Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklCilci .miami-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
AmON, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY AmON, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SEmON, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING
PROCESS ON SUCH AmON, DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A cm 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) Lobbyist Name: tAvftMcm ~C:>l\.ot.tJ.
Last Name First Name
~OS 31l.( 5"'-11 '6
Business Phone [_) Message Phone (_)
tAw oJtftt5 oJ !4J4 Yav/~
S'^ 1< ~ 7t(:) ),{ l'otM ;
Suite City
("(aN @ t<..H IOrl/f FMAN
u",,~(ol M~RcJ.b~
<-Wi (b~ Set-
Street
12l...
H
Middle Initial
Business Name and Address:
100 sE '),lIds~
Street
F-L
$3131
Zip Code
2)
Principal Retained by:
State
coM
CLwrc ~
No.
Email Address:
If different from above
}A\'o..M;
City
Suite
~e~
State
3"$ 13 q
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):
(Dy?poS"'It-'/M h> ZO"'I~ vl\f1/;tI1Ce
f
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
~to be lobbied: Q A'" () . D A-~
DvvvO'- OV fllfCtls~~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
o The City Commission
o City Commission Subcommittee
o City Staff
~City Board or Committee e,J.~jl. MJ'
o Personnel
o Identify Others
.2001
,2001
,2001
,2001
,2001
,2001
on
on
on
on 1..11 b
on
on
6. State the extent of any business, financial, familial, profeSSional or other relationship which exists with any
individual identified in number (4) above: Nc>V\e.
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. \7
Signature of Lobbyist: '" ~~ ~~
o 9ff5onally known J,) 1. """r:.,,, ". r /'Co r )
i!("'Produced ID ~ _"l :; - J~o -" ~ ~ ~ ..... ('
~. Identify
tv15id take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn tQ. 9.9d sUbscrib~e
This I,-rn day of 2001.
If Notary, print, stamp or type as commissioned
Registration:
If rejected, state reason: ~
Registration fee paid: [1):&8' [ ] No [] Not-for-Pr It Organ~a-...
o!'T~ [ ] Check MCR # . 7 .L.-.-.
DATA ENTRY DATE: ~ /6 (" . 2001 ENTERED BY:
~D
FOR CLERK'S USE r:J...L Y
[ ] RElECfED DATE:~F;- 0 I