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Affidavit (05/04/2001) lD - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerklOlci ,miami-beach. f1, 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 FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION, OR A OTY BOARD OR COMMITTEE. THE TERM SPEClFICALL Y INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT, ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIvrnES 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: <::;~~'N\~ ~\J L Last Name First Name Middle Initial Business Phone ~ ,1 \.( - I 2. "t '"L Message Phone L) S. t1I'< Business Name and Address: ~')2~ '5v.J 11.""( Sf- 6-'"1 M' . '''iv\' \ F( 5>1 ~, Zip Code No, Street Suite City State Email Address: 4 2) Principal Retained by: t:> ", {.Ie f\..(g(\4 ~-N'(d~ (g ?tJ\ If different from above Street City State Zip Code (a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner, beneficiary or interests. "ioA{ a ~ 3) Subject Matter (Describe in Detail): ~~\-~ar-J~IJ:.( ~f.(~lV 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: ~d O~ A.Jp&t~W+ 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): n ~\ . r A.~,'. ~ '- J ~ en \~NP^""",,, o The City Commission o City Commission Subcommittee o City Staff &~-'- ~ City Board or Committee '~ . MJ;v"" o Personnel o Identify Others on . 2001 on . 2001 on I ~ 2001 on '5 { 'f" I: 2001 on I , 2001 on . 2001 6. State the extent of any business, financial, fa i1ial, g,rofessional or other relationship which exists with any individual identified in number (4) above: ~ 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 ego with the provisions contained in Sectio requirements. { Signature of Lobbyist: o Personally known IJ'15roduced ID ft> L i\; So ,n. 0 - I ""l "2. - 1../ I . " l.tj - () Identify facts are true and correct and that I have read or am familiar - 2 f the Miami Beach Ci de as amended, and all reporting o Did take an oath, or s-t>id not take an oath State of Florida, County of Miami-Dade Sworn ~a;;; subscribed before me This day of 4.Wj , 2001. ~<!<../..--P , Not or Deputy Clerk Ld/J 'fj-,.J ~a u{'~tJ. ~ If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: ~CEPTED [] REJECTED DATE: 5' - l/- 0 I If rejected, state reason: ./ Registration fee paid: [\1'Yes [ ] No A ] Not-for-Prpf~~anization ( [ ] Cash ['-ftheck MCR f/d'. Of I) DATA ENTRY DATE: .2001 ENTERED BY: