David J. Zack - Annual Lobbyist Registration Form MIAMI MI BEACH p
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: David J. Zack
Business Name: Coffey Burlington, P.L.
Address: 2601 South Bayshore Drive, Penthouse, Miami, FL 33133
Office Telephone Number: 305-85S-2900
Cellular Telephone Number: 305-490-0933
Email Address: dzack@ coffeyburlington.com
If more than one lobbyist,please list:
1)
2)
3)
-z
4) „
5)
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#: LitO q
Amount paid: S50 Date paid:
19 2,0 I C
Processed by: Date: 2-0 ( C
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx