Jasco Construction Company
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aty d rotarni Beach 0lIice d the aty ClerK
1700 ComIention Cenb!r Drive, Miami Beach, R. 33139
Email: dtyderk@ci.niami-belld1.f1.us
LOBBYIST REGlSTRAnoN FORM
(aty d Miami Beach, aty Code Chapter 2, Division 3, Section 2-481)
.Il5 Chec:k Box If .n Amenclment
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(Last)
"fl;,-fi{;~2
F. . (
(aty (State) (Zip Code)
.M/7- L./ 12.-/3~1I {' AI'/A ~ ('hAz...Cd. c.o..vt
FAX NUMBER: EMAIL:
.?/)~- 4/7 - / 'I ~~
lELEPHONE NUM3ER:
(~?J/7 c<SW
BUSINESS ADDRESS: (Number and Street)
3of)~ 23 Lf - ~ 'iLf~
lELEPHONE NUMBER: FAX NUN3ER: (Optional)
I. ~"'AB8)1IYl C
0A-5 r ~ ~^)t?...J-r.IAL4-/ ()AJ f)Mf)NJl' IA.J r
NAME OF PRINCIPAlI : I '
/211-1-h S (. f11/AMt' FL 33/ ~~
(aty) (State) / (Zip Code)
EMAIl: (OptIonal)
RlIIIII:'* ......Ir..l. '1 'In Q...... 11-. ....tl.-~ _'1ftIIt [Sed1D112-482 (e)]
? NAME OF CHIEF OFFICER. PARlNER, OR BENEFICIARY:
E"~tc,PAAJ S(A.~""~2-
? LIST ALL PERSONS HOlDING, DIRECTl. Y OR INDIRECTl. Y, A 5% OR MORE CMlNERSH[P IN1"ffiEST IN SUCH
CORPORATION, PARJl<ERSHlP OR 1RlJST:
)r~ Bf't 2ueto... / E5+eb~ SCAA-f'e~
Do . E d"- LOBBY IBIRE:
See.k ,',..;
Issue Ix> be lobbied
. (.,{~ +e
+t?-...+ION #2.
DL c:ny M1Eh,. d~JIN)IVIDUIlLS TO BE L<III .....
A)......._ afll.ll.1J 1}'ftIe
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IV. msa 0Il_ OFlERMS .MUMOU'f1S OF LOII8YISI' OOM'EUSA11a'II (DIBCUISll' WIEnER HOURLY,
RATRATEOR OTHER):
B) PRINCIPALS DISCLOSURE (OF LOBBYIST COMP8'6ATION):
f I,?!). 410 / h r
/
~ f/?c//h r
A) LOBBYIST DISCLOSURE:
V. SIGNA~UMlI!IlCM1H:
ON OCT'OIER 1'" OF EACH YEAR. EACH LOBBYIST SHAU. SUllMIl'TO THE c:nY a.ERK A SIGNED
SfATI!MI!NT UNDER OATH, usnNG LOBBYING EXPENDIlURES IN THE c:nY OF MIAMI BEACH FOR
THE PRECEDING CALEllDAR YEAR.
Signature of Lobbyist:
and that I have read or am
Beach City Code as amended, and all
I do solemnly swear that all of the fo
familiar with the provisions contai i
reporting requirements.
Signature of Principal/Client:
VL
.II! Produced 10
Fonn of Identification
.II! Personally Known
VB. SlGNA1UII!! AND SI'AMP OF NCmlIlY at DJ!IIUI'Y aBIIC
State of Florida, County of Miami-Dade
Sworn to ~ subscribed before me
This ~day of 11JN. ,2002.
~,~y'!.;;:""" Teresita ~Ut.;,
~f.,"'l&'~;Commis.ion # cc 9381~"
~""...A/~~ Expires ~ 18,2004
".,~/j-DF'f....~"'~ .Bon. Thru
'1/111\\\' AtlantlQ Bonc:hR{l Co., Inc.
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Print, stamp or type name of Notary Public
FOR CLERK'S .. OIILY
Registration: J><I ACCEPTED [] REJECTED
DATE: J UtJf:, 2..Cf -M....
If rejected, state reason:
Registration fee paid: ~Yes [ ] No
'[ ] Cash 'k1 01eck. MeR # ~~~ 0 '2.-,
DATA ENTRY DATE: Ji.)t.J0 1Uf .2002 ENTERED BY:
1
I First~-05/17f02