HomeMy WebLinkAboutBercow, Jeffrey 1/7/02
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention ~nter Drive
Miami Beach, FL 33139
citvclerk@lci.miami-beach.f1.us
AFFIDAVIT
. '.
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINaPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLlJTION, ACTION OR
DECISION OF ANY COMMISSIONER; ANY ACTION, DECISION, RECOMMENDATION OF ANY aTY BOARD OR
COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
AlTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVrnES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, AlTORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A .CERTIFICATE OF WITHDRAWAL:
1) Lobbyist Name: Bercow Jeffrey
Last Name First Name Middle Initial
Message Phone L)
Business Phone Uo..s) 177-1>7.10
Business Address: 200 S. Biscayne
No.
Miami
City
Email Address:
," . .' . ~-'>
~)Prln~;: R~tain~dbY.::
Sunset Three-~??,.I~tI'.7.~.-' 1800
If different ITom above
Miami
State
33131
Zip Code
850
Suite
City
Sunset Harbor Drive
Street
Florida
, State
Suite
33139 '
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
3)
Subject Matter (Describe in Detail):
Modification to prior Lot Split Approval
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) ,
to be lobbied: City Staff. We will not communicate with members of the
Planning B-~ard prior to the public hearina sin~p t-hAY w; 11 rou; 9,.7
this application while acting in their quasi-judicial capacity.
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
on . 2000
on . 2000
on . 2000
on Jan. 22 . 20~ .
on . 2000
on . 2000
a The City Commission
a City Commission Subcommittee
a City Staff
'c- City Board or Committee Planning Board
a Personnel
a Identify Others
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: NORe
ON JULY 1sT OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, USTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
Signature of Lobbyist:
X Personally known
a Produced ID
are true and correct and that I have read or
'on 2-482 of the Miami Beach City Code as
Identify
~"""'" USA C. BROOKl~
Qlr , MV COMMISSION' CC 856829
:, : EXPIRES: July 20, 2003'" .
'. ' _Tlwu-'P_~
a Did take an oath, or
.x Did not take an oath
State of Florida, County of Miami-Dade 2 I
Sworn to and sUbscri~8 before meOD
This _b~ day of .e.c. . . 2~
~-~
Notary or Deputy Clerk
_----L(.sa. Cv eVVO k5 .. "
If Notary, print, stamp or type as commissioned
Registration:
FOR ClERK" USE ONLY if (
[ ] REJECTED DATE: { 7. O~
If rejected, state reason:
Registration fee paid: [ Yes [ ] No ] Not-for-Profit Organization
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DATA ENTRY DATE: 1 00..1tea- ENTERED BY: