Komar Investments, Inc. (10/5)
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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. f1.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 COMMISSIDNER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY cm BOARD OR COMMITTEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE OECISION-MAKING
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMITTEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIvrnES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHORAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAW)L)"
1) Lobbyist Name: ~l+ IA"'~ C::::ie:~'A. \! K
Last Name First Name Middle Initial
Business Phone (~ i. 7 ~ -II b I
Message Phone (_)
t..cM.~ ~ --st 1f ~/R
N_~- ~7-(
No. Street Suite City State
Email Address: Qe,......L..D K @ .:s.e. \J,......B~4.~ L ^. ~ . c.CS"h1
~,,-.-- --
(\ t:> 11119 R ~ ves.T.wI~ ,~ c.
J...{ 11-<<'; 6 rt-
Street
JL(A.
Business Name and Address:
lilt
.:S ~/ 3 ?
Zip Code
2)
Principal Retained by:
:SO'" T( lOe.o...ct...
If different from above
I(,{ O,..~,........ "Dr.
City
Suite
"1-1
d$/.ii7'
Zip Code
State
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests~ A'
:s"c M. IlDI D
3)
Subject Matter (Describe in Detail):
\
YA~a.H~ i(:=.?'~s:.V-
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: .pk .......~ ~ _ Z B It-
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
o The City Commission
o City Commission Subcommittee
~ City Staff
K'City Board or Committee .z. 6A
o Personnel
o Identify Others
.2001
,2001
,2001
,2001
,2001
,2001
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:
A.J 0?c.J2..
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 ion 2-482 of the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
pl Personally know
o Produced ID
1- Did take an oath, or
o Did not take an oath
Identify
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This S--t;.t:; day of Oe L.Jb..,-, 2001.
/~/MJ '1) ~ .
, Notary or eputy Clerk)
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: [vfACCEPTED [] REJECTED DATE: ~ 5 / () l
If rejected, state reason:
Registration fee paid: M'fes [ ] No [] Not-for-Profit Organization 0 . {_
[ ] Cash [ ] Check MCR # 2--'1- <0 ~ l 'f::-
DATA ENTRY DATE:
.2001
ENTERED BY: