Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(Cilci .miami-beach. fi. 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 CITY BOARD OR COMMffiEE; 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 CITY
COMMISSION, OR A CITY BOARD OR COMMffiEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATIORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVmES 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: fy\Oi'MWYI OL1zo,nn€.-
Last Name First Name
Business Phone (CO[ (/201 ~q44 Message Phone (_)
Business Name and Address:. --=t:liJ CfhA) 55 Aff,
MiOlVY\l fL. 33~3
No. Street Suite City
Email Address: S(y\A\'YIi:~
2) Principal Retained by: () steM G H'c;;M..v l"6(o...wJ.
r/o
Middle Initial
State
Zip Code
#5kDMO
/
Nseo C.
If different from above
Street
Suite
City
State
Zip Code
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(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
3) Subject Matter (Describe in Detail):
f)~-on -b :1JEJ3 -: m7C2.t Wirfld ~.Js.
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: lJjZEJ
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual): 8caItI /fea;nng dtdy II{ '200 (
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnei
o Identify Others
.2001
,2001
,2001
,2001
,2001
,2001
on
on
on
on
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6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: flCl1P,
ON OCTOBER 1 Sf 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 2-482 of the Miami Beach City Code as amended, and all reporting
~q",~m~" ~ &
Signature of Lobbyist: '!t:~ wM)t 7tfA...-
o Personally known a d'as,
w Produced ID OY'lvef"<G LIOUt'Se r1 (PeS 1 83 So 10-'1 '1 D
Identify
1- Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This IltL day of JUlY, 2001.
.~tJ~
Notary or Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration:
[ ~CEPTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE: 71 t I ) LJ I
If rejected, state reason:
Registration fee paid: [~s [ ] No [] Not-for-Profit Organization
[.:.rcash []Check MCR #
DATA ENTRY DATE:
.2001
ENTERED BY: