Affidavit (05/18/2001)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .miami-beach. fl. 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 FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY 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) LObbyistName::s(.HWAA.T....... ~cI K
Last Name First Name Middle Initial
Business Phone ~) (..13-1/ 0 1 Message Phone (_)
Business Name and Address: ,,~ l_ l !.- 'R...\ &/...({' {~"<<'T-
S~ ~ 1/11 LtHCPt.. ~ S7C VPo HI? 1/ 33/.$.-'7
No. Street Suite City State Zip Code
Email Address: ~RA-'-t::>J:;; (ji> 'SOOTH Je.l:ItCNL-AuJ.C!DJ11
2) Principal Retained by:o-ttek ~)t:.od P~^,Rods
t c>e-e"""N\ 'DriVe. M, P.:>. ~31.sc:r
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.
.:rAe-Ie. PeN Je.ocJ
3)
Subject Matter (Describe in Detail):
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. 4.
identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: ' ~k
~ v~ ~ Z>~ "::.t: a.c..'a..-Q.
~f)o...;",- kD~ ~h ~c:..>-..c!.
5. The subject matter in number thr~e (3) above is to be considered at the meeting of (Identify each entity or
individual): \ _ .
~csu..~
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
.2001
,2001
,2001
.2001
,2001
,2001
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6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: AJc:,~
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 ion 2-482 of the Mia i Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
~SOnaIlY known
o Produced ID
Identify
o Did take an oath, or
B""'Did not take an oath
State of Florida, County of Miami-Dade
Sworn to,aJ]d sUbscrib~re m.e
This /1"fL. day of 2001.
k
ned
DATA ENTRY DATE:
FOR CLERK'S USE ONLY I
[ ] REJECTED DATE: b'IJ I / Ql
I I
MCR
2001