Brian KeaneMIAMIBE H ,
City of Miami Beach
I700 Convention Center Drive
Miami Beach, Flor ida 33139
OFFICE OF THE CITY CLERK
Emal: BC@miamibeachfl_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFILIATION WITH THE CITY OF MIAMI BEACH
ST8. CF FLORIDA
OJNTY OF MIAMI-DADE
l ar in compliance with tho affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
() all that
/1ara resile/i ofthe City oí Miami Beach for six months or longer.
'have an cwne rship interest ¡or a mirimum of six months) in a business established in the City of
Miam i Beach (for a minimum of six months).
¿{{{ {F ¿,jlzg-o.
usin1ss Ader ess
• ara a ai-tmns cmployse fa a minimum of six months) and l am based in an office or
oner iocation of the business tnat is physically located in Miami Beach (for a minimum of six month s).
gl4 ff ?¿¿?¿}boo«--
business dares
2i ten percent (10%) or more {including the ownership of
10% or mo re of the outstanding cap ital stock} in a busine ss.
usiness means any sole proprietor ship, sponsorship corporation, limited liability company, or other
Ut.sr&ss association
NOTARY
ani susci before me by means of{ ohysical presen ce or online notarization,
t . ow
TG!Cà L
#Re.. LUIS GONZAL EZ
3% 2RY 6@ii4is$Io # 66 964 02
±±¿, :; EXPIRES: June 29, 2024
jg" onad Thro Notary Public Underwriters