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Tracy Slavens - Baptist Health South Florida, 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 • r i 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 Tracy Slavens Principal Baptist Health South Florida, INC. Issue Planning Board consideration of conditional use at 708 Alton Road, Miami Beach, FL PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: HOURLY CATEGORIES OF EXPENDITURES Food and Beverage: —0— Entertainment: —0— Research: -0- Communications: —0— Media Advertising: —0— Publications: —0— Travel: —0 Lodging: —0— Special Events: —0 CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 dis ed here' . • any attachment hereto are true and correct. � � 11 LAi Lob: st Signature SIGNATURE AND STAMP OF NOTARY: Produced ID ek lu. _.t 1 Form of Identification Sig ature o ' illi-e4 et. --State d1'FTorrida Sworn to and su• •=.d before r►ie c.�Personally known This 2 Zday of of:214 20 i (o A*:... PAMELA JACKSON ' MY COMMISSION#FF 068707 ,q¶_ EXPIRES:December 17,2017 4,;:6),T," Bonded Thru Notary Public Underwriters