David Blum - Alan Potamkin 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 citvclerk@miamibeach.gov.
Lobbyist David Blum
Principal Alan Potamkin/633 Alton Road Property
Issue HPB&Planning Board
PLEASE COMPLETE THE SECTION BELOW
'
Detail Compensation Received: 1''��' -/L jl 00 trb
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CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE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 Miami-Dade
I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any attachment
hereto are true and correct.
Lobbyist Signature
SIGNATURE AND STAMP OF NOTARY:
Produced ID �' y prretit
Form of Identification Si A i
g ature blic Notary—State of Florida
DIARY P.PETRIE Sworn to and subscribed b fore me
Personally known ry pv�,iic.Stag of Florida Thi ay of i ,20 14
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�comm.t,.;ites.luly 22,2019