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W. Tucker Gibbs - Michael Krieger 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 tq 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 W.Tucker Gibbs Principal. Michael Krieger Issue Design Review&Other Miami Beach consideration of development approvals regarding 28 W.Dilido Dr. Application No. DRB 23074 PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: As S 0150460 CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: Publications: Travel: Lodging: Special Events: XCHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: 1 Z-31-/r OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose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. 14/*J/��/' L byist Signature SIGNATURE AND STAMP OF NOTARY: \/ Produced ID Fb L _, ! AF_.0 _: t . Form of Identification Si:nature of Publi otary—State of Florida Sworn to and s • ibed before me Personally known Th. _ d. • 0 __ LILLIAN BEAUCHAMP } ` • = Notary Public-State of Florida My Comm.Expires May 5,2018 • .rte %,;oF Commission # FF 11S190