Affidavit
m
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(Cilci. miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNOPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR
DEOSION OF ANY COMMISSIONER; ANY ACTION, DECISION, RECOMMENDATION OF ANY cm BOARD OR
COM~~mEE; 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 FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE cm COMMISSION,
OR A cm BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIvmES
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: (fa d.t:t.(a. - HCW"/a... fla-1v/C/A- J2.
Last Name First Name Middle Initial
Business Phone (.?t>5) 19"'-1- 0 tl ;L.;t
Business Address: 331 f)alb1/VY-,o
/' ~~ I No.'
vl"Y"" Gwbu5
City
Email Address:
Message Phone (_)
6I-J.;UJut:.-
Streetp- t.
State
~?/Jjite
Zip Code
2) Principal Retained by: J" tJYq.e &. H-w V1 U414 fly~.kd.
~1A/v1'V'
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.
J ~5~ L. I-le-vVlt:/.A.'lo<?l '" Ilrc..hifed-
3) Subject Matter (Describe in Detail): ro/Yuudt"n~ o/t',c.y, 1- m ""
ci-ur C()m r.:i Fi ,-n~5 h~avin.1'; ~ v/JVViCt/VI u- -nJv'
ntWV urt~q ,,-I /30 5". HJJris?tAS (;jy/Ix
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: BDA/vd d 1Jt?t vv. d m (/n 17;,.
o
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
0 The City Commission on .2000
0 City Commission Subcommittee on .2000
0 City Staff on .2000
;s( City Board or Committee 8 on . zeoo 2~/
0 Personnel on ,2000
0 Identify Others on ,2000
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
ON JULY 1ST OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, US1lNG A 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 requirements.
Signature of Lobbyist: f~ ~.~
o Personally know~ 3 - (q / J A
~Produced ID l J 4!J - \0 L, - '/ U - lO is'' - u
Identify
g/[)id take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
sworn~d sUbscrir~r
This , day of 2000.
f1f)tt4f! ~
If Notary, print, stamp or type as commissioned
Registration: [~ED
If rejected, state reason: /
Registration fee paid: [LfYes [ ] fJo ---Y1 Not-for-Profit O~nization I
[ ] Cash ['t"C""heck MeR # ~ :2, ~ 4-- I ..
. 2000 ENTERED BY:
FOR CLERK'S USE ONLY
[ ] REJECTED DATE:) - S-- OlD
DATA ENTRY DATE: