La Gorce Country Club 11/19/01
SENT BV: BERCOW & RADELL, PA;
3053776222;
NOV-16-01 3:55PM;
PAGE 2/3
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 ConvenbOn Center Drive
Miami Beach, FL 331]9
citvclerk(!j)ci.m ia mi .beach .11. us
AFFIDAVIT
L066Y15T MEANS ALL PERSONS EMPLOYEO OR RETAINEO, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS
TO ENCOURAGE Tl1E PASSAGE, DEFEAT OR MODIFICATION Of ANY ORDINANCE. RESOLUTION, ACTION OR
OEQSION OF ANY COMMISSIONER; ANY ACTION, DEaSION. RECOMMENDATION OF ANY cm SOARD OR
COMMmEE; OR ANV ACTION, OEOSION OR RECOMMENOATlON OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTlON,
DECISION OR RECOM"'ENDATlON THAT FORESEEA8LY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMITTEE. THE TERMSPECIFlCALL Y 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 'CERTlFICA TE OF WITHDRAWAL.'
1)
Lobbyist Name: Shulman
Last Name
Allan
First Name
Middle Initial
Busine55 Phone (305) 438-0609
Business Address: 434 NE 28th Street
No. M' ..
l.am]"
Message Phone (_)
Street
Florida
331~te
Zip Code
City State
Email Address:4l/tWlt6]sMlm4rJ4~hife.c-f.c.CI.l?
2) PrinCipal Retained by:
La Gorce country Cl~b
IF different from above
Miami Beach
5685 Alton Road
Street
Florida 33140
Suite
City
State
Zip Code
(a) IF it corporabon, partnership, or trust, identify and prOllide the address For the chief
officer, partner, beneficiary or interests.
3) Subject Matter (Describe in Detail): Design Review Approval
4. Identify each Individual (CommiSSioners, Board. Committee. Authority member or City staff)
to be lobbied: City staff and ORB.
Since this wi~l be a quasi-Judicial proceeding, we will not contact
ORB members prior to the hearing.
SeN! BY: BeHCaw & RADELL, PA;
3053776222;
NOV-16.01 3:55PM;
PAGE 3/3
5. The subject matter In number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
o The City Commission
o City Commission Subcommittee
o Ci ty Staff
III City Board or Committee Design Review Board
o Personnel
o Identify Others
.2000
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,2000
20 . 200
.2000
.2000
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6. State the elCtllnt of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
ON JULY 1ST OF EACH YEAR, EACH LC)BBYST SHAU SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, USllNG A 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:' 0Y~ ShL-"II?-;J~
. e/P'ersonally known . .
o Produced 10
Identify
Ill'" Old take an oath, or
o Did not take an oath
State of Florida; County of Miami-Dade
""m to ,,"'....,.bod _. m,. ~ .
This Iq"li'l day of NrNE#I~2000, . ~ '(;;!;:(!
1l; IAytI - tary or Deputy Clerk
. . My~ccaqoo.10 M
\t..~ EllPIrMJonuoIy06.~YLA V. I 1cAe./LIAP
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registrabon: r] ACCEPTED [] REJECTED DATE:
If re)ected, state reason:
Registration r.,. paId: [ ) Yes [ ) No [. ) Not-lor'Profit Organization
[ J CaSh r ) Checfc MCR If
DATA ENTRY DATE:
.2000
.
ENTERED BY: