Jeff Bast
r
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(ii)ci.miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLLrrION, ACTION OR
DECISION OF ANY COMMISSIONER; ANY ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR
COMMITTEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMIlTEE. THE TERM SPECIACALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFACER OR EMPLOYEE OF A PRINCIPAL, 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 A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: ~E{2MS La",,' "-
Last Name First Name Middle Initial
Business Phone ~3 7I..J .. 8 60t:> Message Phone L)
Business Address: 10\ 8". c..J{~\, A ,I eNvC
No. S~L
City State
Email Address: Ll'JEEi\-\&e.1-\.,(lA'YJ.COM
Principal Retained by: -:Je-{' ~ Be. S--t
N\; ~N\\"
...36c1O
33 SUite
/3. J
Zip Code
2)
If different from above
Street
Suite
"l
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address forthe chief
officer, partner, beneficiary or interests.
3) Subject Matter (Describe in Detail): Rt.~ve6..J-J \/AR"{.)lJeE of
M\",i(Y\v~ ~')~+-f7,jo.c.K ~8~udtE.mE'-&+s 0;""\ side AND a.e,:)~ Df
Lc..k
4. Identify each indiv~ual (Commissior:!ers, Board, Committee, ~uthority member r City staff)
to be lobbied:' l.O S on ~ Lon\
\.
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
.2000
, 2000
, 2000
, 2000 ~
, 2000
,2000
o The City Commission
o City Commission Subcommittee
o City Staff
~ City Board or Committee ~l ( €:d. 0( Ad j ,
o Personnel
o Identify Others
on
on
on
on ,c:y..pf-. l(
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:
. ~O VI e...-.
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 ["ljIuirerl!"'%... ( .
Signature of Lobbyist: cA~ ~~
~rsonallY known
o Produced ID
Identify
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me:2.oca
This ~4.t-t day of ~ ~
I ioned
~ FOR CLERK'S UsE ONLY
~CEPTE~ DATE:
Registration:
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