Affidavit
m
-
CIlY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Be3~~', Fl 33139
citvclerk@lci.ml,:',li-beach.f1.us
AFFIDAVIT
LOBBYIST MEANS All PERSONS EMPlOYED OR RETAINEO, WHETHER PAlO OR NOT, BY A PRINCIPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION Of ANY ORDINANCE, RESOllJTION, 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 DEfINEO 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 COMMmEE. THE TERM SPECIfICAllY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OfFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH lOBBYING ACTIVm~
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: ZYSCOVICH
Last Name
BERNARD
Rrst Name
Middle Initial
Business Phone (~372-5222 __ Message Phone eM) 372-5222 EXT. 111
Business Address: 100 N. B I SCA YNE BLVD. #2700
City
Emai! Address:mail@zyscovich.com
2) Principal Retained by:
COOLIDGE-SOUTH MARKET EQUITIES
If different from above
SCARSDALE
State
Suite
33132
Zip Code
MIAMI
Street
FL
No.
City
670 WHITE PLAINS ROAD
Street
NY
State
#106
Suite
10583
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
3) Subject Malter (Describe In Detail): . . ..
MODIFICATIONS TO HISTORIC PRESERVATION BOARD APPLICATION
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: HISTORIC P~ESERVATION BOARD, CITY STAF~. (THIS IS A
QUASI-JUDICIAL PROCEEDING, THEREFORE WE ARE NOT PERMITTED TO LOBBY MEMBERS
OF THE H.P. BOARD.)
5. The subject matter In number three (3) above is to be considered at the meeting of
(Identity each entity or individual):
o The City Commission ___
[J City Commission Subcommittee __ ___ _ _, .__
o City Staff___
~ City Board Or Committee _~ (jQARD
a Personnel
a Identify Others _ _.
.2000
.2000
.2000
.'2001
.
.2000
.2000
on
on
on
on AUGUST 14
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: __
N/A
ON JULY 1ST OF EACH YEAR.. EACH LOBBYST SHALL SUBMIT TO THf CI1Y CLERK A
SIGNED STATEMfNT 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 - ection 2-482 of the Miami Beach OtyCode as
amended, and all reporting req ire ents.
Signature of Lobbyist:
rIi Personally known
o Produced ID
Identify
a Did take an oath, or
tV' Did not take an oath
m...~.~
I '
.. ..-
\"'.W
~~CIF ~
.....;;.j'hl~'to'
IE.JSS' tBIlIIT
-,.PIilio.SlIloct_
MrC<m:tt.~.Ul2!,2lXI4
~1CCS;\a73
issioned
State of Florida, County of /oiI'ami-Dade
Sworn to and subscribed before me
This 28 day of JUNE _' ,2001
fOR CLERK'S USE ONLY
)
Registration:
[~~qPTEO
[ ] REJECTED
DATE:
'l/~~I
,
If rejected, state re~son; ._ _ ._.._.. _
Registration fee paid; [ ] Yes [ ~ ] Not-for-Profit Org,anizalion
[ ] Cash [ Check MeR # ~.?J::2 :::;~
DATA ENTR~ DATE; --2/..:s).iJ!--- 200t ENTERED BY: ~