Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cit;yclerkcmci.miami-beach. fl.us
AFFIDAVIT
LOBBYIST MEANS AlL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAl 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 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 ACT10N, 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 PRINOPAl AS WELL AS ANY AGEI'IT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES 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: S fYt;M 1'1\ C K Gu rr
Last Name First N me
r
Middle Initial
BusinessPhone G2.'!J 5"'1..'-1- QQ"1"1 MessagePhone(lliJ5'z-lj- Qt)1"1 .x"i-./"Z.
Business Name and Address: PI (51 t1 Mr:;YlclJrV IE' IFf OM eM- 'P' L FirS; !JItIFfI(/JN 4JvEYf-,'S,;(II'!J (orp
/57...7 N/2 4 ME. fOrT 1~~Jf'yd/JIG FL 3330'-/
No. Street Suite City State Zip Code
Email Address:FMCorP{!)IIUJ.CO/l1
2) Principal Retained by: ,~~, 0..." ~ ~ "
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. .
6nv tlN D{I.{i, 60s i ~ V It , pr FS ,"(hAl+
I
3) Subject Matter (DIII_lw in Detail):
PUtJil'c:' +pIF(')Vl^",~NI'C..(t+r()r-..JS. ilM~Nh vAt.(,.}--"""1 {}{ltJi'AJA:.rJt€ rU
::r N r \ Ii ~ r; ~cl V pr +1'( ; AI ~ _
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4. Jde"tllJ each individual (Commlnione.5, IJaerd, Cammi.... AutharIty memberorOty &bill')
tD be lobbied,
1\\\ ('01/\"'- i.)S~OtJUS .
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
on IiJ6 I
on fFiJO;'[V 6
on
on
on
on
III The City Commission
,iJ City Commission Subcommittee
CI City Staff
CI Oty Board or Committee
IJ Personnel
IJ Identify Others
.2001
.2001
.2001
,2001
.2001
.2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: ~ n,v P. .
ON OCTOBER 1 Sf OF EACH YEAR. EACH LOBBYJSr SHALL SUBMIT TO THE Q1Y CLERK A SIGNED
STATEMENT UNDER OATH, LJSl'ING LOBBYJNG EXPENDITURES IN THE Q1Y OF MIAMI BEAOt
FOR THE PRECEDING CALENDAR YEAR.
1 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 ~ Code as amended, and all reporting
requirements. ~ ^ 1 /\
Signature of Lobbyist: C:J 'V '-/ '----"" '----
IJ Personally known
IJ Produced ID
Identify
IJ Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
S~n 'P, arct sUbscri~ me
ThIS ~ of - .2001.
~J~
~Mycommlssion CCB1104~
'\;.:Y E>lplres FollnJary21. 200"
If Notary, print, stamp or type as commissioned
FOR a.ERK'S USE ONLY
RegistratiOn: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for-Profit Organization
[ ] Cash [ ] Check MCR #
DATA ENTRY DATE:
. 2001 ENTERED BY: