Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citycl erk(6lci. miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINQPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DEQSION OF ANY COMMISSIONER; ANY
ACTION, DEQSION, RECOMMENDATION OF ANY em BOARD OR COMMmEE; OR ANY ACTION, DEQSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEQSION-MAKING
PROCESS ON SUCH ACTION, DEQSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE em
COMMISSION, OR A crll' BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINQPAL, 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: Ift=/(e^,'!.orru: ,.e-c.IM yV) .:;;
Last Name First Name Middle Initial
~5 ~5
Business Phone (.-J 4tfb ' 71'1 1 Message Phone L) ~t/". 71~ '1 ~ l"'7. If
Business Name and Address: (2..:r lIe/ret..J~D7it..6 A/'2C.{.ftn:cr:~.;:?,4..
,
.!tfd I"f/AJOILCA A-*. IfI ~teA<- 9AI$c.es R.- $ 'S(~f
No. Street Suite City State Zip Code
Email Address: /2/e.HA IU> e... /Z..r~. "'€T
2) Principal Retained by: c./ t:1P >>fIA701/ 6EAQ{
17~o coAlII€ IIIA.J ~~,e P.
If different from above Street
14(1 AmI &EAG.f/ Fe...-
City State
Suite
S!/(t
Zip Cod
(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):
JZ.e S("Q/2A rid"'; A+J./)
,4r.Jr,J/Tt 6 A./
To
,lIE
C4t..4l11j
-r#f,?AT,e€"
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: 11 L _ _.......
ft/{Til/2..1(;. ~€fl-I/A'T//lJ ~.-'
Clry ~/Of/f1IS51()~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
on .../"'i (I
on
on
on (, ~ /-z.."
on
on
ov'The City Commission
o City Commission Subcommittee
o City Staff
~ City Board or Committee I-I~"",,~ l'Jz6<GttVA7/o,V
o Personnel I
o Identify Others
.2001
.2001
.2001
.2001/71;" !'Ut1/
.2001 I'
,2001
-
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. ~.
Signature of Lobbyist: ~ ~
o Personally kno~S I 7 (]) - (0 '~ 3 - ()
ill- Produced ID - , ' - CL
/' Identify
~Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to, il.nd subscribed before me
This 1 S-4h day Of=Y'J' 2001.
2~~
( Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration: ~PTED
[ ] REJECTED
FOR CLERK'S USE ONLY
DATE:. 5~ \{'-o I
If rejected, state reason: .....-
Registration fee paid: ~s [ ] No [1 \l[ot-for-Profit
[ ] Cash [ ] Check c;:)1CR #
DATA ENTRY DATE: ~~ I r--~ 0 l .2001
ENTERED BY: