Karen EdelsteinCity of Miami lea«h
I Canwentic Cer Drio
Miami Bosh, Florido 3.3139
OFFICE COF TE CITY CIERK
Emal BC.±mmth gov
Tel«phano: 70.5.873.7411
RECEIVED
MAR 10 2023
CITY OF MIAMI BEA CH
OFFICE OF THE CITY CLERK
AFFIDAyI QF AFFILIAIQN yITH HE cry OF MIMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMM-DADE
t I have an ownership interest (far a minirum ot six months) in a business established in the City of
Miami Beach (tor a minim um o! six months]
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I lam a full-tire employee ot a business (tar a minimum ot six months] and I am tased in an colfce or
other locatin of the business tat is physicaly located in Miami Beach (tor a minimum at six months}
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·Own ership interost" men s Ihe wnaorshp o! ten percent (10%) or moro [including the oworstup ot
t0% or moo of th o outst a vkn g capit al s o ck) ir a busine ss
Business" moans any soio propnetrstip, sponsorship, corporation, mitt potty company, or other
atty or business association
ILJ!rnti l!'. r l}C\lll-i.'I , 'ei ~1' !Pll'fJLIIY, I det'.f.il} tM'l I haw read lM foregoll"lg d'.OC IJl!ll(lfl; ;c111d ~ill1. l 111'1 (: r.ric:L$ Sltibi.~ ii'i •J.
are true; ,y 4] .),)2
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Sigrat ut e Date . Ka@ fad;ts}in
NOTARY
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