Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 ConventIon Cenb!r Drlve
Miami Beach, R. 33139
cltyclel1dilld.miami-beach.fl.us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR REf AINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, AcnON OR DECISION OF AN'f COMMISSIONER; AllY
ACTION, DECISION. RECOMMENDATION OF AllY CITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN AN'f MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEClSION-MAKlNG
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 AN'f AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTtVI11ES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FI A "CERTIFICATE OF WITH WAL.
1)
~
Lobbylst Name: 0 c..
Last Name Middle Initial
Business Phone c22.)~:'?J- 311L Message Phone <.3:1;) L.\ C6 - \ 07.. 3
Business Name and Address: ~o \X... It ~O t!>,ro "11-1 EeLS YY\I CI ~y,.. L\..(
1 c'\ .1- \ tJ( 3b-tf\ (0\)(1...\ J\)CV1JlI.A F\.q. ~J\ ~o
No. Slreet Suite Oly State Zip Code
Emall Address: $~l'\(b\{ ~\\ ((l. @ I\hl. Cor'!
2) Principal Retained by: ~\)J(\,\~,(\. ~'t'o ~r fI\\ 1\ \6;.\-) Llt
If different from above
Street
Suite
City StatE Zip Code
(a) If a COI'pOlatiOn, partnelship, or trust:, identify and provide the address for the chief cfflcer, partner,
beneficiary or hltl!tests.
~\r/\ t\\Jt'V'lV 1.0"l}\ Nt. '3.o~ Cov(\;f
t>.JeoJ'IJQ.1' t\. :.31'i>O
3) Subject Matter (Des~ ibe in Detail):
\SQ MY' \.or-lt '<'''\\)..1 (If ~
4. Identify each Individual (CommlsslonelS, Board, Committee. Authority member or CIty statI)
to be lobbied: ffi f' (\c\ C 11 N"'
'Il\yoll \ C.,\,\ '-otlll\ ,e'l'\. 1'\1'lI \\4, l\1"tD(Nl~~ \)\-TlLt
5. l1'le subject matter In number three (3) above Is to be considered at the meeting c:l (Identify each entity or
Individual):
u l1'le CIl.y ConvnlssiOn on .2001
u City Commission 5ubcommltD!e on .2001
u City Staff on .2001
lJ CIl.y Board or ComlT1it:lee on .2001
lJ Personnel on .2001
u Identify Others on .2001
\
6. State the extent c:l any business, financial, familial, professional or other relationShip wIith exists with any
IndMdual identified In number (4) above:
ON OCTOBER 1 sr OF EACH YEAR, EAOi LOBBYlST SHALL SUBMIT TO THE CITY Q.ERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly &Wear that all c:l the foregoing facts are true and correct: and that I halle read or am familiar
;::i:=sions contal\if i~ ~ 2-482 c:l the Miami Beach City Code as amended, and all reporting
Signature c:l Lobbyist: -Dl\~
~I~LD~ f> 2-&>0-5;'+'1 ~~- ({(V-u
Identify
lJ DId take an oath, or
lJ DId not take an oath
State c:l Florida, County rI M1aml-Dade
~19~SUbou~me
This ~day rI .2001.
c~~
If Naary, print, stamp or type as corrmI$Ioned
Registration:
FOR CLERK'S USE ONLY
REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-fOr-Protlt Organization
[ ] Cash [ ] Oleck MCR #
DATA ENTRY DATE:
. 2001 ENTERED BY: