JB Slater
.~
Ii
.,
~
-
f7{ECEfveD
02 MM? 26 PM 3: 36
,~-'\
- ERn'S lJj!F.
CITY OF MIAMI BEACH
OFFICE OFTHE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@ci.miami-beach.fI.us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, AmON OR DEOSlON OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY AcrION, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKING
PROCESS ON SUCH AcrION, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALL Y INCLUDES THE PRINOPAL 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 ~lE A 'CERTIFlCATE OF ~~~WAl.'
1) Lobbyist Name: _/N~ __tJI: ~~lS?) N
-
Last Name First Name Middle Initial
Business Phone ~ 63d.-OSOO Message Phone (_)
Business Name and Address: \ ~~ 'f L-e'f\SA f~b 1b N Au ~
--!)l(A-f'V\, ~ FL- 33@.9
No. Street ) Suite City
Email Address: --Khrn~ ti) bfUSOll-th I re +
2) Principal Retained by: :::r~ s...~~
40..1 Ocr;A~ Q{t\vE.
If different from above Street
(V\t~, ~~~ J FL-
City \ State
State
Zip Code
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 i"nDetail):
L~l jQel'''c-'t'~ ~ ~~c.e"1i .
~ tor\" ~'M, ~~O:?b:A~ .. .~~ ths~,c., t>r~l~cr
,..
~. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: O.L a-.- rt..f
~NN~e:,. ~AR.~ ~ ANNH~6- u,A~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
--
v-"fhe City Commission
Q City Commission Subcommittee
~tyStaff
V-City Board or Committee ~NtJ\N r.-
-
Q Personnel
Q Identify Others
on FE e,
on
on
on
on
on
~~
. 200~ -'-L.A-\E' iL
2001
: 200~ +L.4-~EQ.-
2001. -T L..\-'tE\2-
, 2001
,2001
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above:
~ ,-
~ N #-c.
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 t forego~are tru
with the provisions contai i Section 2 f the .
requirements.
Signature of Lobbyist:
Q Personally known
f. Produced ID
i- Did take an oath, or
Q Did not take an oath
d correct and that I have read or am familiar
ach City Code as amended, and all reporting
Identify
r.t."~
........-"'!" .
-i
-<.
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This .2f,-u day of ~ , 20~
A&.dc0J ;)~
/ Notary or Deputy Clerk
('i
I
M
;:c
~
(/)
G
-t1
"'"
~
(:)
N
:J:
:pt
:;0
N
CJ'
;0
rn
o
m
-
-0 <.
:x rn
~ c
U)
0'\
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: r;6 ACCEPTED [] REJECTED DATE:,~ .2-{,:? 2.J:II.I 2-
If rejected, state reason:
Registration fee paid: [0es [..1 ~ [] NoHor-Pn~{it Qrg~ni~ti.9(1~
[] sh ~J,Check MCR # dL 4 :J ~~ ~
DATA ENTRY DATE: ,:; ENTERED BY: ~