Lummus Park concessions 1/29/02
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerktwci .miami-beach .fI. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DEOSION OF ANY COMMISSIONER; ANY
ACTION, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION 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, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINOPAL 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."
1) Lobbyist Name: GoV\L ~\-e-z.. ~\ ~'€cb
last Name First Name
-
..J.
Middle Initial
Message Phone (_)
C!.. ~ f'c:.. IT (\ C!. .
5-8::1.5 ~\ \i ~s A\l€.. :tI" (o-~ ~ ~
No. Street Suite City
Email Address: A-:r (~ .1. @. +ne - b-e ~C \r\ . (\ e. t
2) Principal Retained by: 1) ~U'l tJ ... s c.....r c=:..
\(054 M-eetdi ~V\ ~ue..
If different from above
MB
Business Phone @Q~)..:Jq~- <6.1-\ '01
Business Name and Address: "D~u" D s
-s~c....
-FL
State
~~\y.o
Zip Code
City
Street
.f='L
State
Suite
""3"31 L.{ 0
Zip Code
(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):
LuMIAU S '?AQ...\~ ~e~c\^ r1>n~'P.ssk)Vl ~
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: A I c.J I . r r rI I. rJ ,
. \.....('i-V ~t""+; GI'+-Y ~tul4lSS1 DIV
..
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
0 The City Commission on .2001
0 City Commission Subcommittee on ,2001
0 City Staff on ,2001
0 City Board or Committee on ,2001
0 Personnel on ,2001
0 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:
ON OCTOBER 1 ST 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 e . on 48 f the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
, Personally known
o Produced ID
Identify
o Did take an oath, or
o Did not take an oath
If Notary, print, stamp or type a
FOR CLERK'S USE ONLY
Registration:
~. ACCEPTED
[ ] REJECTED
DATE: t::J\
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Pro t rg niza '
[ ] Cash~ Check MCR # .
DATA ENTRY DATE: . 2001,J.. ENTERED BY: