M/A-Com, Inc RFP 800
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@ci.miami-beach.fl.us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETIlER 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 COMMmEE; OR ANY ACTION, DECISION OR
RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER IN TIllS SECTION, DURING THE
TIME PERIOD OF TIlE 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 COMMITfEE. TIlE TERM
SPEClFICALL Y INCLUDES TIlE PRINCIPAL AS WELL AS ANY AGENT, ATTORNEY, OFFICER OR
EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETIlER SUCH LOBBYING ACTNITIES FALL WJTIIIN
THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITIIDRA WS AS A
LOBBYIST IS REQUIRED TO Fn.E A "CERTIFICATE OF WITIIDRAWAL."
I) Lobbyist Name: Mehta. Eileen
Last Name
First Name
Middle Initial
Business Phone (305) 350.2380
Message Phone (305) 350-2380
Business Name and Address: Bilzin Surnber11Dunn Baena Price & Axelrod LLP
200 South Biscavne Boulevard: Suite 2500
Miami. Florida 33131 .
Email Address:shalimarhomes@cs.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 Di~ 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
staff)
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
.2001
City Commission Subcommittee
TBA
on
1@
,2001
1@
,2001
1@
,2001
1@
,2001
1@
,2001
on
City Staff
on
City Board or Committee
on
Personnel
on
Identify Others
on
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
-....n-r& A
Signature of Lobbyist: ~ ~
.... Personally known
{; Produced ID
Identify
1@ Did take an oath, or
~ Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~(. day of )l~
, 200 I.
..........~'" M8fC8d88 Padron
'~~.~ MY COMMISSION I CC 789840
~ .' i EXPIRES: November 9, 2002
"':>':Rr:~ BondedThruPictlardlnsuranceAgency
FORCLERK=Y
Registration: CCEPTED r 1 REJECTED DATE:
If rejected. state reason:
~"b!W ~
Notary or Deputy Clerk
If Notary, print, stamp or type
as commissioned
2001 ENTERED BY: