Carly Grimm - Bilzin Sumberg ! N
City of Miami Beach 2016 JAN d 5 AN 9: 05
1700 Convention Center Drive
Miami Beach, Florida 33139 %; 1°y,,r F F ICs_
www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 I Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Carly Grimm
Business Name: Bilzin Sumberg
Address: 1450 Brickell Avenue, Suite 2300, Miami, FL 33131
Office Telephone Number: (305) 350-2352
Cellular Telephone Number:
Email Address: Cgrimm @bilzin.com
If more than one lobbyist, please list:
1)
2)
3)
4)
5)
6)
7)
Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
MCR#: b3D
Amount paid: 50 O • O Date paid: 0 I - 15- I b
Processed by: _J 0 SkLAj mak, Date: 0 1
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx
s s r}
Yu
z z !JE
2 . > CD-
City of Miami Beach-Florida .a",' Oo to
Finance Department
1 City Hall °a ?-,
1601520-1 01/15/2016 BR1 T131 - - -' z--- _
Fri Jan15,2016 09:13AM Trans#16-16 m .�a .: n ... o 16 $500.00 MCRCLERK - MCR-Cqty Clerk _ c , � =
* MCR#: 408630 _ E
1 ITEM(S): TOTAL: $500.00 C
CD _.
Check (008332) PAID $500,00 '°
Have a nice day!
m
'" r-- , 4 -
•
- r
•
O < O
cn- 0
rO m co co
W Z . N
00 o Z
N N
-1 C
n �
G)
m
= 0
-< w
0 a.
- <<• m m
- o
5.
E Z
a CD D a
° - o
m m
M
n
Re
T 0
0 X
N ,. m
o -a
v.
C
r
73
CD
CD
C
o'
0
C)
v
G)
3
3
C
c
O
a)
EF)
C)
�G
N o
7 Co CW
O O W
O
W
IV