Affidavit
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MIAMI BEACH CITY CLERK Fax:305-673-7254
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May 23 '01 8:39
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P.02
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Bead1, FL 33139
citvclerklCilci. miami-beach, fl.us
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AFFIDAVIT ~.
LOaBYIST MEANS ALL PERSONS ~MPlOYED OR RETAINED, WHETHER PAlO OR NOT, BY A PRINOPAL W. 0 SEEKS TO ENCOVRAGe
THE PASSAGE, DEFEAT OR MODlI'lCATION OF ANY ORDINANCE, RESOLUTION, AmON OR DEQSION OF. NY COMMISSIONER; AIN
AmON, DEOSION, RECOMI-IENDATION OF ANY CITY WARD OR COMMlITEE; OR M1Y AmON, DeOSI~.. 1'1 OR RECOMMENDATION
OF ANY PERSONNEL DEFINE..D IN A. IN MANNER IN nus SECTlON, DURING THE TIME PERIOD OF THE. RE DEO$ION-MAl(JNG
PROCESS ON SUCH AC110N, DEqSION OR RECOMMENDATION THAT fORESEEABLY WILL BE HEARD 0 REVIEWED BY THE em
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICAllY INCLUDES THe PRlNOPAL,AS well. AS ANY AGENT,
ATTORNEY, OFFICER OR EMI'LOYEE OF A PRlNOPAl, REGARDlESS OF WHETHER SUCH LOBBYING AC1iimES FALL WliHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSO~ WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A 'CERTIFICATE OF WITHDRAWAL." L.
1) Lobbyist Name: Jili MAt.) :J !;, q () M e ~,. \.
Last'~ame First Name Middle I~al
Business Phone ~ '3 S" B' 0 1.'a4 Message Phone L) S F\ M e. 1
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Business Name and Address: ,$/20 F(~~r U. ',h"o~ FiV'JQ. J,jCi/4-( 4 e 1\ Tot R...
~ 0::> 5t:ll..l.1t... ~ t SrYl-r~" -aJ rJ<t WI.."A1t.1, i. P 114 - "3 ~ I S I
No. Street Suite Oty State Zip Code
Ema;1 Address: ""B.i IJ Wi M.I'rN ~ Yet.hoo. Co A11
2) Principal,Retained by: -r"'-e 'K o~e..j--Pa..IGLC ~ Ke~Q~Tl
~3tJq COlliAJr;, AiL) yn,'AM;lSea.clt.) P.IA..')
IfWfferent from above Street Suite J
,
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City State Zip co,
(a) If ~corporatlon, partnership, or trust, identify and provide the address for thelchief officer, partner,
beneficiary or interests. 1
i{tl"'~~~{).. /VltJ,(\()..!Je.tn4I1T ~f' ~
M,'cAa. (2./," :1., t i Ve etJlJic..a.. 'j)re[;/fJ"1t t--
Su~ct Matter (DeSCribe In Detall):.J.. ) .(.of.. I _ J I
rt'.e. ^ c .,. nf Gl. + r 0 ,.:l ~ ~ wo.. re 12 Co. (\0..;-+ \ CIo\LL. e:! ,AJ e..
r '.eM. ~
S.ee
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MIAt11 BEACH CITY CLERr-: Fax:305-673-7254 May 23 '01 8:39 . P.03
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4. Identify each ,ndividual (Commissioners, Board, Committee, Authority ~ ember or City staff)
to b4illobbi~d: J '. ~.
tVe..iS J..J < OS I'N rn~ .erze~ro... J)ow,n- Cr~?.
1:> ,,' e.. M e.. 'R.. l- ~'S {, If,f IfoIJ
::::10 SE:.. Shl,'~ J
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual): j
4~
J c.A./oIf.j,~
.., rD,,'
)tl. The City Commission on :\ "''''eo (".( . 2001
o City Commission Subcommittee on J . 200t
o City Staff on ,I . 2001
Q City Board or Committee on , 2001
Q Personnel on , 2001
o Identify Others on l . 2001
6. State the extent of a~ybusiness, financial, familial, professional or other relations~p which exists with any
individual identifieQ in nlirT\ber (4) above: tJ tJ ~ a i
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.... .... . i
ON OCTOBER 1ST OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE CIIrv CLERK A SIGNED
STATEMENT UNDER OATH, LISl1NG LOBBYING EXPENDITURES IN THE cm OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR. I
I ?o solemnly. ~ear that.~1f of the fo.regoing facts are ~e .and correct and that I hav~ read or am famil~ar
With the prOVISionS contained In Settlon 2-482 of the Miami Beach Oty Code as amenqed, and all reporting
requirements. _ \ . / . I
Signature of Lobbyist: ~l
,L Personally kno
o Produced 10
Identify
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Notary, print, stamp or type as commissioned 1
j
o Did take an oath/or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscn1led before me
This 7'7 day of .,.;, AY , 2001,
.~/
. 5 Notary or Deputy Clerk
fOR. CLERK'S USE ai'lL Y
R.egistration: (J ACCEPTED [1 REJECTED DATE:
If rejected, state reason;
Registration fee paid: . ( ] Yes [ 1 No r ) Not-for.Profit O'ganization
( ] Cash ( 1 Che<:k MCR #
OATA FNTRY OAn;:
2001
EI\ITEREO BY: