Scott Needelman (2)MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC rniarnibeachfI. ov
Telephone: 305.673.741 1
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (J) all that apply):
19 1 am a resident of the City of Miami Beach for six months or longer.
Home Address: 1455 Drexel Avenue 1
19 1 have an ownership interest (for a minimum of six months) in a business established in the
City of Miami Beach (for a minimum of six months).
Name of Business. SAN Development, Inc.
Business Address: 1455 Drexel Avenue 1
0 I am a full-time 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 Beach (for a
minimum of six months).
Name of Business. York Towers Apartments
Business Address: 1463 Drexel Avenue
"Ownership Interest" means the 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 sole proprietorship, sponsorship, corporation, limited liability company,
or other entity or business association.
Und en ties of perjury, I declare that I have read the foregoing document and that the facts
st ed n it a tru
June 5, 2023
Signature Date
Printed Name