Dorrie FosterMIAMI BEA CH
City of Miami Beach
1700 Convention Canter Driv
Mi0m i B8sch , fki da 33 139
RECEIVED
MAY 10 2023
OFF IC E OF THE CITY CL ER K
Em ail. 8cgmiamibeach.gos
Telephone: 305 .673.7411
A FFIDA yII OF AFFILIATION WITH THE CIT Y OE MIAMI BEACH
CITY OF MIAM I BEACH
O FFIC E O F TH E C ITY C LER K
STATE OF FLORIDA
CO UNT Y OF MIAM I-A OC
t am in compliance with the affiliat ion requirement of Miami Beach City Code Sections 2-22 (4), as ({check
(/) alt that apply):
ta lam a re sident of th e Cty of Miami Beach for six months or long er.
Home A&are,,450 Collins Ave, #906 Miami Beach, FL 3314
{have an ownership inte rest (far a minimum of six mont hs) in a business established in the of
Miami Beach (for a minimum of six months)
ta lam a full-tim e 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 Bach {for a minimum of six months}.
O wnership In terest" moan s the own ership of ten percent (10%) or more {including the ownersh ip of
10% or mor e of th e outstanding capital stock) in a business.
'Business" me ans any sole proprietors hip, sponsorship, co rpora tion , limited liability company, or other
entity or busine ss asso ciation.
,1 declare that I have read the foregoing do cu ment and that the tacts stated in it
05/09/2023
Dorrie Foster
Prin ted Name
NO TAR Y
Swo m to (or affir me d) and subsc ribed before me, by me an s ot stysical presence or o onl in e no tarizat ion .
»2 ar +1A A( _mas » D orie, Hoke
_(City of Miami Beach Board/Cormittee Member),
Produced
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My {mm. Ls«res et 15, 2027
(NOTARY SEAL)