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Debra (Debi) Quade _ RECEIVED ' `° Ir `' FEB 13 2024 City of Miami Beach 1700 Convention Center Drive CITY OF MIAMI BEACH Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK OFFICE OF THE CITY CLERK Email:BCCa.miamibeachfl.Qov Telephone:305.673.7411 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(✓) all that apply): 1 I am a resident of the City of Miami Beach for six months or longer. Home Address:2301 Collins Ave#724 Miami Beach, Fl 33139 I 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: Mantell 301 LLC, Mantel) 336 LLC, Meridian 6 LLC Business Address:255 W 24th St#301 &#336 MB, 1035 Meridian Ave#6 MB 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:Cervera Real Estate, Inc Business Address:1000 South Pointe Dr STE 100 Miami Beach, Fl 33139 "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. Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true. Z7.2624, Qu,ae. 2/13/24 Signature Date Debra Quade Printed Name