Sunset Three LLC
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-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Ct'nter Drive
Miami Beach, FL 33139
cityclerktlDci. miami-beach. fl. us
,AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, AmON OR
DEOSION OF ANY COMMISSIONER; ANY AmON, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR
COMMmEE; OR ANY AmON, DEOSION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SEmON, DURING THE TIME PERIOD OF 1HE ENTIRE DEOSION-MAKING PROCESS ON SUCH AmON,
DEOSION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALL Y INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATIORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING AmvrnES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATIORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A ~CERTIFICATE OF WITHDRAWAV
1) Lobbyist Name: Bercow Jeffrey
Last Name First Name Middle Initial
Business Phone Un.s) 177-67.7.0
Message Phone L)
Business Address:
200 S. Biscayne Boulevard
No. Street
Florida
Miami
City
Erriail Address:
2)PrlriCiP8l:: RetaiQ~bY.::'
I ""',' ,,;
Sunset Three-~_?~..r,.:~.:r.,J 1800 Sunset Harbor Drive
If different from above Street
State
33131
Zip Code
850
Suite
Suite
Miami
City
Florida
, State
33139 '
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):
Modification to
Approval
4. Identify each in~ividual (Commissioners, Board, Committee, Authority member or City staff) ,
to be lobbied: c~ ty Staff. We will not communicate with members of the
Planning Board prior to the public hearina since rhpy ",ill ...."'uj'ii'W
this application while acting in their quasi-judicial capacity.
51f. Ji>
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
a City Commission Subcommittee
a City Staff
'It City Board or Committee Planning Board
a Personnel
a Identify Others
on
on
on
on
on
on
Jan. 22
.2000
,2000
.2000
, 20Qil
,2000
.2000
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 JULY 1sT OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, USTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing fa are true and correct and that I have read or
am familiar with the provision ntained in e ion 2-482 of the Miami Beach Oty Code as
amended, and all reporting r qu r ts.
Signature of Lobbyist:
.x Personally known
a Produced ID
Identify
>>...... USAC. BROOKl,
" . MY COMlolISSlON t CC 856829
~ : EXPIRES: July 20, 2003., . .
,.. _dTMI~Pubic~
a Did take an oath, or
X Did not take an oath
State of Florida, County of Miami-Dade Z f
Sworn to and SUbscri~() before me 00
This _b...f1-.. day of fJ2 . . 2~
~.Q(YwfL
Notary or Deputy Clerk
_---L~C{ C"evvokS . ....
If Notary, print, stamp or type as commissioned
FOR CLERK'a USE ONLY
( ] RElECrED DAl'E' -4 7 f 0;:;>---'
Registration:
MCR#
er
ENTERED BY: