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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.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 COMMIlTEE; 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 COMMIlTEE. 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 WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL." I) Lobbyist Name: McDowell. Carter N. Last Name First Name Middle Initial Business Phone (305) 350-2355 Message Phone (305) 350.2355 Business Name and Address: Bilzin Sumberg Dunn Baena Price & Axelrod LLP 200 South Biscavne Boulevard. Suite 2500 Miami. Florida 33131 Email Address:cmcdowellla>bilzin.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 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 TBA o City Commission Subcommittee o City Staff o City Board or Committee ,2001 ,2001 ,2001 ,2001 on on on on . on on ,2001 ,2001 o Personnel o 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 ity Code as amended, and all reporting requirements. Signature of Lobbyist: tl"""Personally known o Produced ill Identify la"bid take an oath, or o Did not take an oath State of Florida, County of Miami-Dade Swo~to ~ subscribed before me ThisofU' dayof/1fYe'~ ,2001. Q}<..."'~ .'" ' . . , , ClIBeUEPACHECO MY COMMISSION I DO 016e8S EXPIRES: ApOllO, 2005 BoncIed'1'1uupk:ftlnltnllifllllOtAf/tlt11'f If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: [ ] ACCEPTED [ ] REJECTED DATE: I' J:;p'1 /n I ( ( If rejected, state reason: Registration fee paid: [~...] N~ Not-for-Profit r [ ] Cas [vj""Check MCR DATA ENTRY DATE: II ;)-' ,2001 ENTERED BY: