HomeMy WebLinkAboutH. J. Ross
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@ci.miami-beach.f1.us
AFFIDAVIT
LOBBYIST MEANS All PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DEOSION OF ANY COMMISSIONER; ANY
ACTION, DEOSION, RECOMMENDATION OF ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG
PROCESS ON SUCH ACTION, 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,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAW~ AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL." ,/-
1) Lobbyist Name: L (J/( I r J y L [I f J II f/ ~ Jf.
.
Last Name Rrst Name
Business Phone (3~$J <('1/. /). 7 r Message Phone L)
Business Name and Address: U4 k/ f l3c./;- t Y ~ L t.. C-
'"J b t.. "3 S fJJ g"~ -2 ~ It t.? [Nt! ~ I
No. Street Suite City
Email Address: J /.., tJj<lf 7 ?tj;- @ IJ.e,L , C-tJrYi
2) Principal Retained by: IJ r !? () J S'
J 770 5'lJ yH. J I-;f(ll
If different from above
Middle Initial
FL
State
]3 / 3:J
Zip Code
!/vi ' r.; M /
Street
77/]1
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief Qfficer, partner,
beneficiary or interests.
3)
Subject Matter (Describe in D~b:
~S/AJG~EI 'G
{! d fliT}? It r,;r )
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: /'I
5+~ f-f ("'---' rvY"o""""" 1.J J ) ~ ~
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual) :
I
16 The City Commission
Cl City Commission Subcommittee
Cl City Staff
Cl City Board or Committee
Cl Personnel
Cl Identify Others
.2001
I 2001
12001
12001
12001
12001
on
on
on
on
on
on
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above:
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 for
with the provisions cont?lined in Se '0
requirements.
Signature of Lobbyist:
o ~onally know') L. ~/) _:.'\
ZUced ID L,7,;;2- tJ - 2~ } - <fh;?D - 0
Identify
Did take an oath, or .
Cl Did not take an oath
d correct and that I have read or am familiar
each City Code as amended, and all reporting
State of Florida, County of Miami-Dade
SworW~d subscri~11W.~ me
This ~day of ~ 2002.
~~
'Notary. or Deputy Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: ~PTED [] REJECTED DATE: S - 7- 0 C>
If rejected, state reason: ~.
Registration fee paid: L'1'Yes [ ] No [] NoHor-Pr
[ ] Ca~a-] Check MCR #
DATA ENTRY DATE:S..... '1-()~ 2002 ENTERED BY: