Laurie Golurs - Shore Club Property Owner, LLC . MIAMI BEACH
City of Miami Beach 2016 S .P 30 Pi 1: 50
1700 Convention Center Drive
Miami Beach, Florida 33139 CITY Ci_I_,•,, ' 01- r Il;L
www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
Oc aolL- S , v' l
ANNUAL LOBBYIST REGISTRATION FORM
Name: itIKA-SA(v" OL4
Business Name: 5 Nei-Q. CAKAD Pip.' w0,r, fjt-�—
Address: .6 00 itikokso,N /1-/c , .i rs' �d�or-� i IT? i doga
Office Telephone Number: -21a - 300 - <3(7o0
Cellular Telephone Number:
Email Address: L C' €/ C.0 rl
If more than one lobbyist, please list:
1) Thor5 !L i -C&r - 16 ear • zcy • Ga►mt
2) -041k,eN_ IA)€S s e r,54"e, W X.-i ss-e.,n s ire-in -�_ h c acv. o
3)
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Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
MCR#: LI I a q0'.5
Amount paid: 1500 • 00 Date paid: C7C' 30 -
Processed by: -,. /1SotJ Date: 0 3o - 1(�
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx
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