Comvas Co's 3/7/2002
f
...
in
-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(Cilci .miami-beach. f1.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, ACTION OR DEOSION OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANYCITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-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 SPEOFICALL Y INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, 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 TIFICATE OF WITHDRAWAL.n
1) Lobbyist Name:
Last Name Firs ame Middle Initial
Business Phone {ldJ) 5Yy l.t' J j-7 Message Phone L)
Business Name and Address: ct,,/J 7 .4 /?v;'(-'\... /d
- Ide- /M/~( k~~4/J ^
No. Street I Suite City State /
Zip Code
Email Address:
2)
Principal Retained by:
&lnl/'lf-O'
a!.r
1-.., ~~,l ~
If different from above
4t(/.~ /ll!'~~
City
r~o )
S reet
S~
Suite
J..//.:;J~
Zip Code /
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
"~, '
'..I:' ..
.'
>-
Subject Matter (Describ~ in Detail):
t:'~o n pfl-l/r
JJ 1-1/ C" '" J' <7
3)
, ,
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: h... / /' Y "
~ c-- ~ twt. r .//'~~~~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
~ The City Commission
[J City Commission Subcommittee
[J City Staff
[J City Board or Committee
[J Personnel
[J Identify Others
.2001
, 2001
, 2001
, 2001
. 2001
. 2001
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: ~
,;G 1~ ~---
ON OCTOBER 1ST 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 Section 2-482 of the Miami Beach City Code as amended, and all reporting
requirements. ./ ~
Signature of lobbyist: ~~ ___-
[J Personally known /.J
~ Produced ID Ie.. ;) a - g Y'b '). & \' - yJ --::ro _ 0
Identify
[J Did take an oath, or
[J Did not take an oath
State of Florida, County of Miami-Dade
Sworn tq.pnd subscribed before me
This =t (j., day of (h,fA.Jld! ' 2001.
\
(,*/~~
- Notary or D Clerk ."~'\. Uliam ~ H.tfIeId
JM u \~j"""---
fA {t'C( /Yl r<....:. ' e- O;n: Expires FebnuMyf!..i88!
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONL 1 /
[ ] REJEcrED DATE:0J716~
I I
If rejected, state reason'
Registration fee paid: It-i Yes [ ] No [] Not-for-Profit r anizaf n
I j sh Check MCR # 61
DATA ENTRY DATE: 3 J 2001
Registration:
~
Miscellaneous Cash Receipt
&I,Y OF MIAMI BEACH
N~ 24229/
,;)4,G, ~ :H $ D5 00
GV~C\:+ 20~
'\ ~
For
(THIS INFORMATION MUST BE COMPLETED)
d<l~
Preparer:'
Dept:
15:21
... R'S
25
By
EXT:'fl1J