Affidavit (Leah's House)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Cel,ter Drive
Miami Beach, FL 33139
cityclerk(1ilci .miami-Ileach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL 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 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 DEOSION-MAKING PROCESS ON SUCH ACTION,
DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALL Y INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER 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 'CERTlFICATE OF WITHDRAWAL"
Michael
First Name
r..essage Phone <->
w.
Lobbyist Name: Larkin
Last Name
Business Phone Wl5) 377 - 6 2 31
1)
Middle Initial
City
Email Address:
2) Principal Retained by:
Leah's House, Inc.
If different from above
Miami Beach
State
33131
Zip Code
850
Suite
Business Address: 200 s. Biscayne
No.
Miami
Boulevard
Street
Florida
City
420 Lincoln Road
Street
Florida
SMe
suite 240
Suite
33139
Zip Code'
(a). If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
3) Subject Matter (Describe In Detail): Vari.ance to permit the sale of >beer
and wine at the House R~~~~l]rant
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: Board of Adjustment (~ puhli( f>>ltl) ; CJ~ rt4
5. 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 .2000
a City Commission Subcommittee on .2000
a City Staff on .2000
ltJ City Board or Committee Board of Adiustment on Fp.b. 2 ,2001
- Person nel on ,2000 .
a
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, USTING 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: ~ ~
X Personally known
a Produced 10
. :~~. .
..,
Identify
,', '
o Did take an oath, or
J( Did not take an oath
State of Florida, County of Miami-Dade
Sworn f-o ~ subscribes! before me
This ~day of ~ 2000.
..,..";~.,, , LISA C. BROOKS
f!':iJ:~ MY COMMISSION # CC 856829
. " i;j EXPIRES: July 20, 2003
~->':fl.';-;';'" BondedThtuf'tolaryPublicUndlilrwriters
....,"'.
~G~
Notary or Deputy Clerk"~ ..T.
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
/ jrt/o I
Registration: ~ ACCEPTED
[ ] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-ProfiUlr.9.anlzatiQr\ '7
[ ] Cash [--rcheck MeR # ',j--f- I.-{ 'l! '-f
DATA ENTRY DATE: ,~/ /1ft I .2000. ENTERED BY:
,~ . :1