Seth GuttenbergM IA M I BEACH
City of Miami leach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@mnlamibeachfl_go
Telephone: 305.673.7411
A FFIDA VIT O F A FFILI ATIO N W ITH THE CITY O F MIAMI BEA CH AND THE CO MMITT EE
FO R Q UALI TY EDUCATIO N IN MIAMI BEACH
A s a voting m em ber of the Com m ittee for Q uality Education in M iami Beach, I am in
co m pliance w ith the affiliation require m ent of M iam i Beach City Code Sections 2-22 (4) and
2-190.137 as:
[ tam a City of Mi a m i Beach residen t for six m onths or longer.
Jom e Adara. 4307 Alton Rd. Mi am i Beach, FL 33140
[t am th e parent/guardian of a student attending a Miami Beach sch ool tor # }-+ .Al
year.
schoo l: Mechina of South Florida
Under penalties of perjury , I declare that I have read the foregoing document and th at the facts
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S ignature Date
S eth Guttenberg
Printed N am e