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Jose Villalobos - Ric-Man Construction, Inc. 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 cityclerk @miamibeach.gov. Lobbyist Jose Villalobos Principal Ric-Man Construction, Inc. Issue RFP 54 Inch Redundant Force Main RFP 2014-253-YG PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: g,00() per rnorri-k CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: A Iv Publications: Travel: Lodging: Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 --,s.ed he,ein and any attachment hereto are true and correct. lAd / obbyist Signature SIGNATURE AND STAMP OF NOTARY: e••P:;�%. MARIA GONZALEZ Produced ID * c_ * MY COMMISSION#FF 909142 • 'no' • EXPIRES:October 22,2019 Form of Identification �q o.Foe Bonded Thru Budget Notary Serrices Signature of Public No ary—State o •rida Sworn to and subscribed before VPersonally known This.Qaday of70'l;20 (t0,