de la Fuente, D.A. 1/11/02
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
LOBBYIST REGISTRATION
AFFIDAVIT
LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS ANY AGENT,
OFFICER OR EMPLOYEE OF A PRINCIPAL. EACH PERSON WHO WITHDRAWS AS
A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
(1) Lobbyist Name d~ lo. h>.IAU D.ti. (,
LAST NAME FIRST NAME MI.
Business phone (.BaS ) 5.Bb-1lI.,'l..
Business Address ,A,ol Souq.f.. ~l$+ ~"L If1.('J l~~ .Pent I , ~I\U. I CI ~31f>1
(2) Principal Retained By: '~ (ola <;D~f) C-t lA, ll.U.1
Principal's Address ,2Q JhWca..~ PQ(tl1~ -N~ Q ~I'l/ISI! Zip ~-3..)~
(IF DIFFERENT FROM ABOVE) , Cl.
a, If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary, or,interests.
(3)
r
Subject Matter (Describe in detail!) ~I1,'}",^+ r,b+ 1/\ flry)(}'pl~Jv'V'\ Lo~ ~
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(4)
Identify each individual (Commissioners, Board, Committee, Authority member, oi;:, -
City staff) to be lobbied. ~jl^bt1{/YIa.,~ VI'.-h"dD~ 4t~6B ~ :=;.
~QW..(( j 1l"'1 {!O/nfYI'ISS(o/'lRfS
(5) The subject matter in number (3) above is to~be considered at the meeting of:
(Identify each entity or individual - no f'~,heuW ~ p.U ~ ~ .J.rYU.. .
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
,19_
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(6) State the extent of any business, financial, familial, professional or other relationship
which exists with any individual identified in number (4) above,
~
ON JULY 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK, A SIGNED
STATEMENT UNDER OATH, LISTING ALL 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 2-48 of the Miami Beach City Code
as amended, and all reporting requi ent
Signature of Lobbyist:
~ersonally known
o Produced ill
(IDENTIFY)
o Did take an oath, or
)(Pid not take an oath
State of Florida, County of Miami-Dade
S~om to,lfld subscri~ ~efore me ;;),COz-
thiS / /f/- day of -U.J(ut:J'l ' ~
If a Notary: Print, Stamp or Type as Commissioned
o
ANA M JIMENEZ
NOTARY PUBLIC !rATE OF FLaUDA
COMMISSION NO. CC8S9117
MY COMMISSION EXP. Y28
******************************************************************************
Ifrejected, state reason:
FOR CLERK'S USE ONLY
D REJECTED
Registration:
DATE
Registration fee paid:
D Not For Profit Organization
D Documentary Proof Attached
MCR No,
ENTERED BY
D
DATA ENTRY DATE
221998