Saul GrossMIAM I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
MAR 21 2024
Q!TY OF MIAMI BEA CH OF F!CE THE ITV [En
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OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
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):
I✓i I am a resident of the City of Miami Beach for six months or longer.
Home Address: 2900 Flamingo Drive, Miami Beach, FL 33140
I✓l 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: Streamline Properties, Inc.
Business Address. 1125 Washington Avenue, Miami Beach, FL 33139
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 Miami Beach (for a
minimum of six months).
[]Q17 ( HIS][9S,
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
stated in it are true. Sl 'an ·aa
'C ------------- Signature Date
Saul Gross
Printed Name