Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@ci..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 OTY 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 OTY COMMISSION,
OR A cm 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) LobbyistNa~ fl\'i k:'tV\A) S .
Last Name First Name Middle Initial
Business Phone LJiIz) ,flU ~ 0 b :;, Message Phone G::3) .~ 0> '-( (:3 ')
Business Address: J- I ( I /Iv IL ;, I> IV I'; L. <.J 1). g v 0
All L {1Vr.7(~o. Strt~t ;;;,;2 )~t~
City State Zip Code '
Email Address:-P....ec..l c " \ d e - {' 0-.." . C. u"""
, ,
2) Principal Retained by:
_3(\m~ o~ 0. bo -..J ~
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): f e.. ~ <C V'...1 {." -e ~ f'( ~ ~ ^ 1" ",Jt ,I c.J ~
Cu......t YCAI l'
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: CO"" "'"': ~~,',..,~......; ~ Y>tI""'<4' , Cv-v"Z. f)e,r",,{V'/ ;:;,"""<,....
"- ,,, ~M",", I ~."'Vt; tl1 ~ M "'yn'" IC",-$cli Y\ .. An, ,'<'1\:'1 (',T,,> t'lANAC'VL
Cr':'7t\(\~ l(v~",Vtll ~ JO r~ <. G.O""'L~(< ,; c-.'",,/ ~".....)'(''''; (),.,.,. 0 +-
Pl"OL.",rttM.ewt GUI l-ofe'1--
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
/
'31 The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
on 1/!-::20;
on
on
on
on
on
.2000
.2000
,2000
,2000
,2000
.2000
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: N ()A I P
ON JULY 1ST OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEM~ UNDER OATH, LISTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
o Personally known
i3'/ Produced ID
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.
(L?~
~ It-
Identify
d-d~-g 2- '1~O U
Signature of Lobbyist:
o Did take an oath, or
o Did not take an oath
State of Fiorida, County of Miami-Dade
Sworn to and subscribed before me
This :!) ~ day of /\/V'vi(/'1102000.
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
{{ftfo v
Registration: [(5 ACCEPTED
[ ] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [f'fXes [ ] No [] Not-for-Profit Organizatio
[)lCash [ Check MCR #
I
2000
ENTERED BY:
DATA ENTRY DATE: