Luis Bellmas Annual Lobbyist Registration Form i
AMI BEAC 1■40-
4 City Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miannibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Luis Bellmas
Business Name: BAPTIST OUTPATIENT SERVICES
Address: 1500 San Remo Avenue, Coral Gables, Florida, 33146
Office Telephone Number: (786) 527-9404
Cellular Telephone Number:
Email Address: LuisB @baptisthealth.net
If more than one lobbyist,please list:
1)
3) -
4)
5) Q
6)
7)
Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
MCR#: poi y g7 614P
Amount paid: gro Date paid: f 2r ui
Processed by: Date: /72,7 ir-
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