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CITY OF MIAMI BEACH
OFFICE OF TH E CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk(O)ci .miami-beach .fI. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNOPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, AmON OR DEOSION OF ANY COMMISSIONER; ANY
AmON, DEOSION, RECOMMENDATION OF ANY OTY BOARD OR COMMmEE; OR ANY AmON, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SEmON, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKING
PROCESS ON SUCH AmON, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFlCALL Y INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING AmVITIES 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." r-.
1) Lobbyist Name: I _u(< ) ..s
Last Name
Business Phone (t1J) y, '1 ) - ) >-7 y
S-Yl Uf7,J~V
First Name
~ 11 ~
, Middle Initial
.~
Message Phone C-)
Business Name and Address:
:J(.A..) ~I-L
Street
J 66:1
No.
~oyO
Suite
.
)/V7 119-rI},
City
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( S te
'JJ ) Jr
Zip Code
Email Address:
2) Principal Retained byJlrde n
/;;2./ S Il-H fJ--d 11- .
. If different from above
r~, J /-Jot /r J.,.~
City
bv(}~p
I
Street
~.
State
Suite
If! I/f
' 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 Det .
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: ..L.- /' .
J7V\f'f I- ~-fYl~)JJ)~/)
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
D The City Commission on .2001
D City Commission Subcommittee on , 2001
D City Staff on ,2001
Cl City Board or Committee on ,2001
Cl Personnel on , 2001
Cl Identify Others on ,2001
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 Y
I do solemnly swear that all of the ~ egoi g facts are true and correct and that I have read or am familiar
with the provisions cont~ined in S ion -482 of the . i Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
~YI~noD::2-0 -j 0' 1- <-I s::- dr3 - U
. ______--- Identify
tJ Did take an oath, or
Cl Did not take an oath
State of Florida, County of Miami-Dade
S~orn~ atf s~bscri~~e!?r~ m~
This ~ay of ~~v02.
O~lr--
or Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration: ~D
[ ] REJECTED
FOR CLERK'S USE ONLY
DATE: S---I- {).L-
If rejected, state reason:
Registration fee paid: [~No [] Not-for-Pr
( ] Cash Check MCR #
DATA ENTRY DATE:
ENTERED BY:
2002