUST: ~ ,(f; lePJlU/ D. SPECIFIC LOBBY ISSUE: m. CITY AGENCES/INDMDUALS 10 BE LOBBIED: A) Full NlIme or Indlvldual/Tlde B) ReIatIonahIp , c' IV. DISCLOSURE OF TERMS AfID AMOUNTS OF LOBBYIST COMPENSATION (DISCI OSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: ~lJOO ~ dl~~ COMPENSATION):~ e'Vl ~/ L6eAJ<) V. SIGNATURE UNDER OATH: ON OCTOBER 15' OF EACH YEAR,. EACH LOBBYIST SHALL SUBMrr TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING LOBBYING EXPENDDURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. I do solemnly swear that all of the ~ familiar with the provisions con ' reporting requirements. egoing facts are true and correct and that I have read or am in S ion 2-482 of the Miami Be h City Code as amended, and all Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDEN11F1CATION: 65 Produced ID Form of Identification ~Kno;> vn. SIGNATURE AfID STAMP OF NOTARY OR DEPUTY a.ERK: State of Florida, County of Miami-Dade Sworn to~d subscribfd 2J?~e me This 10 day of ~ 2002. ry - State of Florida ~ ~ Elizabeth Bem8t'dO Print, sta~~.~ Public FOR CLERK'S USE ONLY Registration: [] ACCEPTED [] REJECTED DATE: If rejected, state reason: Registration fee paid: [ ] Yes [ ] No [ ] Cash [ ] Check MCR # DATA ENTRY DATE: 1 2002 ENTERED BY: 1 First Revision - 05/17/02 , " IV. DJSCLOSl1llE OF TERMS AND AMOUNtS OF LOBBYIST COMPEMSATION (DJSCLOSE wHEnIER HOUllL Y, FLAT RATe OR OTHER): A) LOBBYIST DISClOSURE: .....-hm 1 1 0 (f VUL:b.. g ~ $.-(l<D B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): \. '16 l e2R IJY1 I::th lfY)~ 1>>,aLO V. SIGNAT\IIlI: UNDBR (Hl1M: ON OCTOBER lSf OF &ACH YEAR. EACH LOBBYIST SHALL SUBMIr TO THE CLERK A SIGNED srATEMENT UJ'.lDER OATH, LJS11NG LOBBYING EXPENDrruRES IN THE OF MIAMI BEACH FOM THE PRECEDING CALENDAR YEAR. SIgnature of Prlndpal/cllent: VI. LOIIIlYlST IDEN'I1FICA11ON: d ProduadID ~~~ /).wJ~SW& ~,uV1 Fa dentification ~~ d that I have read or am City Code as amended, and all I do solemnly swear that all of the famlllar with the provisions con ' reporting requirements. Signature of Lobbyist: I'< Personally Known VII. SlG....1URE AND srAMP OF NOTARY OR DBPUn' cLERIC: state of Florida, County of Miami-Dade Swom to and subscribed before me This day of J 2002. Signature of Public Notary - state of Florida Print, stamp or type name of Notary Public FOR CLI!RJ('S USE ONLY Registration: [] ACC6'TED [] REJECTED DATE: If rejectEd, state reason: Registratlon fee paid: [ ] Yes [ l No [] sh [ ] CI1eck MCU DATA ENlRY DATE: 2002 1 I First Revisign - O'!./17/1J2 E90-~ BOO/EOO'd 21E-l 91119E550e+ ~va3H SVN3a~V~ M3l-MO~~ WVl5:80 2002-10-lO .. . STATE OF FLORIDA, COUNTY OF MIAMI-DADE SWORN TO AND SUBSCRIBED BEFORE ME TInS ~ DAY OF ~-o/- .2002. E90-~ BOO/~OO'd ZlE-l 91119E990E+ ~~~, / New lfe"u"- Print, stamp or type name of Notary Public KRHRYN e.8AlYEMN NalllJNIIo, 8llllcltwl1llk NIL 018l\1li8_ ", - j In ....""CDlIlII Cl....,hllM__....~ ~va3H SVN3aHV~ M31-WOH~ WVl9:60 ZOOZ-lD-lO . , ~ . . .-'