Carol MotleyMIAMIBEACH
City of Mi am i Beach
1700 Convention Center Drive
Mi ami Beach, Florido 33139
O FFIC E O F TH E C ITY CLERK
Email: BC@miamibeachf] qoy
Telephone: 305.673.7411
RECEIVED
MAR 16 2023
CITY OF MIAMI BEACH
O FFIC E OF THE CITY CLERK
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STA TE OF FLO RIDA
CO UNTY O F MIAM I-DADE
I am in com pliance with the affiliation requirement of Miam i Beach City Code Sections 2-22 (4), as (check
(/) all that apply):
□I am a resident of the City of Miami Beach for six months or longer.
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□I have an ownership interest (fo r a minimum of six months) in a business established in the City of
M iam i Beach (fo r a m inim um of six m onth s).
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!21 I am a full-tim e em ployee of a business (for a m inimum of six months) and I am based in an office or
other location of the business that is physically located in Miam i Beach (fo r a minim um of six month s).
Nam e of Business G reater Miam i Convention and Visitors Bureau
Business Address 1901 Convention Center Drive 33139
"Ownership Interest" means tho 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 solo proprietorship, sponsorship, corporation, limited liability company, or other
entity or business association.
Under , nalties of per'ur , teclare th at I have read the foregoing document and that the facts stated in it
are t 03/14/2023
Sign Date
Carol Motley
Printed Nam e
NO TARY
Sworn to (or affirm ed) an d subscribe d befor e m e, by means of1p hysical presen ce or o online notarization,
this /@"tu ay ot LIA cu
(Ci ty of Mi ami Beach Board/Com mittee M ember ).
Produced ID
Form of Identification
L Personal ly Known
D e c . do a. eer-
Signature of Notary Public
DA U ER&N teuh
Nam e of Notary, Typed, Printed, or Stam ped
AINA IRENA LEON
#; Notary Public - State of Flori
l3i Com missi on 4 HH 040087
7$$ y Com m. Explres Jan 3, 20 AG @t0eh3/ Nary A