La Gorce Country Club 04/08/02
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(Ci)ci .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, ACTION OR DEOSION OF ANY COMMISSIONER; ANY
ACTION, DEOSION, RECOMMENDATION OF ANY OTY BOARD OR COMMmEE; OR ANY ACTION, DEOSION 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 FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE OTY
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 ACTIVrnES 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 A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: CUffe /2..A...cz.. 1f1l1J1A'~Da
Last Name First Name
Business Phone (3 0)) ~ [b -I '1 ~ <( Message Phone (~~
Business Name and Address: t J, 0 \ (? tt { C 1< ( ~ 1W f:-
A ( /.J- lit
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No. Street Suite City jH ..
Email Address: ~A1IDo ~(.Jt(~~,t-#.P ~S'oc.l"f~. 0/11,
2) Principal Retained by: I~ C.~ ClcJ~ ~p
s'C g f /yL. -rtJ7\T /l,()a, -
If different from above Street
I'tlhM, 1~p-- ~~
City State
Middle Initial
3Jf:(-!'b Y'f
S'Jrr E ';J 2- 0
r:l.,R--
, .;state
1:!J/] ,
Zip Code
Suite
, " yu
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 Detai~:, ~ J/lnb 17..... _ _ _ d - - ~ ~ .L
DtLD /lJ}Ir,/l. e Rd5-4s- ~ L:!/ ft/V~ {;U/.;..-v~-
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied:
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5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
/'
VThe City Commission
CJ City Commission Subcommittee
~ City Staff
CJ City Board or Committee
CV't>ersonnel
CJ 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: ../'"
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ON OCTOBER 1ST OF EACH YEAR, EAC:H 1.0SMST SHALL SUBMrt rb 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 swe~r that all of rJjh oregoir'\9 facts are t~ue and correct and t;hat I have read or am familiar
with ',t.he provisions contained in e ion . 482 of the. Miami Beach City Code as amended, and all reporting
reqUlr~~nts. '.\
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Signature of Lobbyist:
CJ ~nally knoVV'1 Cr. q () 3 () 7' I .'
~P;~d~ced ID ()J (;)
Identify
....'... '" ~
I .)
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9 Q.i,d-take an oath, or
~id not take an oath
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State of Florida, CountY of Miami-Dade
S~orn ~ subscrffl ~f~~ejne--.., ""\J1,'l ~ ~ " .
ThIS~dayO~ LIJUIic7VV ~ ~
Deputy Clerk
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If Notary, print, stamp or type as commissioned
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Registration: ~EPTED
[ ] REJECTED
FOR CLERK'S USE ONLY
DATE: 'tl?l ~
If rejected, state reason: _____
Registration fee paid: ~s [ ]~Not-for~~niza~
~sh [ eck MeR ~
DATA ENTRY DATE: ., .~ ENTERED BY:
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