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Carter McDowell - Jeffrey Miller 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 Carter McDowell Principal Jeffrey Miller Issue All matters regarding land use/zoning/development of property located at 125 E.San Marion Drive, Miami Beach, FL PLEASE COMPLETE THE SECTION BELOW — Detail Compensation Received: CATEGORIES OF EXPENDITURES Food and Beverage: 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Research: Communications: Media Advertising: Publications: Travel: Lodging: Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 information disclose. r ein and any atta ment hereto are true and correct. Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: a r P� p � sow � 0 i •••,7 .� IBIS DIAZ – b2t, Produced ID � * MY COMMISSION It FF 111262 EXPIRES:May 24,2018 Form of Identification ^ql t BoridedmruBudgetNotaryServices Signature of Public Notary—State of Florida Sworn to and sub gibed before me r/ Personally known This i Zday of ,L, 20��