Affidavit (Charles E. Smith)
lQ
-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(Cilci .miami-beach. fl. 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 LOBBYING ACTlVffiES 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 "~RTIFlCATE OF WITHDRAWAL;? I. A
1) Lobbyist Name: VC)'J<s he-r1~ /--.1,) c., C\.
Last Name '3 Fi st Name
Business Phone (~ 5l q - 0 6 D Message Pho~e (~
Business Name and Address: ) J.. 2., , ~ ( \ ~ II AN
M\~ FL- ~)D1
No. Street Suite c;"t 1 c~ . U,;Y'f1 State
Email Address: \\(\ \)~,^9^f\7 L@)-t}:-~
2) princiPa~e~ CV\oJ\\~jJ [: SYn\-bL,
If different from above
Middle Initial
Zip Code
Street
Suite
City
State
Zip Code
(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):
((Me) \-\1\ fI'".oJ ~ fMY'I\r-V
~<.l~ f\0W,,{0\'^] ~QJ~ J
4. Identify each individual (Commissioners; Board, Committee, Authority member or City staff)
to be IObbied:f\,^NI\h~ 1?:>0! Bel c1 AJ)
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
a The City Commission
a City Commission Subcommittee
a City Staff
,,)7 City Board or Committee f I '^ V\J I\/]
a Personnel
a Identify Others
on
on
on
on 7/3 I
,
on
on
.2001
.2001
: 2001
2001
,2001
,2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above:
110()
ON OCTOBER 1ST 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 Se ' n 2-4 2 f the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
a Personally known
y Produced 10
Identify
a Did take an oath, or
a Did not take an oath
State of Florida, County of Miami-Dade
SW~f.lnd sUbscr~e me
Thi day 0 ---o--t 2001.
~'
, ~
r Deputy Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not.for-Profit Organization
[ ] Cash [ ] Check MCR #
DATA ENTRY DATE:
.2001
ENTERED BY: