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Affidavit . m - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerk(Ci)ci. miami-beach. fl. us AFFIDAVIT LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMISSIONER; ANY ACTION, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKING PROCESS ON SUCH ACTION, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALLY INCLUDES THE PRINOPAL AS WELL AS ANY AGENT, AlTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVrnES FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, AlTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FIlE A 'CERTIFICATE OF WITHDRAWAl." 1) Lobbyist Name: Bell Linda Last Name Rrst Name M Middle Initial Business Phone ~f- 448-5955 Message Phone (30y' 448-5466 Business Name and Address: Civil Works, Inc, 3195 Ponce de Leon Blvd" Suite 200 No. Street Suite City Coral Gables, FL State 33134 Zip Code Email Address: cwi@civilworks.com 2) Principal Retained by: Civil Works. Inc. 3195 Ponce de Leon Blvd., Suite 200 If different from above Street {"'nr::.l ~:=thl~~ City . Fl (yrin;:li State Suite 33134 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): RFO 10-00/01 Urban Desion. Landscaoe Architecture ~nn En~ineeering services for planning, design and constrctuion administration for North Shore and Biscayne Point Neighborhoods. . . 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: All Commissjnnprs, M~ynr. riry M~n~~~r. Mo~~rivrion ~nmm;r~oo and City Staff 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): 1!\X The City Commission on 5/16 .2001 CJ City Commission Subcommittee on .2001 XllJ City Staff on tba .2001 Xlx City Board or Committee on rn9 .2001 CJ Personnel on .2001 Xlx Identify Others on t-h;::lo .2001 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: No Relationship ON OCTOBER 1 Sf 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. ~ Signature of Lobbyist: C ~ JQ: Personally known /iJ / CJ Produced ID A Identify CJ Did take an oath, or ~ Did not take an oath State of Florida, County of Miami-Dade Sworn to and subscribed before me This 14.t'- day of ,MAY. 2001. VAUCHN~ NOl'ARYPllBLIc S1'ATE 0Jl FI.OIlIDA OONMJSsiON NO. CC17S3I11 ~ ~ I MY-...,.~_, - Va No"" ~puly d,~ If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: ~ ACCEPTED (] REJECTED DATE: /vi"::;) IS? J..-O()l If rejected, state reason: , Registration fee paid: ['I1Yes ( ] No (] Not-for-Profit Ol]ani~tj.o(l, ( [ ] Cash ry.J Check MCR # b:::l, ~~ /6 _ DATA ENTRY DATE: . 2001 ENTERED BY: