Affidavit (06/14/2001)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci. miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINQPAL 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 OTY 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 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~ JA~,g I+Le-'tC~
Last Name First Name
Business Phone ~$) 3~'1 ~~ L.( Message Phone (_)
Business Name and Address:, A, \e~Jl.Ju- ~ - '""\~ ,v'\..e4, p .<ft--
IDO 5SE 8,..J _r:<-. ~ 57.2-0 ~\a.-"'^-t"
No. Street I Suite City
Email Address: a; ~ ~~ ~ ct {) ( . C-OIV'
2) Principai Retained by: r~ 1 ~.A.-1..pv~ t ~ -
I Lf~~D ~.sc. ~1vJ
If different from above
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City
L
Middle Initial
F-<--
State
'351:'/
Zip Code
Street
f'c
State
Suite
'3~ It (
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests, IOn -.e ,5
rf:"r~CA'.s .::\a..e.....e.D g,~~'
3)
Subject Matter (D~ribe in Detail):
C, Cf & ~ rllY\ f+v-e. ~
'I~ ~-'Y'
IJ\A..~ ~~~
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4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be I~bied: ....
)1; '~~~~~~~~~~'
_~ ~(5 ~~ ' O~ ..J- C-cVV'lM...'~:fu,2."'"
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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):
0 The City Commission 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: '~
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 soiemnly 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. ^ fl ~
Signature of Lobbyist: ~ ~
.---:
"d Personally known
o Produced ID
Identify
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Swor7 ~9.d!:id subscri d before me
This ~day 0 2001.
r~~
or eputy Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'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: