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Lucia Dougherty - Mango's & David Wallach 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 thereporting 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 Lucia Dougherty Principal Mango's&David Wallach Issue Development permits and extension of time PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: ` '7 S CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: ,/. Research: Communications: Media Advertising: Publications: \ 41 :\)\*- \) Travel: Lodging: Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath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 disclosed herein and an tachment hereto are true and correct. Lobbyist Signa ur SIGNATURE AND STAMP OF NOTARY: Pr uced ID p Form of Identification Signature of Pu is Notary—State of Florida WENDY CORREA Sworn to and subscribed before me 1,7 Personally known P...--3."A°�'' Notary Public-State of Florida This/'� day oft,20./k — • i- ;3 My Comm.Expires Mar 23,2018 �� '?� / ' -' a; 104732 Commission# FF ':;;nuNC.