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Affidavit (Rudy & Betsy Perez) .. '. lQ - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerk@ci,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 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 REVlEWED BY THE OTY COMMISSION, OR A CITY BOARD OR COMMmEE, THE TERM SPECIFICALLY INCLUDES THE PRlNCIPAL AS WELL AS ANY AGENT, ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlvrnES 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: Lor/,{;() /V7jchIclJ Last Name First Name Business Phone (-3~) :3 --n- (, d. 31 Message Phone (_) &c~ w oJ-- ~Je /I ) f. {J.. ate ~ 131.!{l<4jrL ralvJ I 6k ~m (f7,q';' t3Ar~. PI No. Street Suite City , State (.J, Middle Initial Business Name and Address: 3.~/3~ Zip Code Email Address: 2) Principal Retained by: /{W:j f Ij~.h'f Per'Cz.. If different from above Street 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. 3) Subject Matter (Describe in Detail): ~:.~~I ~~J otMj ;t t'~L.., (";, !tlr 01~d(C~i~ ],.,i~ I\pr&f#1 CorN <f " " 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: ) W I ..Iv /" 01 5tr-'H;;fJk,>1{)~ 6~""l IctA (J'vUi( i"./ft1J'J Ct'{ 4;MMdj/V\ .(CI+ /)(;(,,//'( ItS' _2 , 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): 0 The City Commission on .2001 a City Commission Subcommittee on ,2001 a City Staff on .2001 0 City Board or Committee on ,2001 0 Personnel on ,2001 a Identify Others on .2001 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: 11 or\:. 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. /J /1/1, /1 , Signature of Lobbyist: ~ L./ ~ a Personally known ~ Produced 10 bL:#'- C &;;;)..5' ' 5~ - ~ -:; - 3 f" r 0 Identify a Did take an oath, or a Did not take an oath State of Florida, County of Miami-Dade Sworn to jnd subscribed before me This ,l.. t!:l- day of Y'.r)~ 2001. ~~~ ~otary&~~ ({; :::;~::.:-~~.:o If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: [v(ACCEPTED [] REJECTED DATE; ""''''J LtJ ")...ut..! I If rejected, state reason: Registration fee paid: [,rYes [ ] No [] Not-for-Profit OrganilatiPIl. [ ] Cash [.,rtheck MCR # '2- :> '0'11 0 DATA ENTRY DATE: .2001 ENTERED BY;