152 Palm Avenue (10/4/2001)
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CI~Y or KIANI BBACK
oprICB or TaB CI~Y CLBRX
LOBBYI8~ RBGI8TRATIOH
urIDAVIT
LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS ANY AGENT,
OFFICER OR EMPLOYEE OF A PRINCIPAL. EACH PERSON WHO WITHDRAWS
AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF
WITHDRAWAL."
(1)
Lobbyist Name Heffernan, Gerald
LAST _. FIIST _
Business phone (~) 854-0800
T.
MI.
Business Address 2665 S. Bavshore Dr. i420 Miami Zip
11111
(2) Principal Retained By: Palm Hihi~~l1!=::. ;:::!l1n ~""~r T~':::lonnC! llC!C!t"'I(";::d-ions, Inc.
Principal's Address 152 Palm Avenue. Mi"mi R"",.h
(IF DIFFEIEMT FION ABOVE)
Zip <<1 <q
a. If a corporation, partnership, or trust. identify and provide the
address for the chief officer, partner, beneficiary, or interests.
Same as above
(3)
Subject Katter (Describe in detaill)
Establishment of a special
assessment or taxina district bv Miami Beach for
underground utilities.
(4) Identify each individual (Commissioners, Board, Committee, Authority
member, or City staff) to be lobbied.
City Manager's Office, City Attorney's Office and
Finance Direc~9~~__Offi~e.
(5) The subject matter in number (3) above is to be considered at the
meeting of: (Identify each entity or individual)
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
19_
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(6) State the extent of any business, financial, familial, professional or
other relationship which exists with any individual identified in number
(4) above.
NnT1P
ON JULY 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBKIT TO THE CITY CLERX, A
SIGNED STATEKENT UNDER OATH, LISTING ALL LOBBYING EXPENDITURES IN THE
CITY OF KIAMI 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 2-48 of the Kiami B ch City Code as amended, and all reporting
require.ents.
tdJ ()
Signature of Lobbyist:
~rSOnallY known
o Produced ID
(lDUlI FYI
o Did take an oath, or
o Did not take an oath
State of Florida, County of Dade
Swo~ /,0 and subscribed before ..... /")-,0\
thh":f- day of,l),::::..-r. ~.:7'-'v
II.
C_lllloned
********************************************************************AA1111111l
Registration: ~ACCEPTED
If rejected, state reason:
FOR CLERX'S USE ONLY-
o REJECTED
DATE ( u
() \
DATA ENTRY DATE
miYes 0 No 0 Not For Profit Organization
o Doc~~ntary Proof Attached
OCash IJ"'Check KCRPo. 2..8~6"1
, 19 . ENTEaEll BY
Registration ree paid: