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Perry Boucher - Boucher Brothers Management City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 1 Expenditure report for period of:1/1/2015 through 12/31/2015 A statement shall be filed even if there have been no expenditures or compensation during the reporting period. This statement is to be signed, notarized and returned to the City of Miami Beach,City Clerk's Office, 1700 Convention Center Drive, Miami Beach, FL 33139 by February 28th.A fine of$50.00 per day,per issue,shall be assessed for statements filed after the due date. If you require any assistance,please contact this office at 305.673.7411 or at cityclerk@imiamibeach.gov. Lobbyist Perry Boucher Principal Boucher Brothers Miami Beach, LLC Issue Beach Contract for Lummus Park,OSP, NSOSP, Umbrella,Chair,Watersports and food and beverage. Fined$950 PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: O CATEGORIES OF EXPENDITURES Food and Beverage: '"Anti Entertainment: No A Research: Mor�v Communications: No r1></ Media Advertising: Np, c� Publications: MD n€..- Travel: Np n Lodging: 4/0 Special Events: 4/0n r___. CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any atta ment hereto are true and correct. obbyist Signature SIGNATURE AND STAMP OF NOTARY: Produced ID �:L°J . ti 114i L t. Form of Identification .�., •Signature of Public Notary-State,.f Florida ' •. ASIA TOUISITHIPHONEXAY Sworn o and sub c ibed before me • * MY COMMISSION#FF 938183 Personally known 4 EXPIRES:November 22,2019 This-day of��,120 R D Bonded Thru Budget Nota • 9 Notary Services