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MB Redevelopment, Inc. 2/8/02 ~ /" ", 10 ,. . CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK LOBBYIST REGISTRATION AFFIDAVIT LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS A/fi 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: }...l-~. fLf.btd.nj!J; J-J'( I j",c Principal's Address Zip (IF DIFFERENT FROM ABOVE) 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!) \ f.~de~.NE IJl Sire & f. 11\[ A ol'.lJVC I~ tJ. 'OY l: J ~~~-r 11 ON S ~T fbOI )1) 111~ (1{(;I\.).! A ~bMl~lll s " k;uJJ (4) Identify each individual (Commissioners, Board, Committee, Authority member, or City staff) to be lobbied. C /L,s"t- :tJA ~ llJ(JlUO . I BOII)At J(..f~t' (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 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 re erne ts, Signature of Lobbyist: ~rsonally known o Produced ID (IDENTIFY) o ))id take an oath, or ;t Did not take an oath State of Florida, County of Miami-Dade Sworn to and subscribed efore me this ~ day of If a Notary: Print, Stamp or Type as Commissioned NorgY~~:::Pf.clIuoA MMlSSloN NO ,..,..,..... MY COMMISSION ",,'; ...........111 "".-. Y28 ****************************************************************************** Registration: FOR CLERK'S USE ONLY o REJECTED If rejected, state reason: / Registration fee paid: ~s o Not For Profit Organization o Documentary Proof Attached MCR No. ENTERED BY 221998