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Carli Koshal - Sebastian Casano City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 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 cityclerkPmiamibeach.gov. Lobbyist Carli Koshal Principal Sebastian Casano Issue Development Approvals related to 234 Washington Avenue,Miami Beach,FL PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: $275 per hour CATEGORIES OF EXPENDITURES Food and Beverage: $o rea Entertainment: $0 - Research: Communications: $o ' Media Advertising: $o Publications: $o - • -- w Travel: $0 Lodging: $0 Special Events: $o CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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. I 14 • itig lobbyist Signature SIGNATURE AND STAMP OF NOTARY: ,, I 9 f '. Pr 'duced ID L/ Form of Identification Signature of u is Notary—State of Florida Swor t ands scribed before me Personally known ThisZZday f!! ►1,20 1,6' �ef PI' Notary Public State of Florida 4Diana Ramos %449; y My Commission FF 207719 �'ov fkov Expires 04/10/2019