M/A-Com, Inc. RFP 800
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityc1erk@ci.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 COMMITTEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED
IN ANY MANNER IN THIS SECTION. DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR
REVIEWED BY THE CITY COMMISSION, OR A CITY BOARD OR COMMITTEE. THE TERM SPECIFICALLY
INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT, ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL.
REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES FALL WITHIN THE NORMAL SCOPE OF
EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRA WS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."'
I) Lobbyist Name; PowelL Norman C.
Last Name
First Name
Middle Initial
Business Phone (305) 375-6144
Message Phone (305) 375-6144
Business Name and Address; Bilzin Sumberg Dunn Baena Price & Axelrod LLP
200 South Biscavne Boulevard, Suite 2500
Miami. Florida 33131
Email Address;npoweIlCCilbilzin.com
2) Principal Retained by; MIA-Com. Inc., 3901 DeITY Street, Harrisburg, PA 1711
If different from above Street
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer,
partner, beneficiary or interests.
3) Subject Matter (Describe in Detail); RFP 800 MHz Trunked Digital Simulcast Radio
Svstem. Digital Multiplex, Tower. Shelter. and Services for City of Miami Beach
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staft)
to be lobbied:
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each
entity or individual):
X The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
.2001
,2001
,2001
,2001
TBA
on
on
on
on
on
on
,2001
,2001
D Personnel
D 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: NONE
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.
Signature of Lobbyist:
rlersonally known
D Produced ID
/ Identify
/
!3"'Did take an oath, or
D Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~(;,d- day of jUrv('I'>-buL.
,2001.
Q~ GISElLE PACHECO
'ii' MY COMMISSION' DO 016885
'. : . EXPIRES: April 10, 2005
'..W" . BondvdThruPldllrdlllSllll.llCtAgency
If Notary, print, stamp or type as
commissioned
Registration:
~~ED
FOR CLERK'S USE ONLY
DATE: 11/;;;-, / () /
. I I
[ ] REJECTED
If rejected, state reason:
Registration fee paid: [~. [ ] No [ ] Not-for-Profi
[ ] Cash [ ] Check MCR #
DATAENTRYDATE:~'200l ENTERED BY