Affidavit 10/04/2000 #2
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci. m iam i-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, RESOLUTION, ACTION OR
DECISION OF ANY COMMISSIONER; ANY ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR
COMMmEE; 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 OTY COMMISSION,
OR A OTY 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 LOBBYI)T I7REQUIRED TO FILE A "CERTIFICATE OF WITH~WAL."
1) LobbyistNa~ 1:.d?bT" c;;: 60 op[~~
Last Name First Name Middle Initial
Business Phone~q:?73 ~ ~O/Messa e Phone (_)
Business Address: '3 S '
State
/ 0 Suite
Zip Code
City
Email Address:
2)
City
State
Zip Code
3)
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
otfi~r )lart~er, begeficia~nterests. I
t/~ ~4 /J~/hd..
Subject Matt r Describe in Detail):
10 iA.. r ~ e-
4. Identify each individual (Commissione~ Board, Committee, Authority member or. City staff)
to be lobbied: .' -
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual): '/0 d--oI1tf---
.2000
.2000
,2000
,2000
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.2000
e City Commission
o City Commission Subcommittee
dvOty Staff
o City Board or Committee
o Personnel
o Identify Others
on
on
on
on
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: ~ /~011 ~
ON JULY 1ST OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEM~ UNDER OATH, USTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing cts are true and correct and that I have read or
am familiar with the pro i '0 s contained i e ion 2-482 of the Miami Beach City Code as
amended, and all repo i i ts
Signature of Lobbyist:
~~~~:~YI~now{j ~~ -177~~9 ~3 b ct
Identify
o--1:5id take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn yd subscribed be~e
This day of 0 . 2000.
~
~f)j~
, Nom! y or Deputy Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY J~
[ ] REJECTED DATE: JD,~ 6i)
I
Registration: [] ACCEPTED
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] NJV"'l ] Not-for~~on
[ ] Cash ["1 Check MCR
DATA ENTRY DATE:
.2000
ENTERED BY: