Adrian Dabkowski - Camilo Miguel, Jr. 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$50.00 per day,per issue,shall be assessed for statements filed after the due
date. If you require any assistance, please contact this office at 305.673.7411 or at cityclerk@miamibeach.gov.
Lobbyist Adrian Dabkowski
Principal Camilo Miguel Jr.
Issue Development Board Approvals for 4000 Alton Road, Miami Beach, FL
PLEASE COMPLETE THE SECTIO BELOW
Detail Compensation Received�( 1CG I -p�
'
CATEGORIES OF EXPENDITURES
Food and Beverage: i° /19-
Entertainment:
Research:
Communications:
Media Advertising:
Publications:
Travel:
Lodging:
Special Events:
CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE
DATE REPRESENTATION ENDED:
OATH
State of Florida
County of Miami-Dade
I,the undersigned lobbyist,do hereby depose under oath and affirm that the informatio► : ,•sed herein an. . achment
hereto are true and correct.
L•_ayist Signature
SIGNATURE AND STAMP OF NOTARY:
Produced ID _
Form of Identification :igna ure of Public Notary,te of Florida
Swo n c,and bs ibed fore me
Personally known ,,.,```,ii�P- 0,day . ,$ 20 1
y :�4,4 SHANDA SOON LAYNE
MY COMMISSION#FF 092 3
.y.!`.�� EXPIRES:April ,2018 7
', ;,;;`' Bonded Thru Notary•Public Underwriters