Restoration 1058 Collins1/29/02
.,
"
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(ii)ci. miami-beach.f1. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIACATION OF ANY ORDINANCE, RESOLUTION, AmON OR DEOSION OF ANY COMMISSIONER; ANY
AmON, DECISION, RECOMMENDATION OF ANY cm BOARD OR COMMmEE; OR ANY AmON, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEAN ED IN ANY MANNER IN THIS SEmON, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKING
PROCESS ON SUCH AmON, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE, THE TERM SPEOFICALL Y INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFACER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING AcnvmES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO ALE A "CERTIACATE OF WITHDRAWAL."
1) Lobbyist Name: Gov)'l.~\'ez. 'Al~do :r.
Last Name First Name Middle Initial
Business Phone ~) "'1C)<? - <lS1-.\ '3~ Message Phone L) g...M.. 'C..
Business Name and Address: ~v \ D's c...~ r -e.. I T(')c.
\(054 ~'e2-(eli 'l\Vl ~\-Ue. J.A. ~ .
No. Street Suite Oty
Email Address: ~~ &.1.. e. ~e" beAc~. ()e.. +
2) Principal Retained by: t) ~ \oJ i D .5 r .A F ~ J T () c. .
FL
State
'"3"'5 I L.f 0
Zip Code
If different from above
Street
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
t\ \ M4e-c\o ~ ~\.e,- c;~, " il1 S A tJ e h -A M.:B ( PI "$3/ i.j. 0
3) Subject Matter (Describe in Detail):
~-e\'\ O\) f:\.-\\ OY\ / ~ e.'5 b 2 -ht..:tl 0\1\
lPS~ r~~\l",<; Rve.
.
'\..
4. Identify each individual (Commissioners, Board, COmmittee, Authority member or City staff)
to be lobbied: n I , '""i"'\ ("), f'\ A
l-\-i'StnR-ic" ~'5'e~~",,",'Oll\ Bof>,.~cll \...I"f"~l~1I1 1CeUI'€c..u l)o~~_
~
~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
a The City Commission on .2001
a City Commission Subcommittee on .2001
a City Staff on .2001
. City Board or Committee on "3-1'- . 200lZ-
a Personnel on .2001
a Identify Others on .2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: t'\Ol\'f-
ON OCTOBER 1 Sf 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 famillar
with the provisions contained in Se ion 2-482 of the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
4 Personally known
a Produced 10
Identify
a Did take an oath, or
a Did not take an oath
HUNDEVADT
MY COMMISSION. CC 848243
~XPIAES: October 22, 2003
If Notary, print, stamp or type
Registration: ~ ACCEPTED
If rejected, state reason:
Registration fee paid: [ ] Yes [) f}o [] Not-for-ProfjtRrg~niza~e..
[ ] Cash ~ Check MCR # ~~ \)~
.2001 ENTERED BY:
FOR CLERK'S USE ONL \. t
[ ] REJECTED DATE: 'D\ \ ~ ~~
\
I
I
I
I
DATA ENTRY DATE: