Bibi Andrade/\t\l A./VII BEACH
(jry of Miomi Beach
1700 Convt'rt!•on (1:'nft:1 CV'rve-
Miomi Scoeh, Floddc 33139
Offt:E Of THE Grf Cl£RK
Ern.,a: RC@mi:1mibr..;ichfl.99'!
Tck-.phOC"".e: 305.673.74} I
AFFIOAVIT OF AFRLIATION WITH THE CITY OF MIAMI BEACH
l am in compliance with. !he affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as {clleck (./) all that apply):
~ l am s resident of the City of Miami Beach for six months or longer.
Home Address: 7133 Bay Drive Suite 706 Miami Beach, FL 33141
~ I have an ownership interest (for a minin-.im of six months) in a business established in the
City ol Miami Beach (for a mlnlmt.1n ot six months~
,.,,me ot Business: Bibi Art Media Inc.
BusinessAddress:7133 Bay Drive Suite 706 Miami Beach, FL 331,
D I am a ful-time employee of a business {for a mlni'num of six month$) and I am baised in an
office or other locatio<l ot the business that is physically located in Miami Beach (le< a
minimum of six months).
Name of Business:. ______________________ _
Business Address: ______________________ _
"Own<>lohip lnterost" moans the ownership cf ten percent (10%,) or more (inctuding the
ownership cf 10¾ or more of the outstanding capital stock) in a business.
"Busi,,.,ss· moons ""Y sole pn,prieforship, sponsolohip. co,porotion. Hmited fiabHity companY,
or other entity or business association.
Under penalties of perjury, I declare th.at I have read the foregoing document and that the facts i! in ij ore wea
~:,:,.~( q g\ • C .(9
Signature
May 30th, 2021
Date
fbe ~m: AC'Qc, a.cl,<::.
Printed a
RECEIVED
MAY 30, 2023
OFFICE OF THE
CITY CLERK