Fisher Island Holdings
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~ECE'VED
02 MAR 20 PH 3: 30
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@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 DECISION OF ANY COMMISSIONER; ANY
ACTION, DEOSION, RECOMMENDATION OF ANY CITY 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, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE OTY
COMMISSION, OR A OTY BOARD OR COMMmEE. THE TERM SPECIFICALLY 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, OFI]CER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAl."
1) Lobbyist Name: 1S4L Sb"'K4t IivHLf:-p7iJ
Last Name First Name Middle Initial
Business Phone (gor) l(Lf{ -I z. 7l. Message Phone~
Business Name and Address: 3~ b ? S""LJ 0- S7 S-u( '€ 2t'>~ d
11,411, 11. :rslsJ
I
No. Street Suite City State Zip Code
Email Address:
2)
Principal Retained by:
f, ~ J/1;::'W.
l~lNIItJ tkL<}IIV'S
If different from above
Street
Suite
City
State
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): J1 'U
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IS J va I- /') A ,N 7(:-vJ.4,/"J elF
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4. Identify each individual (Commissioners, Board, Committee, Authority member or City St\ff)~'
to be lobbied: /'
uohf) ISSf"'N r II-ohl#.
5, The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
Q The City Commission on .2001
Q City Commission Subcommittee on .2001
Q City Staff on . 2001
0 City Board or Committee on . 2001
0 Personnel on . 2001
Q Identify Others on . 2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: _
piO N C
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~'n S io -482 of the M. iami Beach City Code as amended, .and all reporting
requirements. r? /7
Signature of lobbyist: "-1 9 ~ 0-'" .
o Personally known
)4 Produced 10
~ Did take an oath, or
o Did not take an oath
Identify
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of ~ . 2001.-
~ uJJ.-
Notary or Deputy Clerk
~
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: [~ACCEPTED [] REJECfED DATE: S/?'o / () ;2..-
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Profit orgari~~'hD
~ Cash [ ] Check MCR # J:l ~Ob(~_ .
0':)- ~_'
DATA ENTRY DATE: I 0 .~. ENTERED BY: v 0
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