Affidavit (02/13/2001)
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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 OTY 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 FORESEEABLY WILL BE HEARD OR REVIEWED BY THE OTY COMMISSION,
OR A CITY 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 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 'CERTIFlCATE OF WITHDRAWAL."
1) Lobbyist Name: ~l..h.OA~TY"' Gcf....,..J&' K
Last Name First Name Middle Initial
Message Phone (_)
?rei
Street 7/ .s3/~t~
City State Zip Code
Email Address:CE:RIf/c:/..@?~O..nt13Q.IK..H/n.u.(!0.n1
Principal Retained by: (' 1I4..Je..J.-eA..c'o.. b-t S~uf{), ~<:J."\ L' C
Business Phone <La('" t- '73 .. / / 0 I
Business Address: / / /1' ,t... Me::....=> ~
H'I$ No.
~." "DO
2)
If different from above
Street
Suite
Oty
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
SIA.s.~ ~"'''4J
3) Subject Matter (Describe in Detail): ~l \ IMAa...J+e("S ~ lo.Je:cO
.::b Ofll1.A.u....1 a... ~...l7'llAArr~ ~ /~c~ ""Pc!!
Oty ~ff)~-/t'
~yI-
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
.2001
.2001
.2001
.2001
.2001
.2001
on
on
on
on
on
on 2//3
/
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: ~
///~
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY
CLERK A SIGNeD STATEMENT UNDER OATH; USTlNG . LOBBYING EXPENDITURES IN
THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are tru~ ancJocorret!t and th1!lt r have read or
am familiar with the provisions~, ined in Section 2-482 9f th iami Beach City Code as
amended, and.all n:!poltin equi ents:" 1 .... , . ,
.:_'l, A
Signature Qf Lobbyist~
~ Personally knpwn.
o Produced Iii> ..
,
t .~ ...;.~
.~ J r I
.. ~ ')"- ,. ';~. .'" " ~ '
o Did take an oath, or
o Did not take an oath
I~entify
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State of Florida, County of Miami-Dade
Sworn to and SUbSCribe~re me
This L"'3 day of r--. 2001.
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If Notary, print, stamp or type as commissioned
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Registration: ~ ACCEPTED [] REJECTED
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Protit Organiz~~on 3
[]Cash~Check MCR# ~3'#)l_
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FOR CLERK'S USE ONLY ..
DATE:
a/;-2,/tJ I
2001 ENTERED BY: