Affidavit (Jasco Constr. Co)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk@ci.miami-beach.f1.us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNCIPAL 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, DURlNG THE TIME PERlOD 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 CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRlNClPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlvrnES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS A )JOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL.'
1) Lobbyist Name: 0, A '2- (' -A-v-l 0 s /1/'\ ,
Last Name First Name Middle Initial
Business Phone c2:2r: y {] - J 1-/63 () Message Phone (_)
Business Address: 'Pj,/ 8 ('('{' keJ I A-lif?- S+e.
Jt1 !?vv1 J No. Street r--L
City state
Email Address:C..-r-I..c.<<i)eN--.-L(.~).CoM
2) Principal Retained by: _ L~)lC.c('1 (/JNc"t-('CAChoN
! .~ '~i / C7 ~N I') 1.Jf- ~\ (; +
If different from above Street
/\11--1' eLM (J FI- .~ 3 ! 2 6
City State
(3 1- i-f(,:2
~ .2, I~ir
Zip Code
IA:c.
.../
Suite
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
Ec~ J-.p ht1. N <S(A 6\ (',.o;Z
3)
Subject Matter (Describe in Detail):
(" CN(',+f'rA('+/'tJ1J 1v14.,u~"" NlpAJ 1-
4. Identify each individual (Commissioners, Board, Committee
to be lobbied: -LA. . {" ,
S. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
a The City Commission on .2001
Cl City Commission Subcommittee on .2001
a City Staff on ,2001
a City Board or Committee on .2001
a Personnel on .2001
Q Identify Others on ,2001
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: tV /,k,
/
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY
CLERK A SIGNED STATEMENT UNDER OATH, USTING 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:
a Personally knowlJ--.i I ... J
V'Produced 10 L: Ioc;t--D- \ l'S- (og~-
~ Identify
~Did take an oath, or
a Did not take an oath
State of Florida, County of Miami-Dade
Sworn ~ sUbscr~~:..:r
This \ day 0 2001.
f}Ck~~~ r f)~fr-~
(J ~ or Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration:
~ FOR CLERK'S USE ONLY
[ )ACCEPTED [1 REJECTED DATE: 1- 11 ~ 0 I
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Profit Organizatio(l .'J /
[lCash []Check MCR# 7squ~()
DATA ENTRY DATE:
.2001
ENTERED BY: