Christy J. Brush
SEP-l0-03 04:19PM FROM-PATHMAN LEWIS.JIP
305-3T9Z420
T-536 P.03/04 F-36B
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pLy of Miami Beach omce of IheClt.y Clerll
1.700 ConveFlIJon center Drive, Mlamllllw:l" fL J31,9
1.maI1: c:Jt.ydel1cOd.mlilml-beadl.n.U5
LOBBYIST llEGlSIlIAnON FOJtM
(CIf.Y of 1"11111'11 Beach. Cl11 Code Chiptel' 2, Division 3, 5llCllOn 2-4111)
C Check... If lIlI Amendment. /1' ,..L- ~
~vU-S L. Gf'\.n. Sl':1 --J ,
NAMe Of I YIST: (LasI) / I (FIrst) r> ( Uo1J) DArr; QUAU~ AS LOIMI'(I5T;
i.fbt-f ~. {)l)Cl-(.. ttY-J~, 6>~ ~"J U F=L 4.3/l/b : :
DU51NfSS "DD~S: (Number ana st.reet) ) (C1i:y) (Sta\.e~ Zip Code) J-. : 1-
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J. LOII8YIST IlIn'AItft!D BY:
~3~~ A-s1~~(.L;ft,
W.M - OF PRINClPAlJCJfNT: '...J . '
163J-. 1~",,~/v/.~ k~ 1- 8. u.tiAJt\A' ~cJ..1 ~L-' '33/~
BU$JNF.SS~; (NuJllberllfld~) (Qly) (Slate) (Zip Coaa) .
;3<>5' 5'3 00 ; .
LE ONe NuM : EMAlI.: (0ptI0njl1)
flU "lItltllstedlora lrpdr)dplll". a..po,1Itlol1,......... or111A1tl..tJon Zo4I2 (c))
. NAME Of OI1fF OFf'JCER, pJll{'rN~, DR IIENI!l'ICIAAYI (' tI i Cl:.) L;. ~ i"
. UST AU- PeRSONS HOLDING, DW!CTl.Y OR JNDt~Y." 5% OR MORl! OWNE~/P 1rm!I\ESTlN SUCH
COIU'DRAmN. pAATNERSI1IP OR 'f1WST:
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D. SPIlCIfJC UJIIIIY I5IUI!:
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tssue to be lof)Illed (0a5c:r11z In detail): :
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Dr. rzrr AGJRCDS/INDIYIJIUAUlTO....~
A) "'U ..... al'WlIMI.../TItI- II) IIdIItIan8hIp 1 :
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SEP-10-03 04:19PM FROM-PATHMAN LEWIS.JIP
a05-3mm
T-536 P.04/04 F-368
~v. ",,:oI.oU_ur '_""U__'lItUrWDD'~1 """'.--.....,9\"...............,.,.,""" nulJl<~l,
R.ATRATI'alloTHEIl); I
A) IDlIfMST DISCLOSUR~: _~ (! Jt ,,, flJ..~.
B) PRlNaPAI.'S DISCLOSlJR! (OF LDaIlYI5TCOMPENSATION):
"
I,)
PuI'!llJ!lnt tn OrdinanCl! No. 2lI03-33t3 Amendlna ,,!laml BelJcl:UJtv Code CheDter 2. Arlide VJ1. Division 5
'rhereof EnHtlfl!fl "CamDililln FlnanCl! RefDlln" Via The Addition Of Code Section 2-48fl Entll1f!d "ProhlbJlJ!d .
Ptmaalon contrJbutlons Bv I.llbbvl!:t!: On ProCurement Issues":
~:':s=I:=:'T:~:~~:rDrse",l- DrOll. Dr-~. .
,
2) PursUAnt tn OrdlnanCf No. 28D'.L~1: Amendlna Miami Beam Cltv OYJe ChaotJ!r 2 Arttdlit VTJ DfvtJ;lon 5
~reof Endtled ''C'.amDlllan F1'l.lnce .!leform". VIa The Addition or CI:ldP. SectIon 2-4!lO Entllled "Prohlb Ired
Camo8lcJn CI:lnI'r1blJtlons Bv Lobbvlst5 On R~I E5tlltJ! Oevelooment J~es.: .
,.... VGU lallbvlna an _ d8dd1na 8DD.1aIIIan far . DMfIIfonnwnt ~t .... HI. atv 9'!' .
.~::.~_ D'I mnlnD maD dlHllmllllfDn or dIInJe fa the Cilv'a 'ilium Land Usa Maa?
I
V. IJGIUTURllINDER OATIfI
!
ON OCI'DHR 1111 OF EACH YEAR. EACH J,OII8YJ5J' ~ IUIMJT 'ro Tft!! em CUlRIC A SIGNED
srAT!M!NT UNDER GAnt, LJSI1NG .LOIJIYJrfG I!XPmfPflVRI!S PI THI! ClrY Of' MIAMI lII!ACH FOll
TIE PRECEDING ~DAR YEAR.
I do solemnlv swear thilt 1111 of the foregplng fa$ are trlJC! and torrect ami that I hBVll rOd or am ;
famIliar "11th the provlsiofl5 tontalned In Section 2-182 of the Miilmll3ear::h Cl1:v Code as amended, ilnll 1.111:
reporting requirements. 63n1 S As' .
treet SOClateS Ltd.
Signature of Lobbyist: hy its gene cd l
. }leu lIel
.. .
Signature of Principal/Client:
VI. LOIJ8YJSTmENTJI'J'a
o Produced 10 _
Form of Id!ntification
YIL srGNA1UJIII AND -rAMP OPIUWARYOR Pl!PUJYa.ERIf;
~te of Florida, County of Miaml-Dade
Sworn to and subsai~ tlefqre me
This ~ '& tJay of ~(' . 2003.
iiJ.Y~ MARIA E BILBAO
~. ~ MYCOMMISSION#CC888282
"''to, f<"~ EXPIRES: Nov IS. 2003
1-8C)()-3.-NOTARV Fla. Notary SeMce & Bonding Co.
&~
Signature of Public Notary - State of RorIda
. AAJt'Q.., e. /3(1~
Prin1:, stamp or type name of Notary Public
...
[]ClIsIl [ . ~'
2003 ENTEIlEP IJY:~ '
F: i1L\LDbbyfsts\reg!stralitll'laOO.doc;
~egt&trIlllDm ~
If rajsc:t8lI, Gt.ille reason:
fIe9lllll'iIIlDtl fee pllkl:
OAT" ~NTflY Dlin;:
2"" RevllIlpn 3/18/03
I'OR Q.IJIK'II" DNJ,y i t
[ ] REJECTEP DATf.::3 2- ~ 0 "3