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Nat'l Outdoor Media Network Inc . FROM :CITRIN FINANCIAL & INS., INC. FAX NO. :305 674 4843 Jun. 27 2002 02:12PM P2 ,N/M: 0= l.CSBYlST: City of Mlam I Beach Offk:e ri the City clerk 1700 ConvEl1t!<n ~r Drive, Miami aeach, A. 331~ ElTl!ln: ~lt'lClclrkCicLmlaml-bllllT>.flU5 LD_YDr ........11011.... (City of Miami BelICh, City c:ode O1aiXer 2, DMslcn 3, Sectkln ~1) #1 Chi" ...I.ft ..........., CITRIN (Last) (Frst) 757 41st street Miami Beach (N.Jmber .rd snet) (City) 305/674-4843 FAX ~ER: II,' , . ., ,"1. . . ~ ,. 1 , . ~....: 1. ,: , ' "........,;.. O1arles A. J~ 31, 2001 (M,I) !:lATe QJ~_JfIED AS LCSBYlST FL 33140-3413 (Sale) (ZIp Cocl3) chascitrin@aol.can EMA1L: BUSli'ESS !'ClOF.~: 305/674-0447 'TEI.EPt-OC N1.Mf3Bl.: I. LDBBYlSTRETAIND BY: NATIClItAL ClJI'IX:)(Ji MEDIA NJm<<:lRK INCCIU'ORATED NAVE OF PRIN:JP/'LJUIENT: 5375 East 2nd street, fl3 IDng Beach BUSIf\ESS POJRE$: (t\lJrrber .rd street) (City) 562/438-4004 562/438-7007 TELEPt-iO'E I\LMBER: FAX 1\lMl8l.: (Qltiorel) C'A (sta12) 90803 (ZIp Cede) EMAlL: (Q:Jtlonal) Fill out this ~ IfprtKlpolll a Cmporatbl, Pllrtnenhlp III" Dust [SI!l:tIDn 2-482 (c:)] ? NAVE OF a-l113' CJ'FlCER, PI'RThBl., OR IlfNTICII'RY: Jeff Jenkins ~ LIST JlLL P!:RSCl'S HClDII'G, DIREC1L Y CR II\DIREC1\. Y, A 5'16 CR M:RE ONi'B<SHIP INTEREST IN su:H e<:RI=CAATlCN, P/'fl.ThERs-tIP CR TRL5T: Jeff Jenkins and Doug Miller p.. !RCIF.lC lOBBY JSSlE: Enhancement of pay telephone sites including the l1I1Pl~tation of telephone a&rertisiTIq in cont;1ion with sites ~tted to ~~t ~ican TelrmmiC"J:lItinn~ ('rim nF r....lI~lA Flnrin.. 1~ to lottlled (Descr1be In detal , m. CITV AQ:NCIES/.N)lVJDl.W.S TO II'; LOIlBIB): ^) Ful Named JndIvkUaI/TIIe B) ReIIItlm 1Ih1p All City Camlissioners, Mayor and Staff, as None necessary FROM :CITRIN FI~NCIAL & INS., INC. FAX NO. :305 674 4843 Jun. 27 2002 02:13PM P3 IV. DUICl.O!Il.JlE Of TmMS IN) No<<JUIflS OF LClflIMST COll.nNM lION (DISCLOSE WtElMR HOUR! Y, R.JlTItA710It07HfR)I, Agree4 fees in the amount of $10 000 already received. '!be fee amount is to be ca= at $10,006 unless the project, as referred to A) L06l\YISTD1SCLCSLRE: in Section II, is ~~, "'r!t"Ap+'..n ;1M ..mth......;~.A'I If so, the additional amount of $5,000 is to be -paid, plus $20 mnthly per telephone unit lilStaJ.J.ed, Which will recruire lobbyist to further represent the interests of princip;J 6) pp.rN:1P,Ill.:S DISQ.09..RE: (0' LCBBYIST CCM:>eNsATlCN): . . . .' . SAME AS ABOVE V. SI~1\A:lN)EROAlH: ON Ge._I. S'" OF EACH ~ MCH ~IHALLIUlMJf'ID tHE CIl'YCLEIUC .__ED lITAlnEIIT......OA'IM, 1..-...- LOB..,.. _ SJDITURIlIDl1HECI1YOfM:wG IDQt FOR 11I1! ,tlU l"'" .1. CALI!IIDAR VEAL I do IlOlemnly &Wear thtt all of the (oNgOing facts are true and col1'eCt and that I have read or am fitmillllr with the provisions contained in SectIon 82 of the Miami ch City COde as amended and all reporting requirements. " Signature of Lobbytst: Signature of Principal/Client: VI. LOBBYIST mENlIFICAllON: I ~$L ~ Produced ID ,v(k Form of Identiftcatlon . ~OnallY Kna.vn . YD. S1~l\R: IN) STA'IP OF NOTMY ORIlQUTY QfRC: State of Florida, County of Mfami.Dade Swom to and subscribed before me f!:t.-1 CL-M ThIs e3 h, day of ...J (){..."f . 2002. - ~Sinna ~1"", cAllMENM.D~ .l1IIl"'*' MY COMMISSION # a:: 164'712 ,./ EXPlRES:AUlI9.- l'illf\l: fIe.-~" 1.soo-3-NOTNI\' fala.a'l" OIIILY RtgIWIt/lln: [J ACCEPTeD (] REJECTEp DATE: If rejldled, .. rellClt'l: Reglstt.uon fee plIld: [ 1 VB [ ] No [ ) Glsh [ 1 Check MCR# DATA ENTRY DATE: 21102 1 I First RevISIcn _ OS/17,(l2