Loading...
South Beach Ocean Parcel " m :111111'" City of Miami Beach OffIce of the City Oell< 1700 Convention Center Drive, Miami Beach, FL 33139 Emall: dtydell<@d.mlami-beach.fl.us LOBBYIST REGISTRATION FORM (Oty of Miami Beach, aty Code Chapter 2, Division 3, Section 2-481) .15 Check Box If an Amendment t1..o 0 a fl'i u--J.~ NAME OF LOBBYIST: (Last) toloo (M.!) DATE QUAU~ED AS LOBBYIST ,::t. 3~13 (Zip Code) ixU. to-hJb..u .&r,., EMAIL: (50$') 53(,- H Co2 TELEPHONE NUMBER: (aty) BoS') .<)3b- l\ \10 FAX NUMBER: L LOBBYIST' RErAlNED BY: ~1)dQ.:.h Pua..-eh ()~ ~o.JW. Idd - do ~ &IJ.~ ~1~Jl.1' NAME OF PRINOPAl/CUENT: ~ (P'1 ~~ a.t1.t ftU-Q.. BUSINESS ADDRESS: (Number and Street) j 'I.f~ ~( I n~lot ~ ~/c }t)CO 100.;)l (City) (State) (~iP Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) FIll out this HCtIon If prtndplll Is B CorpaI'IItIon, PlIrtnenhlp or nu.t [SecIIon 2-482 (e)l ? NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY: W dr; Rrru <?L .$..ctw/ UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARJNERSHIP OR TRUST: ~ ,tj; .eilN/ D. SPECIFIC LOBBY ISSUE: m. ClT'f AGENCIES/INDMDUAlS TO BE LOBBIED: A) Full Nllme f111lndlvlduBI{I1tIe B) ReIBIIoIRlp IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSA110N (DISCLOSE WHE11tER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: ~; J O~ ~ S'a.a&()e) B) PRINCIPAL'S DISCLOSURE (O~~~OMPENSATION):_ ~ e'V\ ~/ C6edlO v. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR. EAOt LOBBYIST SHALL SUBMIT TO THE CITY CU!RK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDnuRES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. I do solemnly swear that all of the f egoing facts are true and correct and that I have read or am familiar with the provisions con . e in S ion 2-482 of the Miami Be City Code as amended, and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFlCA110N: 15 Producecl ID Form of Identification ~Kno;> YD. SIGNATURE AND STAMP OF NOTARY OR DEPUIY a.ERK: State of Florida, County of Miami-Dade Sworn to~d sUbscribfd ~D~~e me This 10 day of ~ 2002. ry - State of Florida ,..; ~ EIIzabel/I BernardO Print, sta~~"ry Public FOR CLERK'S USE ONLY Registration: [] ACCEPTED [] REJECTED DATE: If rejected, state reason: Registration fee paid: [ ] Yes [ ] No [ ] Cash [ ] Check MCR # DATA ENTRY DATE: 2002 1 1 First Revision - 05/17/02 IV. bJSCLOSllRE OF TERMS AND AMOUNTS OF LOIIBYIST COMPENSA'IIOtI (DISCLOSE WHETHER HOURLY, Fl.ATRATEOR. OTHER~ A) LOBBYIST DISCLOSURE: -.....funu 0 (f ~ S'~ s.,oo B) PRINCIPAL'S OJSCLOSURE (OF LOBBYIST COMPENSATION): ~ 6'Y'- LtA Wl~ i:Jg ~ Y. SlGllAlURE UNDER ~tH: ON ocroBER 1ST OF EACH YEAR. EACH LOBBYISI' SHAI.L SUBMIT' TO THE CLERK A SIGNED srll.TEMENT UNDER OATH, LISTING LOBBYING EXPENbrruRfS IN THE OF MIAMI BEACH I"OIt THE PRECEDING CIl.LENbAR YPR- Signature of Pr1ndpaI/Client: VI. LOBBYlST IDENTJI'ICATtON: . PruducedID tofl;:t, T2 1J-lW~~~ ~,lM Fa o1tdentification c5?t ~ d that I have read or am City Code as amended, and all I do solemnly swear that all of the familiar with the provisions con . reporting requirements. Signature of Lobbyist: " Personally Known YD. SlGJtAlUU AND sr""P OF NOTARY OR DEPUTY ClERIC: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of J 2002. Signature of Public Notary - state of Florida Print, stamp or type name of Notary Public FOR CLERJ('S USE ONI. y Reglstr~tion: [] ACCEPTED [] REJECTEO DATE: If rejected, state reason: ltegistratlon fee paid; [ ] Yes [ l No [] sh [ ] O1eck MeRit DATA ENrR.Y DATE; 1 2002 ENTEREO BY: I First ~15ign - 05/17/r:12 ESO-~ BOO/EOO'd ~IE-l SlllsmOE+ ~va~ SVN30HV~ M31-MOH~ ~Vlg:BO ~002-l0-l0 STATE OF FLORIDA, COUNTY OF MIAMI-DADE SWORN TO AND SUBSCRIBED BEFORE ME TInS ~ DAY OF 0'1#1"r- . 2002. ~:r~~, / N&w I..te"u-- Print. stamp or type name of Notary Public KIIIHRYN Eo 8M.VEMINI NalllJNIIID. _clNlWl1IIk Nlt.018Ml11 IIDI o - '''NlWlbIkCallllr ~.".J 11,",___"~ E90-~ BOO/vOO'd ZlE-l 91l19E990E+ ~va3~ SVN3a~v~ M3l~O~~ WVL9:80 ZOOZ-lO-LO ~ . , ~