Carrfour, Inc.
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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.fl.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 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 SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY 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 ACTIVillES 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: -J)()<!)~~,t( Luc \ 0-... Ii
Last Name First Name Middle Initial
Business Phone ~(:'~) '5i'1-c:>60'3 Message Phone (_)
Business Name and Address: \12 \ Bf ,(.~ A,~ (Vl Ii>, m I fL.. ~ '3 \ 31
G~lbJrj \(C\ur\~
No. Street Suite City State Zip Code
Email Address:1).v~...QAiL ~) <t+k,. w . UJ rf'.
2) Principal Retained by: (:'" r /'+0 v r ItV L
/5<; 5o.)-~ miCA (vi \ Pq)~ * J /50
If different from above Street Suite
rill ~ fI1) (' L ~) n I
City State Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
3)
Subject Mj\ltter (Describe in Detail): . h>~J
K Nit'" S \~ \J\.\i\ I C\ I'J u., of ~I :r+ I tV .5 .
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied:l1.. , t. I 0\, . I'}' <"\ 0 ,1if {1 _ \ I
~(\ <( 1\\"J\J$".",,,\ '\ 1r.f'Jf",) .J ,~. '--'-\~ '-:D~'N'o-\c:,"lO\A.-.
I '
5. The subject matter in number three (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
~ City Board or Committee ~.~ l AcAJ v5--\VN.'I.lT,
o Personnel '
o Identify Others
on
on
on
on J Ji-Z
on
on
.2001
,2001
,2001
,200!-
,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 ory.~
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITURES IN TltE 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 2-482 of t iami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist:
rJJf Personally known
6' Produced ID
Identify
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Swom 'pM SObsmtrlf ~e
This day of 20~
Registration:
FOR CLERK'S USE ONLY
[ ~PTED [] REJECTED DATE: 5 - I 1/ - iJ ,;)-
If rejected, state reason: _____
Registration fee paid: ['tYes [ ] No -----./: ] Not-for-Prqfit r
[ ] Cash ['-1l:heck MCR # c::;,{
. " Od-
DATA ENTRY DATE: 0'> 7) ~ ENTERED BY: