Affidavit (01/08/2001)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .miami-beach. f1,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 CITY 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 LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: 11fC ftyv1f;; Au:::y4tJ.fjttL ~ -
Last Name First Name Middle Initial
Business Phone Q::S) 3Lf"12y?cr Message Phone (_)
/00 S ~ d-U J+.
No, Str~~
State
fvl~'<
City
39a..o
~'3 1'3/ Suite
Zip Code
Business Address:
Email Address:
f2; fa.cJ.,'*'Y@J qp(. ~
Idol~~~~~
>>61 &LL":'-- ~,
2) Principal Retained by: to
O~S..;~ ~ {~....c ,
If different from above
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City
,\
Street
FL-
State
Suite
'3~i39
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
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3)
Subject Matter (Describe in Detail):
, .
I (Commissioners, Board, Committee,
r' ,
(J ~'
4. Identify each individ
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):
/'
0he City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel ~
e/Identify Others <r ~' o~
,
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,
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on
on
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6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: ~
'~
O~ OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SiG~TEMENT UNDER OATH, LISTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do soiemnly 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 ~uirements. ~~
Signature of Lobbyist: ~ 9.... '.eJ Q "" ~
o Personally 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 sUbscribt~~~7e
This R!:1L day of 200d. /
/
(/I)~~
Notary or Deputy Jerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
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Registration: [XJ ACCEPTED
[ 1 REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ 1 Yes [ 1 No [l Not-for-Profit Organization
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DATA ENTRY DATE: 1 e/ (),I ~I) ENTERED BY: ' W