Affidavit (07/27/2001)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .miami-beach, f1,us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKlNG
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE OTY
COMMISSION, OR A CITY BOARD OR COMMIDEE, THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL. REGARDLESS OF WHETHER SUCH LOBBYING ACTIVmES 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 "CERTIFICATE OF WITHDRAWAL,"
1) Lobbyist Name: ~cn..t(jVj I11JrY;cte/ {,.j.
Last Name First Name Middle Initial
No.
jV}Jt...IIII i . C-L
Street'
~ 17-,(,JjI
~c.v
,)~nl
Suite
Message Phone (_)
~.tVJ ;:3J$C~;-( ~J..Ji
Business Phone ~)
Business Name and Address:
sL. t'S 6
City
State
Zip Code
Email Address:
2)
Principal Retained by: iJ()r:JS'1J
If different from above
If.ie1'j) I t~
Street
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
OV'lklt'l{~M ('k<.l~ J lD1vt J. A)~" kJ..
3)
Subject Matter (Describe in Detail):
;J/U14I1l' ~,,,...,t~
~~~~ ~ ~ ~ {JI
: ~.;I,l (4 <4t1/U 1t';
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied:
~l~ 41ft GMIV'J/JJ1IVJ) (JIVtA"'/') ~.~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
on . 2001
on . 2001
on 2001
on cf'..-~ n-: 2001
on . 2001
on . 2001
o The City Commission
o City Commission Subcommittee
o City Staff
. City Board or Committee ~ 1ClIIn7 4>....",..{
o Personnel
o Identify Others
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: /lH'vt
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.
/H1~
Signature of Lobbyist:
,~
~~~~~~~:~YI~nown1-- /Pd.;] -501 - (, '7 - 38" C, - 0
~ / Identify
d Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
swoB aft:ibs (be be~ me
This '7 ay of 2001.
a~
5 r Deputy Clerk
Registration:
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY ..() ~
[ ] REJECTED DATE: J ~ d 1
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Profit Organization
[ ] Cash [ ] Check MCR #
DATA ENTRY DATE:
.2001
ENTERED BY: