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Ethan Wasserman - Phillips South Beach d/b/a Shore Club 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 fa A statement shall be filed even if there have been no expenditures or compensation during the repotting 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 Ethan Wasserman Principal Phillips South Beach d/b/a Shore Club Issue B Hotel Project-Shore Club PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: \C-\`(:)\ CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: Publications: Travel: '43 Lodging: Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 disclosed herein and any attachment hereto are true and correct. Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: C" pr��o� � %a MARIA-JOSE LOPEZ ,o. ,`��� '• Produced ID I -; Notary Public-State of Florida , A •�y ' M.1� '�J..�� 1.t\�l _ Form of Identification, l• •? My Comm.Expires Jan 2,20174 �� _ � _ orida '-:', JS Commission#EE 862202 - ��s. '�''�, Bonded Through National Notary Assn. Sworn to and subscrib before me •Personally known _ _ __ _ _ _, This 10 day of 3,,20 ‘1,,1 eAr