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Affidavit 02/28/2001 17:58 FAX 3054439339 tien, bY: Wti~/Hl11iard 305 673 5352 CORNERSTONE GROUP 02/2B/01 15:41 JOb 240 1aI001 ~age 2/~ '" ~~ If lD CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerktalci.mlanii-beach.f1.us AFFIDAVIT LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAlO OR NOT, BY A PRINCIPAL WHO SEEKS TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE. RESOlUTION, AmON OR DEOSION OF ANY COMMISSIONER; ANY ACTION, DEctSION, RECOMMENDATION OF ANY em BOARD OR COMMffiEE; OR ANY ACTION, DEOSION OR RECOMMENDATIoN OF ANY PERSONNEL DEANEp IN ANY MANNER IN THIS SEmON, DURING THE TIME PERlOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION. DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE drY COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALL Y INCLUDES THE PRINOPALAS WEll AS ANY AGENT, ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAl, REGARDLESS OF WHETHER SUCH LOBBYING AmvmES FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO ALE A 'CERTIFICATE OF WITHDRAWAL' ... 1":" .,--- Lobbyist Name: w,~~(. ..l()~e.W last Name First N~ Middle Initial Business Phone &(1.!.-4; 3. f; 2., 1_~ Message Phone ~) 2.&1 ~5'~' I. B~5inessAddre5s:91o?5' .~...D1.xlE~~t~ ..--:: 200 Jlh~~(a ~~t-<. NO. ... _Str~ :3~~_ Ci ty . Sta te Zi P Code 1) Email Address: 2) Group ~- Suite "33/3 tf Zip Code Principal Retained by; The Cornerstone 2./L.I PCJ.JCG ve le.eu C If different from above o 12 "<.. '~(..t:'3 Oty ~l..UD str~ State (a) If ~ cOrpOration, partnership, or trust, identify and provide the address for the chief . _offi~er,-partner, ber::~~iary or intereS~1 J .. ~ ~()~~ . .~~.r 1)+oAiJi . rt~ Subject Matter (Describe in Detail): 11.iiY. S'F .' " R P ~ 3) 4. t~d~~~l~i~~ ~J~m~~:~~~m~itte~,!,~-:~~~~r or~~ff) FEB. 28 '01 (WED) 17:58 COMMUNICATION No :45 PAGE. 1 Sent by: WSP/Hilliard 305 673 5352 02/28/01 17:45 Jab 246 Page 2/2 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): III The City Commission CJ City Commission Subcommittee :J City Staff o City Board or Committee CJ Personnel CJ Identify Others on () I.) to (lm.&)il . 2001 on . 2001 on . 2001 on . 2001 on . 2001 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: 1\01\ <.. 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 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 repo' requirements. Signature of Lobbyist: ~rSOnallY known o Produced ID ~ take an oath, or o Did not take an oath Identify State of Florida, County of Miami-Dade Sworn to and subscribed before me This ..l..l::td-.. daYOf~\"""''''J .2001. ~. Notary or Deputy If Notary, print, stamp or type a l FOR CLERK'S USE ONLY t [ J REJECTED DATE: 3/, _ 0 I f If rejected, state reason: ./ Registration ~ paid: ~ ~ ~sh[ [~ ] N~~~r~~ ~2{D~tir DATA ENTRY DATE: .2001 ENTERED BY: Registration: FEB. 28 '01 (WED) 18:48 COMMUNICATION No:49 PAGE. 2