Affidavit (03/28/2001)
,~
~
-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .miami-beach. fI,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 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 FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
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 ACTIvmES 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) LObbYistName:JlI~~S.\~tJ, ~B"vt\
Last Name First Name
Business Phone ~~ l-~~{")o Message Phone C_)
Business Name and Address: lA ~Lg,\ cJ M.", ~ \J (\. tt.N~t r I ~\ .,.... L
901 ~Nc..~~ I ~-.l ~l...~ ~\ c.t>l'4'c\.~c.(Lr I f~ ,
No. Street Suite \ City State
~.
Middle Initial
~I~c..{
Zip Code
Email Address:
2) Principal Retained by: _IA L- G 0-6..lf'>
n> 0 1 ~ v->. ") L.f C'"t" sns: to3.,
If different from above Street
r-<I~I f::'.... ~ "!. I S.1-
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
'^ L- (2..\ e.A-(. f.~
I
3) Subject Matter (Describe in Detail):
~~;J~~
f"/l..()~L~ JU.1'ctJ~61~tc-\r....,.fl\ ~~ (\... p~ I
, .
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
tobe lobbied:
(.() r.v-.M-\ s.~ 10 /I,)
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
on M.\.,.c.....
on
on
on
on
on
wThe 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:
t-,JotJs...
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING 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
requirements.
Signature of Lobbyist: ~ -fJ '#--9
o P~onally known _ :'\
Vroduced ID JJ-.bLH 5d-.3-16( -~3 ~ IOI-u
. /' Identify
w/'Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
swor~bscri~d befor~
This ay of r"(1 1.
CQ'O~~I
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY j
Registration: 'E/(:C:~EPTED [] REJECTED DATE::A I d 0 l---
I (
Ifrejected,statereason: ~
Registration fee paid: [~es [ ] No [] ~ot-for-Profit Organization
[ ] Cash [ ] Check ~CR #
DATA ENTRY DATE: ~ J 2--(/01 .2001 ENTERED BY: