Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(Cllci .miami-beach. f1.us
AFFIDAVIT 6. '\
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlN . PAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECI .:N-{>F ANY COMMISSIONER; ANY
ACTION, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRlNOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFACER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlVmES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTlACATE OF WITHDRAWAL."
1) Lobbyist Name: C I, t I\..C"I C \, r., 'i. \ "'ph.1l..
Last Name First Name Middle Initial
Business Phone (lli) .l. (. <. - ,t'\ C'l10 Message Phone L)
Business Name and Address:. ~ h \ h... Mil h ~ \ ~C\" ~ I\.<...h \ t u....:ts
~t.()\ \T ll..\f tIN Rc-\ \) n Lt-...\)ch....~ c\...\ ~ [:'L
No. Street I Suite City State
Email Address: (' C lJ t \\. C\ ~ & b-.. \ t1 \."f:I,cb ~.\ Hl N . C() rI\
2) Principal Retained by: J) I F-. J (') ~l t R AN
I ~U (:::, S, .h LI w ...:t- ~ A ~ It \ V E-
If different from above Street
~l!'-MI. ~u,c.h f L
City State
2l :\.3 bh.
Zip Code
Suite
:lHjJ
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
3) Subject Matter (Describe in Detail): ~ 1"
fM f~ ~~1J~~~~ ~*~E~~~ ~ lDN
~(\\\C Ir,~ \ )~ fJ.. ~ C>0
~1 ~ \~N"II~~O"''''~
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied:
j,J\ l1\~ l1\ io~ 1\.<, af eJ~\'MNI"IJ I!lM,,~,~ ~1 ~aj>,.~J ~lS1L11Nj
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
D The City Commission on. 2001
D City Commission Subcommittee on. 2001
D City Staff on . 2001
D City Board orCommittee on --1J.l" Y .2001
D Personnel/'~- :\ on. 2001
Q Identify ~~~ on. 2001
6. State the extent 'of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT 'TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar
with the provisions contained in Section 2-482 of the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
~l"A~~ ~,~ '
D Personally known r-
'1- Produced 10 /- l.po
I!: Did take an oath, or
D Did not take an oath
"/)(>Je.-S L.c""'-Sc.
Identify
C ::>, laD \" \,; +C1 4-~o 0
State of Florida, County of Miami-Dade
Sworn to and subscribed ~re me
This 4 -h. day of , loti I . 2001.
~w~ '
Notary 0 Deputy Cieri)
If Notary, print, stamp or type as commissioned
Registration: 1(4 ACCEf'TED []
If rejected, state reason:
Registration fee paid: [...rYes [ ] ~ [ ] Not-for-Profit Organ~ation
[ ] Cash [v1 Check MCR # :z.3 16 ?- "71
DATA ENTRY DATE: 'f/t'fil .2001 ENTERED BYA'
FOR CLERK'S USE O~
REJECTED DATE: 1 q I 0 l