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Affidavit (Eddi Chabble) m - - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerklOlci. m ia mi-beach. fl. 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, DEOSION, 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 DECISION-MAKING PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE OTY COMMISSION, OR A OTY 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 f)LE A "CERTIFICATE OF WITHDRAWAL." 1) LObbYistName:_1)?Oc.,~ ~ d- Last Name f First Name Middle Initial Business Phone ~ 57 q - D (d') "'$ Message Phone (_) Business Address: I Z- L. ( 0> J2LcJu ~ (r;-..J e _ No. Street Suite City Email Address: State Zip Code ~ ~ /7\..tJ tJ e.e AJ "^^ Street Suite 2) Principal Retained by: If different from above L( D m l>\.JZ City State 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): ~ I') fl (re , 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: :p-~ 0> -S u f( ) 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): on~nJ\.cJJ on on on on on 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 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: r'DflfL V ,- 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 2-4 of the Miami Beach City Code as amended, and all reporting requirements. Signature of Lobbyist: o ~onally kn~n 1/ p../Produced ID t i-()L M?'.::'; - J-:L I - </'1 - 7 J' ,- U Identify o Did take an oath, or o Did not take an oath State of Florida, County of Miami-Dade sworr:d~ sUbscrii4 before we This day of 0,./UJ02001. fl~~~ eputy Clerk If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: [~D [ ] REJECTED DATE: If rejected, state reason: ~ Registration fee paid: ll.])fE5 [ 1 No .....--'- ] Not-for-~gqn~~~'P [ ] Cash [l...fCheck MCR # ~u DATA ENTRY DATE: .2001 ENTERED BY: i.'<