Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerktOlci .miami-beach.fl.us
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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, ACTlON OR
DEOSION OF ANY COMMISSIONER; ANY ACTlON, DECISION, RECOMMENDATION OF ANY CITY BOARD OR
COMMmEE; OR ANY ACTlON, DEOSION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKING PROCESS ON SUCH ACTlON,
DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALLY INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATIORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlVITlES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATIORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A 'CERTIFICATE OF WITHDRAWAL"
1)
Lobbyist Name: BORRELLI
t.ast Name
Business Phone (305) 665-6852
JAIME
Rrst Name
E.
Middle Initial
Message Phone Q05) 665-8852
SUITE 408
Street
FLORIDA'
State
Suite
Business Address: 4960 S.W. 72ND AVENUE,
No.
MIAMI
33155
Zip Code
City
Email Address:
ieborrelli@borrelliarchitects.com
2) Principal Retained by: BORRELLI & ASSOCIATES ARCHITECTS PLANNERS, P.A.
SAME AS ABOVE
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.
JAIME E. BORRELLI
SAME AS ABOVE
3)
Subject Matter (Describe in Detail):
.RFQ 5-00/01
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4. Identify each individual (Commissioners, Board, Committee, Authority member or Oty staff)
to be lobbied: COMMISSION AND MAYOR
S. The subject matter in number three (3) above is to be considered at the meeting of
(Identity each entity or individual):
o The City Commission TO BE ANNOUNCED on
o City Commission Subcommittee UNKNOWN on
o City Staff CANNOT BE LOBBIED UNDER "CONE OF SILENCE" CJIDjINANCE
o City Board or Committee UNKNOWN on
o Personnel CANNOT BE LOBBIED UNDER "CONE OF SILENCE" ClililINANCE
o Identity Others N / A on
.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:
NONE
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! have read or
am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code as
amended, and all reporting reqUirreny / _
Signature of Lobbyist: _~ _
ill Personally known
o Produced 10
JI1/ME ~rel/I .
Identity
;'i,;",
Q( Did take an oath, or
o Did not take an oath
1!.Yf'&. DEIltA ZEeHE.
j'r tb -It~ COMMISSION # c:c 10650~ .
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Notary
or type as comm~oned .
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 9TH day of MARCH. 2001.
Registration: [j ACCEPTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE:
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If rejected, state reason:
Registration~paid: Yes []N []Not-for-profit9r~z~/yt6 " .
[ ]Cash [ Check MCR# .~ ~ . . ..
DATA ENTRY DATE: ..$/I!f/O/ .2001 ENTERED BY: ~ .... .-.--,.-
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