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Ricardo Bofill - 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 pejfaod.' 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 cityclerkPmiamibeach.gov. Lobbyist Ricardo Bofill Principal Camilo Miguel Jr. Issue Development Approvals for 4000 Alton Road, Miami Beach, FL PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: 0 CATEGORIES OF EXPENDITURES Food and Beverage: 0 • Entertainment: Research: 0 Communications: C) Media Advertising: 0 Publications: 0 Travel: 0 Lodging: 0 Special Events: 0 CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 disclosed herei nd an attachment hereto are true and correct. '' C Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: Produced ID Form of Identification Signature of Public Notary—State of Florida Sworn to and subscribed before me Personally known This day of ,20 5f J 154 TA9-11 SAPS NOTARIAL CONFIRMATION: I, ELENA LUACES LOPEZ, Notary of Sant Just Desvern (Barcelona-Spain) , hereby cer- tify and confirm the authenticity of the signature in this document of Ricardo Bofill Maggiora-Vergano, born the 12th of January 1965 in Barcelona (Barce- lona-Spain) . He has signed before me and has shown me him Spanish document of a identity number 35 . 100 . 546-Q, valid until February 25th, 2023, with which I have identified her. Sant Just Desvern, February 9th, two thousand sixteen. N° 62 . Yo, ELENA LUACES LOPEZ, Notario del Ilustre Colegio de Catalunya con residencia en Sant Just Desvern, LEGITIMO la firma de Don Ricardo Bofill Maggiora- Vergano, con DNI/NIF numero 35 . 100 . 546-Q, por, el re- conocimiento hecho en mi presencia por el firmante, como propia, y SIN QUE MI INTERVENCION SE EXTIENDA AL CONTENIDO DEL DOCUMENTO NI LE ATRIBUYA EFECTO PUBLICO ALGUNO, quedando anotada en mi libro indi- cador bajo el numero 62 . Sant Just Desvern, a nueve de febrero de dos mil dieciseis . DOY FE. SELLO DE { i_LEGITIMACIONES Y Ix�,_,� LEGALIZACIONES -,-.4 t,; ,e _ �•. / °� oJ; 0,10 1 € t ej05 � €i 4; i ii1 Ni 4( d . ,6-90 a ,mss ® , ' G _I *._ A"— "dt''''''( iml )i. 6- ''''N, * . ' .,.„1"'<.P,'"4'.4/-1' ) S.' c.SLQ... 'VD". 4)0 ES4 TOA