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Jordan RonsonM IA M I BEA C H RECEIVED MAR 19 2024 City of Mi am i Beach 1700 Convention Center Drive Mi am i Beach, Flor ido 33139 OFFICE OF THE CITY CLERK Email:. BC@miamibeach1). gov Telephone: 305.673.7411 CI TY OF MIAM I EE.A C" OFFICE OF THE CITY CA F AFFIDAVIT OE AFFILIATION WITH THE CITY OE MIAML BEACH I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check (/) all that apply): [] 1am a resident of the City of Miami Beach for six months or longer. 840 Michigan Avenue , Apt. 4 Home Address: _ D 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: _ 1 S[me,S, (tfosS, D 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 Miam i Beach (for a minimum of six months). [am9 tf Py]fS5, Business Address: _ "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 e?ye "..- /--- March 17, 2024 Signature Date Jordan Ronson Printed Name