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Dacra 2/8/02 ... ..04. CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK LOBBYIST REGISTRATION AFFIDAVIT LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS A1fi AGENT, OFFICER OR EMPLOYEE OF A PRINCIPAL. EACH PERSON WHO WI~HDRAWS AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL." (1) Lobbyist Name de la Fuente, Bob LAST NAME FIRST NAME MI Business phone ( 305 ) 536-1112 (Tew Cardenas Rebak Kellogg. et al.) Business Address 201 S. Biscayne Blvd., Suite 2600. Miami FL 33131 (2) Principal Retained By: b~c~ Principal's Address Zip (IF DIFFERENT FROM ABOVE) a. If a corporation, partnership, or trust, identi fy and provide the address for the chief officer, partner, beneficiary, or interests. (3) Subject Matter (Describe in detail!) <'t. C/J.1we;< ~1\.D1€LY- 't~\le~Hf t..'l'r' ~^..(,l\,~IS ~f,) duE)', ~9 '1l\f c.'l-y lOiliii \r'~ ~~ A.r-)tl {h()k\Rll fJt AA:rIJItJ.ic!'iJc (4) Identify each individual (Commissioners, Board, Committee, Authority member, or City staff) to be lobbied. , \AIJ"fl~7 \E t1tt ~ >-tr 1-.1''1'' (5) The subject matter in number (3) above is to be considered at the meeting of: (Identify each entity or individual o The City Commission o City Commission Subcommittee o City Staff o City Board or Committee o Personnel o Identify Others ,19_ ,19_ ,19_ ,19_ ,19_ , 19_ on on on on on on ... (6) State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above. , f 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 ofthe 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 r . erne ts. Signature of Lobbyist: ~OnallY known o Produced ID (IDENTIFY) o ))id take an oath, or rt Did not take an oath State of Florida, County of Miami-Dade Sworn to"'" ,""scribed ~ this ~ W'-' day of R , If a Notary: Print, Stamp or Type as Commissioned !oNA tot llMlNIZ NC7I'AltY PUlUC STATS Of)ll.OlUDA COMMllSlON NO. CC8S9t17 N EXP. Y .............................................................................. Registration: Ifrejected, state reason: / Registration fee paid: ~s FOR CLERK'S USE ONLY o REJECTED DATE o DATA ENTRY DATE o Not For Profit Organization o Documentary Proof ttached eck MCR No. ,~ ENTERED BY 221998