Christopher ToddMIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:BC@rniamibgachf]_gov
Telephone:305.673.7411
RECEIVED
AUG 2'7 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
AFFIDAVIT OF AFFILIATION IIH THE CITY OE MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
Pk0 anat aLamaresidentofthe City of Miami Beach for six months or longer.
"9me A«dress 412.cll,he Ac}3E Med__P 3140
[vf1nave 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 or sousess NJ,Lc_
ausmess A«ares'31A\AH U,6)255 Iv,eel,F 3»4DIamafull-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 aminimumofsixmonths).
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"Ownership Interest"means the ownership of ten percent (10%)or more (including theownershipof10%or more ofthe 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
stA\in it are true.
(kl $/25/20a4
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