Affidavit
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011'1"'! 75 PI! I,: 09
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(6)ci .miami-beach. fl. us
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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 COMMITTEE; 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 FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMITTEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlVmES 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: ?oBBll~S k<\?N\ \-\fW.,~lSo N
Last Name First Name Middle Initial
Business Phone (~s..::Q-cr:oO Message Phone ~ ~ - ( 11 0
Business Name and Address: .\("~ \\1\ ~R~N ~BBI~:-"
\dd.Li W6S1:llliJGTcN MIAM\ ~t\-, FL 33~
No. Street Suite City State I Zip Code
Email Address:
2) Principal Retained by: -Jf;..~.:" ('v\AQ.8J-t
13Qo OCeAN PR
If different from abox~ Street
1V\IA-rYl( B~
City State
R-
3313
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):
~~r.;;~-t t/}'::!;Cf.te,,:~t:;. ~
4~ Ide~tify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: 1-.. rill ~L u ,- r..l' L.. L
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5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
o The City Commission on. 2001
o City Commission Subcommittee on , 2001
o City Staff on . 2001
o City Board or Committee on, 2001
o ~rsonnel on n ' 2001
~Identify Others A e( tit) c- M~b..,.,. on -'-{:2. J- . 2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual ide'ltifiE\d in number (4) above:
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IV
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 th oregoing facts are true and correct and that I have read or am familiar
with the provisions contai I ection 2-482 of e Miami Beac I Code as amended, and all reporting
reqUirements.
Signature of lobbyist:
rJ Personally known
o Produced 10
Identify
~ Did take an oath, or
~ Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This Z~ day of ~,.. . 2001.
If Notary, print, stamp or type as commissioned
Registration: [] ACCEPTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE: ~ k~i tJ I
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