Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(Ci)ci. miami-beach. f\. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIRCATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DEOSION OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-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 SPEOFICALLY INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATIORNEY, OFRCER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBY1NG ACTIvrnES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATIORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: 'BUO("M~ l-'\ Mc..\--e.\ l
Last Name First Name
A
Middle Initial
Business Phone ~ 8~4. C1ao::::> Message Phone C!-)
Business Name and Address: IL\P.~S ~O+IJo..L-+ ....l
Iof# '2-"tO~ .". ~"""\ s""'re.. 't:lr. """.........:.
No. Street Suite City
Email Address: 104 P.o.Ier""...", (9 WSH - 'Fl-AI"Ac..J . Go,^-
2) Principal Retained by: As~C'..e...~ '?CN:""k...~
Fl.
State
~~13~
Zip Code
If different from above
"'^ \ ,.........:
City
Street
~L.
State
Suite
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
~ beneficiary or interests.
~\ (J I L..c\)Q.\\~'O
3)
Subject Matter (Describe in Detail):
o~ o.M)o.r~ o~ \>('O"I'SIc:lf'\~
,
P""\u.~ ~.....:..+ +0 Q..,,\::. ~oc-\r!.
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: .
~~, c.....+-"I.. ""~ I <'......~ ^\I<or~,",\
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
0 The City Commission .J \)1''1:. " on .2001
0 City Commission Subcommittee on .2001
0 City Staff on ,2001
0 City Board or Committee on .2001
0 Personnel on .2001
0 Identify Others on .2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: ~ 0 ~
ON OCTOBER 1 STOF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TolliE 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 foregqing 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:
J1A~'
.,
~~:~YI~O~(oS--S- -5\.f I ~~ Y ~3')d---U
Identify
Q,..--. Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
swor-=-l~ ,,nd SUbsc~,e
This !J,h day 0 2001.
\
20b~h~~
If Notary, print, stamp or type as commissioned
Registration:
~PTED
[ ]
FOR CLERK'S USE o~ I
REJECTED DATE: (p 0 I
If rejected, state reaso\S .....___-
Registration fee paid: r] Yes [ ] No [] Not-for-Profit Organization
[ ] Cas [ ] Check MCR #
DATA ENTRY DATE:
2001
ENTERED BY'