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Affidavit (06/18/2001) m - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerklOlci .miami-beach. f1,us 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 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-MAKlNG PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY WlLL BE HEARD OR REVIEWED BY THE OTY COMMISSION, OR A CITY 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 ACTIvmES 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: J,or11/V) fY)/chu21 Last Name First Name Business Phone (..iJ!D o,7-(;} 31 Message Phone L) tj'1"f(6W t G,<1c/.Q((, p~, , J~joj (\1!l"..h.l A- /Y)/CdI1i, (L 3y13/ Suite City tV Middle Initial Business Name and Address: 8(/\) 6dV] 15),f((J..,'r-t - 'fA)} ,<)4 &5'0 No. Street State Zip Code Email Address: 2) Principal Retained by: V01,}q),,\, <s-r-k/1t1/"l"""J t-GC f 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. y ~ ' \ noli II. , .J/.,JilJ /(~, /VVl., ()rf\'1l-11\) / 3) Subject Matter (Describe in Detail): Gw), 1, W1 / (j I'r:, A(lf7rf.M Iii ( Ik,1Y7/\, /lw(1/1' (1<< ),4, {.J. (/ll .J h7r7 4. Identify each individual (Commissioners, Board, Committee, Authority rnember or City staff) to be lobbied: ' J.f} ,) 11.i 1\,1 lobl)..!/) q/JuiJ"elf -A ((tS (Y'{J1(l6.JI)) (JVl~ ~-1lf\ 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 o City Commission Subcommittee ..)if City Staff 1. V City Board or Committee p (If/I) 6>t1 o Personnel o Identify Others .2001 .2001 2001 8-J. f"" : 2001 , , 2001 , 2001 on on on on ,~ on on 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: Il d V'f. , 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 the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482iJ1f th Miami Beach City Code as amended, and all reporting requirements. n 7 ~ Signature of Lobbyist: p/ - /'" , I 0 Personally known 0 Produced ID Identify 0 Did take an oath, or 0 Did not take an oath State of Florida, County of Miami-Dade Sworn to and sUbscrir:;,o;e m,e This ,If day of 2001. ctP~.A~ Notary or puty CI k If Notary, print, stamp or type as commissioned Registration: ~PTED FOR CLERK'S USE ONLY [ ] REJECTED DATE: If rejected, state reason: Registration fee paid: [ ] Yes [ ] No [] Not-for-Profit Organization ~Cash [ ] Check MCR # .0 '3 n.YV> DATA ENTRY DATE: .2001 ENTERED BY: