Dacra 02/08/02
..
. ,
...
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
LOBBYIST REGISTRATION
AFFIDAVIT
f'~
~
,', r", _ 1 V l= D
-- ~ \>' :..-
GL
! 1 Prl 2: 03
, I'Ll:.,,;.'S qFf ICE
LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS ANY I AGENT,
OFFICER OR EMPLOYEE OF A PRINCIPAL. EACH PERSON WHO WITHDP.WS AS
A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
(I) Lobbyist Name Echemendia. Santia~o D.
LAST NAME FIRST NAME MI
Business phone ( 305 ) 536-1112 (Tew Cardenas Rebak Kellogg. et al.)
Business Address 201 S. Biscayne Blvd.. Suite 2600. Miami FL 33131
Principal Retained By: j~l' l.A
(2)
Principal's Address
Zip
(IF DIFFERENT FROM ABOVE)
,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!) < ".
~~~)~ \ r
~I\ ~~
\J ttJ f\ O? t-f E""'Y
r Ot>J1'(. ~!~ 0~
c~ ci S ~(\(>-:! F r"( .
~Jlll)~N~ )zif
,
~~"1'uIY.Nf~r
~1
~
(4)
Identify each individual (Commissioners, Board, Committee, Authority member, or
City staff) to be lobbied.
~\~tJ[,.}1 ~Ft.lrl~N.fN"l
(5)
The subject matter in number (3) above is to be considered at the meeting of:
(Identify each entity or individual
o The City Commission
o City Commission Subcommittee
o City Staff
o City Board or Committee
o Personnel
o Identify Others
,19_
,19_
, 19_
,19_
,19_
, 19_
on
on
on
on
on
on
:.
if
(6) State the extent of any business, financial, familial, professional or other relationship
which exists with any individual identified in number (4) above.
f
ON JULY 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK, A SIGNED
STATEMENT UNDER OATH, LISTING ALL LOBBYING EXPENDITURES IN THE CITY OF MIAMI
BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read
or am familiar with the provisions contained in Section 2-48 of the Miami Beach City Code
as amended, and all reportin requirements.
Signature of Lobbyist:
~rSOnallY known
o Produced ID
Echemendia
(IDENTIFY)
o Did take an oath, or
~id not take an oath
State of Florida, County of Miami-Dade
s~om~r SUbSCrib~~fOre me
thiS day of J::iL-- ,~
(
If a Notary: Print, Stamp or Type as Commissioned
ANA M JIMENEZ
Nal'ARY PUBLIC STATE OF FLORlDA
COMMISSION NO. COI59111
MY COMMISSION EXP. Y 28
******************************************************************************
Registration:
FOR CLERK'S USE ONLY
o REJECTED
DATE
If rejected, state reason:
Registration fee paid: ~s
o Cash
DATA ENTRY DATE
Z 0 Not For Profit Organization
o Documentary Proof Attached
CheckJjJ 'd- MCR No.
,~ ENTERED BY
221998