HomeMy WebLinkAboutRubin, Jonathan/Metal Coast
~
m
oty of Miami Beach Office of the Oty aerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: dtyderk@ci.miami-beach.f1.us
LOBBYIST REGISTRATION FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
. Check Box if an Amendment
_Kv..bt'l.... ~~'V\.."-~"'-....... ~,
NAME OF LOBBYIST: (Last) (First) (M.I)
5 ~ lR ~ t't + ~or<.. W ~i ~h.. \ Q...a I:&.lt.$.
BUSINESS ADDRESS: (Number and Street) (City) (State)
S:.D~ - 4-{,p ~ - C{ S 00 <305 - 4-~~- "':=1-'300
TELEPHONE NUMBER: FAX NUMBER:
DATE QUAUFIED AS LOBBYIST
f:L- 3'3 ''.S 'f
(Zip Code)
..! Y\.A..(..::r'~ C\..\.f2.VU-\'"\a. b.-... ~'"
EMAIL:
I. LOBBYIST RETAINED BY:
K. I(.. ~<.: \ Cto~rt .
NAME OF PRINOPAl/CUENT: '
LL. C-
00
BUSINESS ADDRESS:
N~
~'(~
(Number and Street)
K, ''''^i t=-L"3 '3 ( Co \p
(Zip Code)
~ev-c.c~t!) 1'1A.!\I'I. c...., ""t
EMAIL: (Optional)
<3D S...... '-t3 b - \:+~o
TELEPHONE NUMBER:
~ Lf?- 1.
(Oty) (State)
'S.cS- '4'3~ '1"e'3 S
FAX NUMBER: (Optional)
Fill out this section If principal Is a Corporation, Partnership or Trust [SectIon 2-482 (e)l
NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
Fe. Ir"'.... --ck> D ~ C-os~
UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: S 't
15\'-\.,,- C=~.s~ -::r::~v",..-*<"""''''' {, LLC: 0 Q
t\<a..-~\.... \?:o...o" \e.. n.., L,t:.....,c:., 'S'O'1o
"'" ,
II. SPECIFIC LOBBY ISSUE:
Aef.\~~o.-. ..Coy-
Issue to be lobbied (Describe in detail):
tc+ sftt+
m. CITY AGENClES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Relationship
f \ a. '" '" ( "'-""- ~oo.yd.
-.J
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WH~HER HOURL Y,
FLAT RATE OR OTHER):
A) lOBBYIST DISCLOSURE:
~ \ ---=+ S ,.00 ~y- "'-ou...r-
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
~ \. '\ S". 00 Fr ~..'-'. yo-
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES IN THE 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 the Miami Beach City Code as amended, and all
reporting requirements.
VI.
LOBBYIST IDENTIFICATION: '
P1>L R. \60 ~?.o tol -041.,~a "'3l,)fVt'th4rJ \<0blt0
Produced ID f t) L- 1> '2 'L3 ~ 0 60.... \1...6 -0 Y<..f t\k\AJo v~ (DS~ ..
Form of Identification
..
Signature of Lobbyist:
Signature of Principal/Client:
.
Personally Known
VII.
SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to ~d subscribed before me
This I 3 day of F I; 01'1-' 2002.
OFFICIAL NOTARY SEAL
ULLIAN BEAUCHAMP
NOTARY PUBUC STATE OF FLORIDA
COMMISSION NO. D0109289
MY COMMISSION EXP. APR. 29
Sign ure of Public tary - State of Florida
L/ / fiCiN '3e QUCj1Ci~'-
Print, stamp or type name of Nota Public
I
Registration:
[ ~PTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE:
12(/3/02-
If rejected, state reason: _
Registration fee paid: [-f"ves [ ] No . ......... r n~o
[ ] Cash [--raleck MeR # c::::=o'-..)..J
DATA ENTRV DATE: JZ) nf J;:J--:2,002 ENTERED BV. ...)
I L
I First Revision - 05/17/02