Laura LeveyRECEIVED
APR 30 2024
MIAMI BEACH CITY OF M!AMI BEACH
OF£" r +.A r/yr
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachf].gov
Telephone: 305 .673 .7 411
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):
[yj I am a resident of the City of Miami Beach for six months or longer.
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).
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osmess Address.:. _lo9 Mori di on/eve, 5ile Gh00
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).
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sousiness Address. _/b%88 eidiaA/eye, 5oh 900 )
"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 pe alties of perjury, I declare that I have read the foregoing document and that the facts
stated i I are true.
Signature
Laura Levey
//0/2024
Date 7
Printed Name