Affidavit
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CITY Of MIAMI BEACH
OFfICE Of THE CITY CLERK
1700 ConYenUon CenIIer DrM!
Miami Beach, R. 33139
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AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS TO ENOOURAGE
THE PASSAGE, DEFEAT OR MODlACATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMISSIONER; Atrf
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEANED IN Atrf MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEClSION+tAKING
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 SPECIACALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFACER 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 "eERTlACATE OF WITHDRAWAL'
Lobbyist Name: e:DlJC.he R ':)TeVe f)
last Name Rrst Name
1)
J
Middle Initial
BusIness Phone ~JJ~- 3CA3 Message Phone L.)
Business Name and Address: \3ouchu \'SlO S. rv'll ~ t' t3eAC I,
2.6Cj:t I tl t '30-+"1 CT f)lJe/TTUR r't- q:L
No. Street Suite Oty 9;atE
EmaIlAddress: 1313vBm5v ~ 00 I . C.OM
2) Principal Retained by: I<nx-: tV C~roo:; tV1'~I. /SeA<; h
L... L. c:.
5$/80
Zip Code
LL.L..
If different: from above
Street
Suite
c~ Sare Zip Code
(a) If a COIpOriltion, partnership, or trust:, identify and provide the address for the chlef~, partner,
beneftciary or i~ ~~ _
"3", O\lc'Jel' ZQC1:r1 (IE. 30 (Oll(< \
AveI)TVRt:), F\ :S31~O
3) Subject Matter (Desc..-ibe in Detail):
(~R (.)...{ '^ ( r.Al)C t"55\'oV\
R F.r.
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4. J.cIentI'!~ Individual (Commissioners, Board, Committee, Authorfty mem~or CIty staf'l)
to be lobbied, ~()R Ctfl ~ CI'-'-\ Cofl,jfl\ c.+~\ M\'II i o'{c e.
5. lhe subject matter In number three (3) abolle is to be considerecl at the meeting d (Identify each entity or
Individual):
a lhe City CommIssion on. 2001
(J City CommIssion SubcomrT1Ittee on. 2001
(J City Staff on . 2001
(J City Board or Committee on. 2001
(J Personnel on . 2001
(J Identify Others on. ,2001
6. state the extent d any business, financial, familial, prttessional or other relationship which exIsI:s with any
individual identified in number (4) above:
ON OCTOBER 1 Sf Of EACH YEAR, EAOI LOBBYlST SHALL SUBMrrTOTHE CITY a.ERKA SIGNED
STATEMENT UNDER OATH, LISllNG LOBBYING EXPENDI1URES IN THE CITY Of MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly &Wear that an d the foregoing fads are true and correct and that I have read or am farrillar
with the provisions contained in Section 2-482 d the Miami Beach City Code as amended, and all reporting
requirements.
Signature d l..oIlbVist:
~I~P L~ Lb()-7q ~- ~~-~j+~()
Identify
(J Did take an oath, or
a Did not take an oath
state d FlorIda, County d Miami-Dade
~~2001. rw~Oot
If Naary, print, stamp or type as conrnIssloned
fOR CLERK'S USE OlIILY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, stale reason:
Registration fee paid: [ ] Yes [ ] No [] Not-fur-Profit OlganIZllUon
[ ] Qlsh [ ] Oleck MeR #
DATA ENTRY DATE:
. 2001 ENTERED 81':
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