Keith Hart - Keith Hart 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 F
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 citvclerkPmiamibeach.gov.
Lobbyist Keith Hart
Principal Keith M.Hart
Issue Miami Beach/Miami World out Games 2017
PLEASE COMPLETE THE SECTION BELOW
Detail Compensation Received:
CATEGORIES OF EXPENDITURES
Food and Beverage: _
Entertainment: _ �
Research:
Communications:
Media Advertising: — �
Publications:
Travel:
Lodging:
Special Events:
CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE
DATE REPRESENTATION ENDED:
OATH
State of Florida
County of Mites-Bar to gQDaltaDI
I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any attachment
hereto are true and correct. j
Lobbyist Signature
SIGN TURE AND STAMP OF NOTARY:
Produced ID AiOeid.A ;0ZiJUZ CA4- Q4oJk
Form of Identification Signature of Public No ry-State of Flori
Swov,�tgnd s bscribed before me
Personally known Thi `day ofj�,20 1l0
SARAH Public IVES State ALVAREZ
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''�M My comm.expires July 18,2017. /71-