Hernandez, Rick
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(Cllci. miami-beach. fl. us
AFFIDAVIT
LOBBYIST ME1\N6 ALL PERSONS 1:_~PlOYED OR..RErAItifD, 'WHErI;lER PAI.D:'OR NOT, .BY A PRINCIPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, [lEFEAToOR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTIOI':J, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATIONTPtAT l=bRESEEABLY 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,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: l-lt;JZ.~AJ Dlee 12,c.~
Last Name First Name Middle Initial
Business Phone ~) ~ I tb -5 (PSG:. Message Phone (~ e::r 75" S.:::r ~O
Business Name and Address: ~ 0, "E::i<.>1e Co,lc.e::. \d"[!::. )'1:J.c..
2 ~o I ? L-cl. Ilb A" pe.. M I A..11 I " 'F L-
No. Street Suite City State
Email Address: -r:::i" 1!:-(L~fC:,. CoJ.~FT'> e ~m \..\ J. ~. J J ~ r
2) Principal Retained by:
3~1~
Zip Code
If different from above
Street
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary oriflt,erests.
3) Subject Matter (Describe in Detail :
J I
A
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: W .a J
'~TO(L'c.. I f<.?i:~"AT'O ~Af-r::> .
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
[J The City Commission on. 2001
[J City Commission Subcommittee on. 2001
[J City Staff on . 2001
[J City Board or Committee on, 2001
[J Personnel on 2001
;aa IdentifyOthers ~\c;,.To(l'C. f'(2.~,,~'o...\.~~on ~"3>!'2- /200'J,.0
6.. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: ~._
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ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALl. SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the fore
with the provisions contained in . 0 2~
requirements.
Signature of Lobbyist:
cts are true and correct and that I have read or am familiar
2. 0 the Miami Beach City Code as amended, and all reporting
#( Personally known ' l
[J Produced ID
Identify
[J Did take an oath, or
[J Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribeq before me
This ePt7 day of ....;~/IrtIA( . 20ol.l
~ "' 00 ....'
~ or Deputy C~ ~
tJ1 ~ It- I u;,Pe 2;;-"
If Notary, print, stamp or type as commissioned '..>.
OF
MARIA T LOPRZ
NarARYPUBUCSfATE OF FLORIDA
COMMISSION NO. 00010418
MYCOM~ISSTOI\lI;XI",~, 10 005
" 'FORCLERK'S.USE ONLY J
Registration': ~D ' [ ] REJ.E;CfED DATE: ~ F ,- d ~
If rejected, state reason: ' .--
Registration fee paid: [ }-V€[] No [] Not-for-~r.Q,fit P[~rWft~"""""'"
[ ] Cash [ ] Check MeR #C'" ~~
DATA ENTRY DATE: . 2001 ENTERED BY: