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Jorge Sergio Kuperman - Quibus Group, LLC 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 Jorge Sergio Kuperman Principal Quibus Group, LLC Issue Façade alterations to 1910 Alton Rd. Before DRB PLEASE COMPLETE THE SECTION BELOW - Detail Compensation Received: ���`'a' � � . CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: }. Research: A RA t -1b C ? / MI s 20 Communications: Media Advertising: Publications: Travel: Lodging: Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 disci.'' rein and an .ttachment hereto are true and correct. tasty NUl pepuO9 `""�� ,,,� Lobbyist •Si: .;l / SIGNATURE AND STAMP OF NOTARY: MONO:SaJldx3 "- '�' f UOISSWWO3 Produced IDS'3 OPod ti,i6 / _ -- Form of Identification Sig ature' Public NI:. ary—State• F• • Sworn to :nd subscribed before me Personally known This 2-c,day of JAN,20 i L i