Affidavit (04/09/2001)
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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, DECISION, RECOMMENDATION OF ANY OTY 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 FILE A 'CERTIFlCATE OF WITHDRAWAL."
1)
Lobbyist Name: R()~RN
Last Name
HAROLD
First Name
Middle Initial
Business Phone (J B ~ <; <4_4 7 <; 7
Business Address: 407 Lincoln Road
, No.
Message Phone (_)
Penthouse S.E.
Miami Beach. 'l
City
Street 'd
Flor~ a
State
3 3~~~
Zip Code
Email Address:
m~il~rn~~n~nn~witkpg.com
2) Principal Retained by: 'Ph" R" 1 "tF!a Group of Florida
"616 "'nr:::al W~y
If different from above
Street
Penthouse 1
Suite
33145
Zip Code
Oty
Florida
State
Miilim;
(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):
pro;ect
Reauest RFO reqardinq 72nd street
4. Identify each individual (Commissioners, Board, Committee, Authority member or Oty staff)
to be lobbied: QQR"r'j~9;on~Y"~ ~nr1 {"'ii-y ~t'~i1r
>
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
ii The Ci~c~~~in~=-) ,
A .
o City CommlSSTon'5iJbcommittee
o City Staff
o City Board or Committee
o Personnel
IJ Identify Others
5/18
.2001
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6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
nIl.
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 - f the Miami Beach City Code as
amended, and all reporting requiremen .
~
Signature of Lobbyist:
~personallY known
o Produced ID
Identify
o Did take an oath, or
o Did not take an oath
State of Aorida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of ~ ';, 0 ,2001.
b,qii,jS ommissioned
If No
Registration:
[ ~EPTED
FOR CLERK'S USE ONLY
1/9/0/~
[ 1 REJECTED DATE:
If rejected, state reason: .-
Registration fee paid: ['1' Yes [ ] No [l Not-for-Profit Organization
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DATA ENTRY DATE:
,2001
ENTERED BY: