Affidavit (03/13/2001)
"
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Cen.tI!r Drive
Miami Bellch, FL 33139
citvderl<(ci)ci 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
COMMITTEE; 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 COMMITTEE. 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 'CERTIFICATE OF WITHDRAWAL."
1)
Lobbyist Name: CITRIN
Last Name
Business Phone (305] 674-0447
Charles
First Name
A.
Middle Initial
Message Phone (305)
674-0447
N/A
Suite
JJ14D:- J4 n
Zip Code
Business Address:
757 41st street
No.
( Arthur Godfrev Rn;oill
Street
FL
State
Mit=lmi ~,...h
City
Email Address: chasclt:r;nta;,nl cnn
2) Principal Retained by: The Cornerstone/Constructa Joint Venture
2121 Ponce De Leon Boulevard, Penthouse II
If different from above Street Suite
Coral Gables FL 33134
City State Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests. 'I'he co~~~Group/Alliance
Construction, 2121 Ponce De Leon Blvd., PH II, Coral Gables, FL 33134
3) Subject Matter (Describe in Detail): Request for Qualification No. 5-00/01
7?nn ~r.....oo.+- D~....ki ng T.n."" "Drv-l.~o......""
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: Each C'LIlII1; ss;on"r or ('; ty staff ITlPmhPr as n~Pil
.
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
fill' The City Commission
a City Commission Subcommittee
a City Staff
a City Board or Committee
a Personnel
a Identify Others
.}OOQQQ{
.2000
.2000
.2000
,2000
,2000
on il!1R/01
on
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6. State the extent of eny business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
None. Except my canpany, Citrin Financial & Insurance, Inc., was the
insurance agent on a policy on the life of Neisen O. Kasdin
ON OCTOBER 1 Sf OF EACH YEAR. EACH LOBBYIST SHALL SUBMITTO THE CITY
CLERK A SIGNED STATEMENT UNDER OATH, UmNG LOBBYING EXPENDIrURES IN
THE aTY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly sweer that all of the foregoing facts are true and COlTect and that I have read or
am familiar with the provisio s contained in Section 2-482 of the Miami Beach City Code as
amended, and all repor' g uiremen.
Signature of Lobbyist:
III Personally known
a Produced 10
Identify
III Did take en oath, or
Q Did not take an oath
State of Florida, County of Miami-Dade
Sworn to rnd subscribed before me
This -l ,-It. day of APril , 2001.
Notary or Deputy Clerk
'''''' cARMEN M, DUMAS
.~\IJ';:<fo CO'-'ISSION .a:864711
MY j\'UO'
"" ~ BXPIR'ES:AUI\9,-
"'t..", F\L.......-. .
,.ecx>>NOTAB'f
Carmen M. Dumas
, print, stamp or type as commissioned
Reglstrat:lal:
~PTED
fOR CLERK'S USE ONLY /
[ ] R~CTED DATE: ~ (3,_0 (
If rejected, state rellson: ___
Reglstrat:lal fee paid: [y..yes [ ] No A ] Not.for-Pr~~n~
[ ] Cash [H'Theck MCR #
DATA ENTRY DATE: '3) I Co 10 I . 2001 ENTERED BY: '
I