Afidavit
lQ
-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk@ci,miami-beach,f1.us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNCIPAL 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 COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERlOD 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 PRlNCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRlNCIPAL, REGARDLESS OF WHETHER SUCH LOBBYlNG 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 "CERTIFICATE OF WITHDRAWAl."
1) Lobbyist Name: .:t>ORTA-}) U<Q. \J c. J O(<..G E
Last Name First Name
E-.
Middle Initial
Business Phone (~ ~ ~(- '>-4 01 Message Phone (30\1 'b t - 0 B 0 '2
Business Name and Address: .j 014; f'- :::DOe-To.\. -J> t.<.-&Je... ,1:-., [[A.. AOcIf \ 'l.Ec-r
, ,
5(;4 S 50 9'7 -\L<.. s-r-(.2f'E''l t-\ f.t.\-11 F L '3 '5 \ 4'S
No. Street Suite City State -Zip Code
Do R- 'T h. 'D u ~ b.() L . CO M
Principal Retained by: C t-ll... R-L E 5 G R.ou f' t-\- Q <: E L.s
.:q3 33 lO\ L-L/4IJ..( h.t&-.. K I A t--ti (SE:J.C N
If different from above Street
k I };. !J\.. I (;; <C4c..H F L
City State
Email Address:
2)
Suite
'3-3l4'1
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or inter~s!=S.
}.t\,'CH4:>EL t<,I>,.VlOFFr Up,
3)
c; (2.Ol) P 1:1 01/3. LS .I;t/
{AJ
oe:, t<o
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: "
.t.;l r ') ~1" E S '\ ):, f' 'F 6) F- f' LA 1IJ 11/ ; IV 6 ~ '20 IV (.4/-6 () e;t>{
iliA!) (Sc..J/L()t1Ah {)f:PAI'2-7M<Z:tUT
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
.2001
,2001
,2001
,2001
,2001
,2001
a The City Commission
a City Commission Subcommittee
a City Staff
)it. City Board or Committee
"}ii( Personnel
a Identify Others
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: IV 6 I.J E
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of tl1elOre
with the provisions containeprri Secti
requirements. .
Ing facts are true and correct and that I have read or am familiar
2-482 the Miami Beach City Code as amended, and all reporting
I
Signature of Lobbyist:
a Personally known
)( Produced ID
~ Did take an oath, or
Q Did not take an oath
,:S3 4--2.6 ~~ 2-.- I J.-Cp
Identify
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ;Z6t;;I- day of III 11 ,2001.
~~uJ~
Notary or Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration: ~ ACCEPTED
If rejected, state reason:
Registration fee paid: [
FOR CLERK'S USE ONLY
[ ] REJECTED DATE: ~ 2S! 01
es [ ] No [] Not'for-profit~~~n~wp,
Cash [ ] Check MCR #
DATA ENTRY DATE:
.2001
ENTERED BY: