Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerktOlci. m iam i-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNOPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR
DEOSION OF ANY COMMISSIONER; ANY ACTION, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR
COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG PROCESS ON SUCH ACTION,
DEOSJON OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALL Y INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRlNOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVTI1ES
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: e t7LSC::'XAI1 ~c:;-y)
Last Name First Name Middle Initial
Business Phone (30f) l{'-({ -/2. n
Business Address:
c","'-"9L
City
Email Address:
3 g s-
G'M~~'"
Message Phone LJ
Ik(ttf~6tL4 C/.r..c.<..€
Street fi.-
State
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4
.., 3 Suite
oJ 13'1
Zip Code
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2)
Principal Retained by:
tJoc..f'fJEiLG IkVM~
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If different from above
Street
Suite
Oty
State
~."tno.J,~'.; .
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Zip Code, '
(a) If a cGrporation, partnership, or trust, identify and provide the address for the chief
officer, partner,beneficfary or interests.
3)
Subject Matter (Describe in Detail):
fw:tf1'W60 f\lfCl'J/ {JOYL/ft!Dt}
flM>:Jc"7..7
S '-4;"F 75 cll;Oc
4. Identify each individual (Commissioners, Board, Committee, Authority member or Oty staff)
to be lobbied: ~ Co"t'lI$.sIO",,,,"\o(.,. + 1-1/l-NJ!-'tl1''s' Orr,Ce
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
~ The City Commission on 3/1'1 .2001
City Commission Subcommittee on ,2001
(J City Staff on ,2001
(J City Board or Committee on ,2001
(J Personnel on ,2001
(J 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: /lfiJN€
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 r~?I\ts. /7 t/
Signature of Lobbyist: C Y ~ - ? !..J a/
(J ~nally kno~ 11.
~Produced ID t:b.U L. /!J i..fi)+ - 0 I 0 ~ 7 " .-If:>~ - ()
Identify .
~Did take an oath, or
(J Did not take an oath
State of Florida, County of Miami-Dade
SW~9t~ subscribed be ore me
Thi day of 001.
()~& Q ~
- Nvt", y or De ty Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: ~D [l REJECTED DATE: '"'2- /"2-7 /6 I
~ If
If rejected, state reason:
Registration fee paid: ~sh[ [l No eel< N~~~r:~~B'~ (
DATA ENTRY DATE:
.2001
ENTERED BY: