Romina Isabel Orozco EncioM IAM I B E A C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachf.gay
Telephone: 305.673.7411
RECEIVE D
APR 03 2024
gTY OF MAMI Ac# OFFICE OF TIE cry E a, - v.ti
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):
D I am a resident of the City of Miami Beach for six months or longer.
Home Address: -------------------------
l] 1have 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.Abbott Florist ·------------------------
Business Address: 1008- 71 Street Miami Beach, FL 33141
] I am a full-time employee of a business (for a minimum of six months) and l 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: _
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
~") m , are true.
l_ 04/02r2024
Signature Date
Romina Isabel Orozco-Encio
Printed Name
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Emai l: BC@mi amibea chf.gov
Telephone: 305.673.7411
RECEIVED
APR 03 2024
CITY OF MIAMI BEACH
OFFICE OF TE CITY CLERK
N O R TH BEA CH CRA ADVISORY COMMITT EE AFFIDAVIT OF COMPLIANCE
I am in compliance with the North Beach CRA Advisory Committee's Membership Composition
requirements pursuant to Section 2-190.151 of the Miami Beach City Code as a:
□Resident Member.
a. Currently residing, for a minimum of five (5) years, within the North Beach area, generally
considered as that portion of Miami Beach located north of 63' Street.
Home Address: _
b. Currently residing, for a minimum of five (5) years within the geographic boundaries of the
North Beach CRA or a 300-foot radius thereof.
[tmme (]feSi,
Business Member with ownership interest for a minimum of five (5) years in a business
established within the geographic boundaries of the North Beach CRA.
N am e or use.Abbott Florist
Business Address: 1008- 71 street Miami Beach
□Real Estate Industry Member residing generally within the City of Miami Beach.
Home Address:, _
License Number: _
□Attorney Member with experience in land use, real estate, or other related practice area,
residing generally within the City of Miami Beach or maintaining a full-time law practice and
physical office located in North Beach.
Home Address:, _
Law Practice Address: _
License Number:. _
□The five (5) year minimum residency requirement for the Resident Member Category has
been waived by a 5/7ths vote of the City Commission.
I have an interest in neighborhood leadership Issues, Including, without limitation,
neighborhood business groups, homeowner or condominium association associations and
cooperatives, civic groups, and/or other similar qualifications.
"Ownership Interest" means the own ership 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, sponsorsh ip, corporation, limited lia bi lity 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.
04/02/2024
Signature
Romina Isabel Orozco Encio
Date
Printed Name