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Esteban Porcelli 12/31/22TPBPFC ESTEBAN PORCELLI 1-22-2021 City Commission 12/31/22 12/31/23 1/20/2021 1/8/2021 1/22/2021 1/22/2021 1/22/2021 1/22/2021 22 Jan I/A MI City of Miami Beach 1700 Convention Center Drive Miami Beach, Florido 33139 OFFICE OF THE CITY CLERK Email: BC@miamibeachfl_gov Telephone: 305.673.7411 AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH STATE OF FLORIDA COUNTY OF _ I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check (/) all that apply): IXI I am a resident of the City of Miami Beach for six months or longer. [] Ihave an ownership interest (for a minimum of six months) in a business established in the City of Miami Beach (for a minimum of six months). D I am a full-time employee of a business (for a minimum of six months) and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). "Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" means any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. that I have read the foregoing document and that the facts Signature Esteban Porcelli 1-22-2021 Date Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of DJ physical presence or [online - a 22n4, January 2o27' n[a[lZa[ion, [[S [ay Ol .'y Esteban Porcelli (City of Miami Beach Board/Committee Member). X Produced ID FL Drivers License Form of Identification Personally Known Cacto'ge Signature of Notary Public Charles J. D'Agostin Name of Notary, Typed, Printed, or Stamped (NOT ARY SEAL) Charles J. DAgostin NOTARY PUBLIC STATE OF FLORIDA "»kk/ Comm# GG168171 Expires 12/14/2021 Porcelli Esteban 3411 Indian Creek Dr. Apt. 903 Miami Beach, FL 33140 X Miami Beach Transportation, Parking,Bicycle and Pedestrian Facility Committee 1-22-2021 Social Security Beneļ¬t Pencion and annuities Various Plans CD Interes 917-294-3511 01/01/21 to 12/31/21 Retired X Received on January 22, 2021Office of the City Clerk Porcelli Esteban X X X X Porcelli Esteban 1-22-2021